Combined cleft lip revision, anterior fistula closure and maxillary osteotomy; A one-stage procedure

Abstract Background When evaluating speech in children with cleft palate with or without cleft lip (CP/L), children with known syndromes and/or additional malformations (CP/L+) are usually excluded. The aim of this study was to present speech outcome of a consecutive series of 5-year-olds born with CP/L, and to compare speech results of children with CP/L + and children with CP/L without known syndromes and/or additional malformations (CP/L-). Methods One hundred 5-year-olds (20 with CP/L+; 80 with CP/L-) participated. All children were treated with primary palatal surgery in one stage with the same procedure for muscle reconstruction. Three independent judges performed phonetic transcriptions and rated perceived velopharyngeal competence from audio recordings. Based on phonetic transcriptions, percent consonants correct (PCC) and percent non-oral errors were investigated. Group comparisons were performed. Results In the total group, mean PCC was 88.2 and mean percent non-oral errors 1.5. The group with bilateral cleft lip and palate (BCLP) had poorer results on both measures compared to groups with other cleft types. The average results of PCC and percent non-oral errors in the CP/L + group indicated somewhat poorer speech, but no significant differences were observed. In the CP/L + group, 25 % were judged as having incompetent velopharyngeal competence, compared to 15 % in the CP/L- group. Conclusions The results indicated relatively good speech compared to speech of children with CP/L in previous studies. Speech was poorer in many children with more extensive clefts. No significant differences in speech outcomes were observed between CP/L + and CP/L- groups.

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Repair of Asymmetric Bilateral Cleft lip: 1 Stage or 2 Stage

The Cleft Palate-Craniofacial Journal ◽

10.1177/10556656211013978 ◽

2021 ◽

pp. 105566562110139

Author(s):

Xinran Zhao ◽

Yilai Wu ◽

Guomin Wang ◽

Yusheng Yang ◽

Ming Cai

Keyword(s):

Cleft Lip ◽

Outcome Measure ◽

Scar Tissue ◽

Anatomical Reduction ◽

Scoring Method ◽

Two Stage ◽

One Stage ◽

Significant Difference ◽

Bilateral Cleft Lip ◽

Surgery Outcomes

Objective: To verify the advantages and indications of 1-stage and 2-stage repair for asymmetric bilateral cleft lip (BCL). Design: Retrospective study. Setting: From January 2004 to December 2016 in our department. Patients: Patients with BCL. Main Outcome Measure(s): Over 6 months after the operation, the surgery outcomes were evaluated and graded by 2 experienced surgeons. Results: The result of surgery was evaluated using the scoring method of Mortier et al and Anastassov and Chipkov. Among 133 patients with asymmetric BCL, 61 (45.9%) had 1-stage repair and 72 (54.1%) had 2-stage repair. Sixty-eight (51.1%) patients had complete-incomplete cleft lip (CL), and those who underwent 1-stage repair showed a trend of better outcome ( P = .028). Fifty (37.6%) patients with incomplete-microform CL showed no significant difference between the outcomes of 2 surgery plans ( P = .253). In 15 (11.3%) patients with complete-microform CL, only one had 1-stage repair with a score of 8.5. The other 14 patients with 2-stage repair were scored 3.68 ± 1.28. Two-stage repair was preferable when the deformity degree was very different on 2 sides, as it could reduce unnecessary scar tissue and extend the nasal columella. One-stage repair could help to achieve the anatomical reduction of the orbicularis oris and a better contour of the vermilion tubercle. Conclusion: One-stage repair is recommended for patients with complete-incomplete CL and incomplete-microform CL. Two-stage repair for patients with complete-microform CL is preferred in our center, but more studies are required to support this conclusion.

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Relationship between Orthodontic Treatment Plan and Goslon Yardstick Assessment in Japanese Patients with Unilateral Cleft Lip and Palate: One-stage vs. Two-stage Palatoplasty

The Bulletin of Tokyo Dental College ◽

10.2209/tdcpublication.2016-0700 ◽

2016 ◽

Vol 57 (3) ◽

pp. 159-168

Author(s):

Takenobu Ishii ◽

Teruo Sakamoto ◽

Munetada Ishikawa ◽

Toshihiko Yasumura ◽

Haruyo Miyazaki ◽

...

Keyword(s):

Orthodontic Treatment ◽

Cleft Lip ◽

Cleft Lip And Palate ◽

Treatment Plan ◽

Japanese Patients ◽

Two Stage ◽

One Stage

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Long term longitudinal follow up of individuals with unilateral cleft lip and palate, cleft lip surgery: one stage palatoplasty outcome: language and maxilar growth

International Journal of Oral and Maxillofacial Surgery ◽

10.1016/j.ijom.2019.03.050 ◽

2019 ◽

Vol 48 ◽

pp. 18

Author(s):

M.L. Lopez Salgado ◽

J.C. Aliphat ◽

N.S. Alvarez

Keyword(s):

Cleft Lip ◽

Cleft Lip And Palate ◽

One Stage

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Effect of One-Stage versus Two-Stage Palatoplasty on Hypernasality and Fistula Formation in Children with Complete Unilateral Cleft Lip and Palate

Plastic & Reconstructive Surgery ◽

10.1097/prs.0000000000005346 ◽

2019 ◽

Vol 143 (3) ◽

pp. 668e-669e

Author(s):

Juanita Parnis ◽

Jonathan Syme-Grant

Keyword(s):

Cleft Lip ◽

Cleft Lip And Palate ◽

Fistula Formation ◽

Stage Versus ◽

Two Stage ◽

One Stage

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A preliminary report on one stage open tip rhinoplasty at the time of lip repair in bilateral cleft lip and palate: the Alor Setar experience

British Journal of Plastic Surgery ◽

10.1016/0007-1226(93)90171-7 ◽

1993 ◽

Vol 46 (3) ◽

pp. 215-222 ◽

Cited By ~ 69

Author(s):

J.A. Trott ◽

N. Mohan

Keyword(s):

Preliminary Report ◽

Cleft Lip ◽

Cleft Lip And Palate ◽

One Stage ◽

Bilateral Cleft Lip ◽

Tip Rhinoplasty

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Midfacial Growth in a Consecutive Series of Preadolescent Children with Complete Unilateral Cleft Lip and Palate following a One-Stage Simultaneous Repair

The Cleft Palate-Craniofacial Journal ◽

10.1597/07-174.1 ◽

2008 ◽

Vol 45 (6) ◽

pp. 667-673 ◽

Cited By ~ 16

Author(s):

Piotr Fudalej ◽

Barbara Obloj ◽

Dorota Miller-Drabikowska ◽

Anna Samarcew-Krawczak ◽

Zofia Dudkiewicz

Keyword(s):

Cleft Lip ◽

Cleft Lip And Palate ◽

Dental Arch ◽

Consecutive Series ◽

Age And Gender ◽

Prepubertal Children ◽

One Stage ◽

Lateral Cephalograms ◽

And Gender ◽

Posterior Position

Objective: To evaluate midfacial growth in prepubertal children with complete unilateral cleft lip and palate following one-stage simultaneous repair. Subjects: A series of 28 consecutively treated subjects with complete unilateral cleft lip and palate were compared with age- and gender-matched controls with normal midfacial structure. Methods: On the lateral cephalograms taken at the age of approximately 10 years, size and position of the maxilla and upper dental arch were evaluated in vertical and horizontal planes. Statistical analysis included independent t tests and nonparametric Mann-Whitney tests. Results: The maxilla was found to be retruded (sella-nasion-point A angle decreased by 4.5° and nasion to point A distance increased by 4.2 mm) and rotated posteriorly (sella-nasion/palatal plane angle decreased by 4.5°) in the cleft group. Maxillary length (pterygomaxillare-point A distance) was diminished by approximately 2 mm. Upper incisors were found retroclined in comparison to controls (both upper incisor axis/sella-nasion and upper incisor axis/palatal plane angles were decreased by 10.7° and 6.1°, respectively). Conclusion: Maxillary prominence, as measured with the sella-nasion-point A angle and the condylion-point A and articulare-point A distances, was decreased. Shortened length and posterior position of the maxillary body were responsible at a ratio of 60% to 40% for a decreased prominence of the maxillary complex. The palatal plane demonstrated a larger inclination to the sella-nasion plane by 4.5° due to a decreased sella-posterior nasal spine distance.

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