A Prospective comparative Study of Vermilion repair by Modified Vadvancement Vermilion Flap in Unilateral Cleft Lip Patients

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Amr A Mabrouk ◽  
Iman M Alliethy ◽  
Niveen F Al Mahmoudy ◽  
Yara S El-sayed
Keyword(s):  
Cleft Palate ◽  
Cleft Lip ◽  
Advantages And Disadvantages ◽  
Congenital Deformities ◽  
Facial Clefts ◽  
Significant Difference ◽  
Cleft Lip Repair ◽  
The Difference ◽  
Congenital Birth Defect ◽  
Surgery Department

Abstract Background Oro-facial clefts include a range of congenital deformities most commonly presenting as cleft lip with or without cleft palate (CLP) or isolated cleft palate (CP). CLP is the second most common congenital birth defect in the U.S. Aim of the Work to assess modified v-advancement vermilion flap combined with Tennison technique for vermilion repair in unilateral cleft lip regarding aesthetic outcome in comparison with repair of cleft lip by Tennison technique. Patients and methods This study was conducted in plastic, maxillofacial and reconstructive surgery department in Ain Shams University between September 2019 to February 2020. It included 20 patients divided into two group; the first group consisted of 10 patients who underwent repair of cleft lip by Tennison technique and the second group consisted of 10 patients who underwent repair by Tennison technique combined with v- advancement vermilion flap. Both groups were assessed postoperatively by Asher-McDade et. al. scoring system. Result The study showed statistically significant difference between the two groups as regard the white lip length which was more symmetrical in cases repaired by Tennison technique combined with modified v-advancement vermillion flap (P = 0.01). The bulge and the deficiency in the lateral vermilion were decreased in the group treated by Tennison technique with modified v-advancement vermilion flap. However the difference was statistically insignificant (P = 0.66). Conclusion The choice of a technique for surgical correction of UCL should be based on an evidence that this technique has the best functional and aesthetic outcomes. The findings of this study support the view that these two methods of cleft lip repair have their own advantages and disadvantages. Tennison technique combined with vadvancement vermilion flap achieved less bulge in the vermilion with no statistically significant difference.

Intrauterine Repair of Surgically Created Defects in Mice (Lip Incision Model) with a Microclip: Preamble to Endoscopic Intrauterine Surgery

1995 ◽  
Vol 32 (2) ◽  
pp. 129-137 ◽  
Author(s):  
Kerby C. Oberg ◽  
Michele L. Evans ◽  
Thanh Nguyen ◽  
Norman H. Peckham ◽  
Wolff M. Kirsch ◽  
...  
Keyword(s):  
Inflammatory Response ◽  
Cleft Lip ◽  
Mononuclear Cells ◽  
Fetal Surgery ◽  
Application Time ◽  
Significant Difference ◽  
Intrauterine Surgery ◽  
Cleft Lip Repair ◽  
The Difference ◽  
Tissue Approximation

We compared the difference between a nonpenetrating silver microclip and suture on wound healing, inflammatory response, and application time in the repair of surgically created standardized unilateral cleft lip type defects in fetal mice. Excellent lip continuity and dermal reconstitution were achieved by both methods of repair. Furthermore, collagen accumulation did not occur. Occasional mononuclear cells were seen around sutured repairs in contrast to microclipped repairs. The most significant difference, however, was in application time with the microclip requiring an average of 7 seconds (±2) compared to 90 seconds (±15) for suture. We conclude that the microclip offers distinct advantages for Intrauterine cleft lip repair: (1) nonpenetrating tissue approximation; (2) less inflammatory response than suture; (3) technically more rapid and less difficult to apply than suture; and (4) can be utilized more readily than suture for endoscopic approaches limiting the risks of fetal surgery for both the mother and the fetus.

Speech Methodologies in Cleft Palate Assessment: A Pilot Project to Compare Two Phonetically Different Sentence Sets

2013 ◽  
Vol 20 (1) ◽  
pp. 49-72
Author(s):  
Jennie Smith ◽  
Tim Pring ◽  
Debbie Sell
Keyword(s):  
Cleft Palate ◽  
Pilot Project ◽  
Wilcoxon Test ◽  
Consecutive Series ◽  
Video Recordings ◽  
Significant Difference ◽  
The Difference ◽  
Audio Video ◽  
Age Range ◽  
The Impact

Objective: To investigate the impact of the phonetic content of two sentence sets on speech outcomes, specifically the effects of nasal phonemes. Method: Audio-video recordings of a consecutive series of 15 participants (age range 4–22 years), with cleft palate (syndromic or non-syndromic), with and without velopharyngeal dysfunction were taken. Participants repeated Sentence Set 1 (with nasals across sentences) and Sentence Set 2 (without nasals except the three nasal target sentences) during a routine speech recording. Two experienced Specialist Speech and Language Therapists, blinded to the study’s purpose, analyzed participants’ speech using the Cleft Audit Protocol for Speech-Augmented (CAPS-A). On day 1, recordings included Sentence Set 1. On day 2, 23 days later, recordings included Sentence Set 2. Main results: The difference between Sentence Set 1 and Sentence Set 2 ‘total scores’ (sum of scores on all CAPS-A parameters) was significant. The Pearson Product Moment showed high correlation. A Wilcoxon test revealed a significant difference between Sets 1 and 2 on the hypernasality parameter, and this alone accounted for the significant difference in total scores. Conclusion: The inclusion or exclusion of nasal consonants in the sentence set significantly affected perceptual ratings of hypernasality but none of the other CAPS-A parameters, highlighting the need for further investigation into perceptual nasality ratings.

Hospitalization, Breast-Milk Feeding, and Growth in Infants with Cleft Palate and Cleft Lip and Palate Born in Denmark

2008 ◽  
Vol 45 (6) ◽  
pp. 628-632 ◽  
Author(s):  
Lisa H. V. Smedegaard ◽  
Dorthe R. N. Marxen ◽  
Jette H. V. Moes ◽  
Eva N. Glassou ◽  
Cand Scientsan
Keyword(s):  
Breast Milk ◽  
Cleft Palate ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
First Year ◽  
Health Visitors ◽  
Facial Clefts ◽  
Growth References ◽  
First Year Of Life ◽  
Milk Feeding

Objective: To evaluate if the duration of postpartum hospitalization, duration of breast-milk feeding, and growth during the first year of life in infants with cleft lip and palate (CLP) and cleft palate (CP) are comparable to infants without facial clefts. Design: Prospective data collection using a registration chart developed by the authors. Setting: Special health care of infants with CLP/CP born in Denmark. Participants: All mature infants with CLP/CP born in 2003 and 2004 were included. Of 165 infants, 115 participated in the study. Intervention: In Denmark, parents of children with CLP/CP receive counseling. This counseling is managed by specially trained health visitors/nurses and is initiated at birth. The counseling seeks to support parents’ confidence in having an infant with CLP/CP and to initiate a relationship between the infant and the parents. Main Outcome Measures: Duration of postpartum hospitalization, duration of breast-milk feeding, and weight and length at birth, 5 months of age, and 12 months of age. Results: Hospitalization was 4 days and comparable to that of infants without CLP/CP. The infants with CLP/CP received breast milk but for a shorter period compared with infants without CLP/CP. Weights at birth, 5 months of age, and 12 months of age were identical with Danish growth references. Conclusion: The authors find the results satisfactory and believe that the counseling provided by the health visitors/nurses plays a part in the results.

Improved Early Cleft Lip and Palate Complications at a Surgery Specialty Center in the Developing World

2018 ◽  
Vol 55 (8) ◽  
pp. 1145-1152 ◽  
Author(s):  
Eugene Park ◽  
Gaurav Deshpande ◽  
Bjorn Schonmeyr ◽  
Carolina Restrepo ◽  
Alex Campbell
Keyword(s):  
Cleft Palate ◽  
Cleft Lip ◽  
Developing World ◽  
Cleft Lip And Palate ◽  
Care Delivery ◽  
Complication Rates ◽  
Surgical Mission ◽  
Cleft Palate Repair ◽  
Cleft Lip Repair ◽  
Palate Repair

Objective: To evaluate complication rates following cleft lip and cleft palate repairs during the transition from mission-based care to center-based care in a developing region. Patients and Design: We performed a retrospective review of 3419 patients who underwent cleft lip repair and 1728 patients who underwent cleft palate repair in Guwahati, India between December 2010 and February 2014. Of those who underwent cleft lip repair, 654 were treated during a surgical mission and 2765 were treated at a permanent center. Of those who underwent cleft palate repair, 236 were treated during a surgical mission and 1491 were treated at a permanent center. Setting: Two large surgical missions to Guwahati, India, and the Guwahati Comprehensive Cleft Care Center (GCCCC) in Assam, India. Main Outcome Measure: Overall complication rates following cleft lip and cleft palate repair. Results: Overall complication rates following cleft lip repair were 13.2% for the first mission, 6.7% for the second mission, and 4.0% at GCCCC. Overall complication rates following cleft palate repair were 28.0% for the first mission, 30.0% for the second mission, and 15.8% at GCCCC. Complication rates following cleft palate repair by the subset of surgeons permanently based at GCCCC (7.2%) were lower than visiting surgeons ( P < .05). Conclusions: Our findings support the notion that transitioning from a mission-based model to a permanent facility-based model of cleft care delivery in the developing world can lead to decreased complication rates.

Objective, Noninvasive Evaluation of Velopharyngeal Function in Cleft and Noncleft Patients

1998 ◽  
Vol 35 (1) ◽  
pp. 35-39 ◽  
Author(s):  
Martin Kunkel ◽  
Ulrich Wahlmann ◽  
Wilfried Wagner
Keyword(s):  
Cleft Palate ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Noninvasive Evaluation ◽  
Control Group ◽  
Pharyngeal Muscles ◽  
Pharyngeal Flap ◽  
The Difference ◽  
Acoustic Pharyngometry ◽  
Velopharyngeal Function

Objective The purpose of this study was to investigate a new diagnostic method that provides an approach to noninvasive, objective measurement of velopharyngeal movement by acoustic determination of epipharyngeal volume changes with velopharyngeal muscle function. Design This was a case control study, using consecutive samples. Setting This study took place at the Cleft Palate Rehabilitation Center of the University of Mainz, Germany. Patients Subjects were 29 consecutive cleft lip and palate (CLP) patients and 31 controls (21 patients with dysgnathia and 10 healthy volunteers). Intervention A series of transnasal acoustic measurements (pressure wave: 55 dB for 2 milliseconds) of epipharyngeal volume were performed with the pharyngeal muscles relaxed in end-expiration and while the velopharyngeal orifice was closed, with the difference in volume representing maximal pharyngeal movement. Results Cleft palate patients yielded significantly lower values of velopharyngeal movement (6.5 cm3) than did the control group (8.0 cm3)(p < .05; Mann-Whitney U test). Overlapping ranges of values were measured for the C(L)P and control groups. The least mobility (4.75 cm3) was measured in patients who had undergone pharyngeal flap surgery. Different patterns of restriction were observed in patients with and without a pharyngeal flap. Conclusion Acoustic pharyngometry may provide access to noninvasive quantitative measurement of velopharyngeal movement and a better understanding of the pattern of movement in C(L)P-patients. We expect it to be a helpful tool in objectively monitoring the progress of logopedic therapy.

scholarly journals Does Hamulotomy during Palatoplasty Have Any Effect on Hearing Ability in Nonsyndromic Cleft Palate Patients? A Prospective, Single Blind, Comparative Study

Scientifica ◽  
2016 ◽  
Vol 2016 ◽  
pp. 1-6
Author(s):  
Anuj Jain ◽  
Pranali Nimonkar ◽  
Nitin Bhola ◽  
Rajiv Borle ◽  
Anendd Jadhav ◽  
...  
Keyword(s):  
Cleft Palate ◽  
Middle Ear ◽  
Function Evaluation ◽  
Tension Free ◽  
Hearing Ability ◽  
Significant Difference ◽  
Tube Dysfunction ◽  
The Difference ◽  
Free Closure ◽  
Age Range

The primary goal of palatoplasty is to achieve a tension-free palatal closure ensuring no postoperative complications. Many surgeons fracture the pterygoid hamulus to minimize tension during palatoplasty. However, this maneuver gained criticism by some authors on the grounds that it may lead to Eustachian Tube dysfunction. Our study intended to figure out the relationship of hamulus fracture with the postoperative state of middle ear in cleft palate children. Fifty consecutive cleft palate patients with an age range of 10 months to 5 years were recruited. All the patients were assigned to either hamulotomy or nonhamulotomy group preoperatively. The patients were subjected to otoscopic examination and auditory function evaluation by brainstem evoked response audiometry (BERA) preoperatively and 1 month and 6 months postoperatively. Otoscopy revealed that the difference in the improvement of middle ear status in both groups was statistically insignificant. Moreover, there was no significant difference in the BERA outcomes of the fracture and nonfracture populations. Complication rate in both groups was also statistically not significant. It can be concluded that hamulotomy does not have any effect on the hearing ability in cleft palate population, so hamulotomy can be performed for tension-free closure during palatoplasty.

scholarly journals Prevalence of cleft lip: A retrospective hospital based study

2020 ◽  
Vol 11 (SPL3) ◽  
pp. 1911-1917
Author(s):  
Pranati T ◽  
Dhanraj Ganapathy ◽  
Adimulapu Hima Sandeep
Keyword(s):  
Cleft Palate ◽  
Cleft Lip ◽  
Single Centre ◽  
Multi Centre Study ◽  
Congenital Birth Defects ◽  
Repair Procedure ◽  
Cleft Lip Repair ◽  
And Gender ◽  
Gender Variations ◽  
Rotation Advancement

Amongst the most frequent congenital birth defects are facial malformations, including cleft lips associated with or without cleft palate (CL/P) and cleft palate (CP). Although the incidence of such malformations worldwide is around 1.5 per 1,000 live births, the rate for CL/P ranges six-fold and for CP three-fold. The study aims to determine the prevalence and gender variations of isolated cleft lip among patients who have visited Saveetha Dental College and have undergone primary cleft lip repair procedure. A retrospective study was conducted and data collection was done from dental archives pertaining from June 2019 to April 2020. Data consisted of patients with isolated cleft lip who underwent primary cleft lip repair procedure. Data was imported to IBM SPSS Version 20 for statistical analysis. Results were tabulated. From this study, it has been observed that prevalence of isolated cleft lip is more among males (55.6%) compared to females (44.4%) and belonging to the age group 0 to 6 years. Millard's technique (rotation advancement technique) is the most commonly employed technique for primary cleft lip repair. Male predilection observed (statistically not significant). This study was conducted in a single centre – Saveetha Dental College. Extensive multi centre study with increased sample size is to be done.

scholarly journals The difference uses of panoramic photo and cbct evaluation of the gnathoplasty surgery outcome

2017 ◽  
Vol 2 (2) ◽  
pp. 110
Author(s):  
Ayu Wahyuni ◽  
Muliaty Yunus ◽  
Muhammad Ruslin
Keyword(s):  
Cleft Lip ◽  
Treatment Plan ◽  
Panoramic Radiograph ◽  
Cross Sectional Study ◽  
Three Dimension ◽  
Cross Sectional ◽  
Surgery Outcome ◽  
Significant Difference ◽  
Before And After ◽  
The Difference

Objective: Gnathoschisis is the most common congenital craniofacial abnormality in patients with cleft lip and/or palate (CL and/or P). The panoramic radiograph is one means to establish a diagnosis and treatment plan with two-dimension photograph. The cone-beam computed tomography (CBCT) is one means of supporting the maxillofacial to get a three-dimension photograph. The aim of this study was to determine the difference in the results of the use of panoramic photos and CBCT in evaluation before and after gnathoplasty surgery.Material and Methods: This is an observational descriptive research with cross-sectional study method. All samples that meet the suitable criteria are put in this research. The data gained by collecting status card at medical record installation about photo panoramic application in gnathoschisis patients was then compare to the examination with CBCT.Results: The result performed shows that there is a significant difference between panoramic and CBCT picture. The CBCT provide better evaluation about teeth age and segment position of jaw curve from the cleft size. While the panoramic photo provides a widely covered area to observe facial and teeth bone.Conclusion: The CBCT results are more accurate in evaluating gnathoplasty surgery than panoramic photo; however, exposure to the radiation should be considered.

scholarly journals Does the source of referral affect outcomes for paediatric testicular torsion?

2019 ◽  
Vol 101 (6) ◽  
pp. 411-414 ◽  
Author(s):  
R Peeraully ◽  
M Jancauskaite ◽  
S Dawes ◽  
S Green ◽  
N Fraser
Keyword(s):  
Primary Care ◽  
Testicular Torsion ◽  
Paediatric Surgery ◽  
Single Centre ◽  
Significant Difference ◽  
Single Centre Study ◽  
The Difference ◽  
Surgery Department ◽  
Surgical Unit ◽  
Do So

Introduction This single centre study retrospectively analysed the intraoperative findings relative to source of referral for emergency scrotal explorations performed in a tertiary level paediatric surgery department. Methods All patients who underwent emergency scrotal exploration under the care of paediatric surgeons in our unit between April 2008 and April 2016 were identified. Clinical data were obtained from contemporaneous records. Results Over the 8-year study period, 662 boys underwent emergency scrotal exploration: 6 (1%) were internal referrals, 294 (44%) attended our emergency department (ED) directly, 271 (41%) were referred from primary care and 91 (14%) were transferred from other hospitals. Excluding procedures in neonates, testicular torsion was present in 100 cases (15%). Testicular detorsion with bilateral 3-point testicular fixation was performed in 66 (66%) and orchidectomy with contralateral fixation in 34 (34%) where the torted testis was non-viable intraoperatively. The orchidectomy rate in the presence of torsion was 23% in ED referrals (12/52), 43% in primary care referrals (12/28) and 50% for transfers (10/20). The difference in rates between ED referrals and patients transferred from other hospitals was significant (p=0.026). There was no significant difference in median age between any of the groups (p=0.10). Conclusions Boys undergoing emergency scrotal exploration had a higher orchidectomy rate when transferred from other hospitals to our unit. This difference was statistically significant when compared with boys presenting directly to our ED. This supports advice from The Royal College of Surgeons of England for undertaking paediatric scrotal explorations in the presenting hospital when safe to do so rather than delaying the care of these patients by transferring them to a tertiary paediatric surgical unit.

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