Effect of One-Stage Bilateral Cleft Lip, Nose, and Alveolus Repair Following Nasoalveolar Molding on the Premaxilla Position at Preadolescence

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Isaac M. Traube ◽  
Court B. Cutting ◽  
Barry H. Grayson ◽  
Pradip R. Shetye
Keyword(s):  
Cleft Lip ◽  
One Stage ◽  
Bilateral Cleft Lip ◽  
Nasoalveolar Molding ◽  
Cleft Lip Nose

scholarly journals Speech in a consecutive series of children born with cleft lip and palate with and without syndromes and/or additional malformations

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Kristina Klintö ◽  
Maria Sporre ◽  
Magnus Becker
Keyword(s):  
Cleft Palate ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Consecutive Series ◽  
Total Group ◽  
One Stage ◽  
Audio Recordings ◽  
Bilateral Cleft Lip ◽  
Palatal Surgery ◽  
Group Comparisons

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.

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

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.

Effects of Nasoalveolar Molding Therapy on Alveolar and Palatal Cleft Deformities in Unilateral and Bilateral Cleft Lip and Palate

2018 ◽  
Vol 29 (2) ◽  
pp. e179-e184 ◽  
Author(s):  
Belma Isik Aslan ◽  
Ayşe Gülşen ◽  
Kemal Findikçioğlu ◽  
Deniz Uzuner ◽  
Neslihan Üçüncü
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Bilateral Cleft Lip ◽  
Nasoalveolar Molding

Presurgical Nasoalveolar Molding Therapy for the Treatment of Bilateral Cleft Lip and Palate: A Preliminary Study

2006 ◽  
Vol 43 (3) ◽  
pp. 321-328 ◽  
Author(s):  
Adam L. Spengler ◽  
Carmen Chavarria ◽  
John F. Teichgraeber ◽  
Jaime Gateno ◽  
James J. Xia
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Average Length ◽  
University Of Texas ◽  
Bilateral Cleft Lip ◽  
Before And After ◽  
Nasal Tip Projection ◽  
A Prospective Study ◽  
The University ◽  
Nasoalveolar Molding

Objective To evaluate the outcome of presurgical nasoalveolar molding therapy in the treatment of patients with bilateral cleft lip and palate. Design A prospective study with blinded measurements. Setting The Cleft and Craniofacial Clinic at the University of Texas at Houston Medical School, Houston, Texas. Patients Eight patients with bilateral cleft lip and palate, treated between 2002 and 2004. Interventions The starting age for presurgical nasoalveolar molding therapy was 34.9 days and the average length of the therapy was 212.5 days. Main Outcome Measures Measurements of intraoral and extraoral casts were performed, and statistical analyses were used to compare the differences between measurements before and after therapy. Results Intraoral measurements demonstrated that there was a statistically significant reduction of the premaxillary protrusion and deviation. There was also a significant reduction in the width of the larger cleft. Extraoral measurements revealed that there was a significant increase in the bi-alar width and in the columellar length and width. Moreover, there was a significant improvement in columellar deviation. Finally, the nostril heights of both sides were increased. Conclusion The authors have quantitatively shown that presurgical nasoalveolar molding therapy has significant advantages in the treatment of bilateral cleft lip and palate patients. It improves the nasal asymmetry and deficient nasal tip projection associated with bilateral cleft lip and palate. It also forces the protruded premaxillary segment into alignment with the dental alveolar segments, improving the shape of the maxillary arch. As a result, the changes associated with presurgical nasoalveolar molding therapy help decrease the complexity of subsequent surgeries.

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