Effect of Lip Closure on Facial Growth in the Surgically Induced Cleft Rabbit

This project was designed to determine whether cleft lip repair has an influence on facial growth. To study this, 62 rabbits were divided into four groups: control, control without repair, Millard-type repair, and Bardach-type repair. Surgical clefts of the lip, alveolus, and the palate were created in 6-week-old rabbits. Periodic measurements were made of the pressure exerted by the lip on the maxillary alveolus. The animals were killed 20 weeks postoperatively. The skulls were processed and measurements were taken from the skulls. The pressure measurements showed a definite increase in lip pressure on the maxillary alveolus for the lip repair group. This pressure was high soon after surgery, rapidly returned toward the control level, but never reached it. Skull measurements indicate an inhibition in anterior maxillary growth for the “control without repair” group. This inhibition was even more profound in the two lip repair groups. No significant differences were found in maxillary width or mandibular length. When correlations were made to see if increased lip pressure resulted in decreased anterior maxillary growth, a significant correlation was found for both lip repair groups. This means that as the pressure of the lip repair increased, it resulted in a decrease in anterior maxillary growth. The data reported here indicates that cleft lip surgery must be considered as having a definite influence on anterior maxillary growth inhibition observed in the cleft lip and palate population. Further studies are indicated to determine the role of cleft palate repair on facial growth.

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

The Cleft Palate-Craniofacial Journal ◽

10.1177/1055665618762881 ◽

2018 ◽

Vol 55 (8) ◽

pp. 1145-1152 ◽

Cited By ~ 7

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.

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Anophthalmia, Cleft Lip/Palate, Absent Vomer Bone, Nystagmus, and Mental-Motor Retardation: A New Syndrome or Fryns“Anophthalmia-Plus” Syndrome?

The Cleft Palate-Craniofacial Journal ◽

10.1597/06-249 ◽

2008 ◽

Vol 45 (3) ◽

pp. 256-260

Author(s):

Derya Özçelik ◽

İbrahim Sağlam ◽

Fatma Sılan ◽

Gülbin Sezen ◽

Toygar Ünveren

Keyword(s):

Cleft Lip ◽

Cleft Lip And Palate ◽

Congenital Nystagmus ◽

Normal Lymphocyte ◽

Cleft Lip Palate ◽

Cleft Palate Repair ◽

Motor Retardation ◽

Cleft Lip Repair ◽

Palate Repair ◽

Rotation Advancement

Objective: We report that a 4-year-old boy presented with right unilateral complete cleft lip and palate, right anophthalmos, left congenital nystagmus, absence of the vomer bone, mental-motor retardation, and normal lymphocyte karyotype (46, XY). Methods: For reconstruction of the deformities, we performed cleft lip repair by Millard's rotation-advancement technique and planned cleft palate repair. Conclusions: This combination of cleft lip and palate, anophthalmos, congenital nystagmus, absent vomer bone, and mental-motor retardation has not, to our knowledge, previously been described. We suggest that this represents either another case of the rare Fryns “anophthalmia-plus” syndrome or a new syndrome.

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Impact of cleft palate repair on speech and development of dentoalveolar deformities

Voprosy praktičeskoj pediatrii ◽

10.20953/1817-7646-2021-3-47-53 ◽

2021 ◽

Vol 16 (3) ◽

pp. 47-53

Author(s):

Yu.V. Stebeleva ◽

◽

Ad.A. Mamedov ◽

Yu.O. Volkov ◽

A.B. McLennan ◽

...

Keyword(s):

Cleft Palate ◽

Cleft Lip ◽

Cleft Lip And Palate ◽

Surgical Techniques ◽

Normal Functioning ◽

Primary Surgery ◽

Cleft Palate Repair ◽

Congenital Cleft ◽

Palate Repair ◽

Late Postoperative Period

Surgical repair of cleft palate is quite difficult because it aims not only to eliminate the anatomical defect of the palate, but also to ensure normal functioning, including speech. Moreover, successful surgery implies no or minimal deformation of the middle face that can be corrected in the late postoperative period. No doubt that primary surgery (both in terms of technique and time) is crucial for further growth and development of the maxilla. However, surgical techniques and the age of primary cleft palate repair vary between different clinics, which makes this literature review highly relevant. Key words: cleft palate repair, cleft palate, congenital cleft lip and palate

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Two Methods of Cleft Palate Repair in Patients With Complete Unilateral Cleft Lip and Palate

Journal of Craniofacial Surgery ◽

10.1097/scs.0000000000004769 ◽

2018 ◽

Vol 29 (6) ◽

pp. 1473-1479 ◽

Cited By ~ 5

Author(s):

Percy Rossell-Perry

Keyword(s):

Cleft Palate ◽

Cleft Lip ◽

Cleft Lip And Palate ◽

Cleft Palate Repair ◽

Palate Repair

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Corelation Of Parents’ Profiles Of Children With Late Cleft Repair In Surabaya Cleft Lip And Palate Centre (January 2015 – December 2017)

Jurnal Rekonstruksi dan Estetik ◽

10.20473/jre.v5i1.24319 ◽

2021 ◽

Vol 5 (1) ◽

pp. 18

Author(s):

Laras Puspita Ningrum ◽

Iswinarno Doso Saputro ◽

Lobredia Zarasade

Keyword(s):

Cleft Palate ◽

Primary Care Physicians ◽

Cleft Lip ◽

Cleft Lip And Palate ◽

Speech Disorders ◽

Education Level ◽

Optimal Time ◽

Cross Sectional ◽

Cleft Palate Repair ◽

Palate Repair

Background : Optimal time of Cleft palate repair is during the 10 to 12 month of age. In this time produce far natural results in terms of speech because it enabled the maturation of scar tissue postoperatively. The soft palate must function properly before the patient starts learning to talk, otherwise speech disorders such as persistent rhinolalia aperta might arise. In pediatric patients, the role of parents is very important on adherence to therapy.Methods: This is a cross-sectional study. The first study group was parents of patients who had surgical repair before two years old and the second group was the parents of patients who had repair after two years old. We compared age, monthly income, education level, number of children, and residential distance from Surabaya of the two groups.Results : The data of this study were obtained from the medical records of patients with cleft lip surgery at CLP Center Surabaya in 2015th – 2017th with total of 358 patients, 172 were female and 186 were male. 52 patients with delayed cleft palate surgery. Patients’ parents in both groups were mostly 31-40 years old, were high school graduated, has one child, earned less than 1.5 million rupiah a month, and lived less than 100 kms from Surabaya. From the statistical results, parent’s income has the strongest correlation with the patient’s age in cleft palate surgery (-2.7). A negative coefficient means that the less parent’s income, the more patient likely had delayed cleft palate surgery. While other factors found weak and very weak correlations.Conclusions: The results form patient's parents' interview, concluded that besides economic factors, the lack of information cleft palate treatment is the key factors that contributed to the delay of cleft palate repair. The education level does not affect the delay in cleft palate surgery, because even in high educated parents, sometimes they don’t understand the stages of cleft lip and palate treatment. This study emphasized the necessity to educate about the stages of surgery by primary care physicians, to minimize delays.

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Hard Palate Repair Timing and Facial Growth in Unilateral Cleft Lip and Palate: A Longitudinal Study

The Cleft Palate-Craniofacial Journal ◽

10.1597/05-119 ◽

2006 ◽

Vol 43 (5) ◽

pp. 547-556 ◽

Cited By ~ 53

Author(s):

Yu-Fang Liao ◽

Timothy J. Cole ◽

Michael Mars

Keyword(s):

Longitudinal Study ◽

Hard Palate ◽

Cleft Lip ◽

Cleft Lip And Palate ◽

Sri Lankan ◽

Facial Morphology ◽

Facial Growth ◽

Clinical Notes ◽

Timing Effect ◽

Palate Repair

Objective: To investigate whether timing of hard palate repair had a significant effect on facial growth in patients with unilateral cleft lip and palate (UCLP). Design: Retrospective longitudinal study. Setting: Sri Lankan Cleft Lip and Palate Project. Patients: A total of 104 patients with nonsyndromic UCLP who had hard palate repair by age 13 years, with their 290 cephalometric radiographs taken after lip and palate repair. Main Outcome Measures: Clinical notes were used to record surgical treatment histories. Cephalometry was used to determine facial morphology and growth rate. Results: Timing of hard palate repair had a significant effect on the length and protrusion of the alveolar maxilla (PMP-A and SNA, respectively) and the anteroposterior alveolar jaw relation (ANB) at age 20 years but not on their growth rates. Conclusion: Timing of hard palate repair significantly affects the growth of the maxilla in patients with UCLP. Late hard palate repair has a smaller adverse effect than does early hard palate repair on the growth of the maxilla. This timing effect primarily affects the anteroposterior development of the maxillary dentoalveolus and is attributed to the development being undisturbed before closure of the hard palate.

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Hard Palate Repair Timing and Facial Growth in Cleft Lip and Palate: A Systematic Review

The Cleft Palate-Craniofacial Journal ◽

10.1597/05-058 ◽

2006 ◽

Vol 43 (5) ◽

pp. 563-570 ◽

Cited By ~ 48

Author(s):

Yu-Fang Liao ◽

Michael Mars

Keyword(s):

Systematic Review ◽

Hard Palate ◽

Cleft Lip ◽

Cleft Lip And Palate ◽

Case Reports ◽

Case Series ◽

Long Term Results ◽

Facial Growth ◽

Cleft Lip Palate ◽

Palate Repair

Objective: To evaluate the effect of timing of hard palate repair on facial growth in patients with cleft lip and palate, with special reference to cranial base, maxilla, mandible, jaw relation, and incisor relation. Design: A systematic review. Methods: The search strategy was based on the key words “facial growth,” “cleft lip palate,” and “timing of (hard) palate repair.” Case reports, case-series, and studies with no control or comparison group in the sample were excluded. Results: Fifteen studies met the selection criteria. All the studies were retrospective and nonrandomized. Five studies used cephalometry and casts, seven used cephalometry, and three used casts. Methodological deficiencies and heterogeneity of the studies prevented major conclusions. Conclusion: The review highlights the importance of further research. Prospective well-designed, controlled studies, especially targeting long-term results, are required to elucidate the effect of timing of hard palate repair on facial growth in patients with cleft lip and palate.

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