scholarly journals The efficacy of transnasal palatal transillumination for the diagnosis of submucous cleft palate

2021 ◽  
Vol 17 (1) ◽  
Author(s):  
Yasir S. Jamal ◽  
Sabah S. Moshref ◽  
Abeer M. Baamir ◽  
Mazin O. Kurdi ◽  
Doaa Y. Jamal
Keyword(s):  
Cleft Palate ◽  
Cleft Lip ◽  
Diagnostic Techniques ◽  
Lateral Release ◽  
Feeding Difficulties ◽  
Presenting Symptoms ◽  
Submucous Cleft Palate ◽  
Cheap Method ◽  
Operative Findings ◽  
Simple Repair

Abstract Background Submucous cleft palate (SMCP) is a congenital abnormality with various clinical and anatomical features. Submucous cleft pathologies may be unrecognized during routine examinations. Current diagnostic techniques are constrained and unrevealing in presurgical patients. This prospective study aimed to evaluate transnasal palatal transillumination technique in diagnosis of SMCP at our institute hospital, during period from 2005-2020. Patients and methods Twenty-one cases with SMCP were recruited with age range from 2-60 months. Transnasal palatal transillumination with controllable light intensity endoscope used to evaluate SMCP and cases were photo and video recorded. Results In this study, 21 cases (13 males and 8 females) with SMCP were detected or confirmed by intranasal transnasal palatal transillumination. Frequency of SMCP patients at our institute was 3.39%. All patients presented with symptomatic complaints at diagnosis time, apart from 5 patients (23.8%) were diagnosed during cleft lip repair operations. Presenting symptoms were hypernasality (23.8%), delayed speech (23.8%), perforated palate with nasal escape of milk and food (14.3%), feeding difficulties (14.3%), and otitis media (4.8%). During intra-oral examination, all cases had a bifid uvula accompanied SMCP. Submucous cleft palate appeared as thin palate with central lucency. According to operative findings, operations done for repair were mostly two long palatal flaps (n = 13, 61.9%), von Langenbeck (n = 5, 23.8%), simple repair with lateral release incisions (n = 2, 9.6%), and simple repair without lateral release incision (n = 1, 4.8%). Conclusions Intraoperative assessment of submucous cleft palate with transnasal palatal transillumination is easy and cheap method to avoid missing cases of SMCP.

Phonological Profile of Patients With Velopharyngeal Dysfunction and Palatal Anomalies

2021 ◽  
pp. 1-15
Author(s):  
Ariela Nachmani ◽  
Muhamed Masalha ◽  
Firas Kassem
Keyword(s):  
Cleft Palate ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Age Groups ◽  
Phonological Process ◽  
Phonological Processes ◽  
Process Error ◽  
Submucous Cleft Palate ◽  
Different Types

Purpose This purpose of this study was to assess the frequency and types of phonological process errors in patients with velopharyngeal dysfunction (VPD) and the different types of palatal anomalies. Method A total of 808 nonsyndromic patients with VPD, who underwent follow-up at the Center for Cleft Palate and Craniofacial Anomalies, from 2000 to 2016 were included. Patients were stratified into four age groups and five subphenotypes of palatal anomalies: cleft lip and palate (CLP), cleft palate (CP), submucous cleft palate (SMCP), occult submucous cleft palate (OSMCP), and non-CP. Phonological processes were compared among groups. Results The 808 patients ranged in age from 3 to 29 years, and 439 (54.3%) were male. Overall, 262/808 patients (32.4%) had phonological process errors; 80 (59.7%) ages 3–4 years, 98 (40, 0%) ages 4.1–6 years, 48 (24.7%) 6.1–9 years, and 36 (15.3%) 9.1–29 years. Devoicing was the most prevalent phonological process error, found in 97 patients (12%), followed by cluster reduction in 82 (10.1%), fronting in 66 (8.2%), stopping in 45 (5.6%), final consonant deletion in 43 (5.3%), backing in 30 (3.7%), and syllable deletion and onset deletion in 13 (1.6%) patients. No differences were found in devoicing errors between palatal anomalies, even with increasing age. Phonological processes were found in 61/138 (44.20%) with CP, 46/118 (38.1%) with SMCP, 61/188 (32.4%) with non-CP, 70/268 (26.1%) with OSMCP, and 25/96 (26.2%) with CLP. Phonological process errors were most frequent with CP and least with OSMCP ( p = .001). Conclusions Phonological process errors in nonsyndromic VPD patients remained relatively high in all age groups up to adulthood, regardless of the type of palatal anomaly. Our findings regarding the phonological skills of patients with palatal anomalies can help clarify the etiology of speech and sound disorders in VPD patients, and contribute to general phonetic and phonological studies.

A Systematic Review of Feeding Interventions for Infants with Cleft Palate

2021 ◽  
pp. 105566562110512
Author(s):  
Cameron Penny ◽  
Connor McGuire ◽  
Michael Bezuhly
Keyword(s):  
Systematic Review ◽  
Cleft Palate ◽  
Systematic Reviews ◽  
Cleft Lip ◽  
Positive Impact ◽  
Delivery Systems ◽  
Measurement Tool ◽  
Education Programs ◽  
Feeding Difficulties ◽  
Feeding Interventions

Objective Various devices and techniques have been proposed to reduce feeding difficulties experienced by infants with cleft palate. The aim of this review is to identify and assess the scope and quality of evidence for these interventions. Methods A systematic review of published literature evaluating feeding interventions for infants with cleft palate (with or without cleft lip) from database inception to 2021 was conducted using Preferred Reporting Items for Systematic Reviews guidelines. Quality appraisal of included studies was conducted using a methodological index for nonrandomized studies, Cochrane, or a measurement tool to assess systematic reviews 2 instruments, according to study type. Results Fourteen studies met inclusion criteria, with the majority (71%) of studies consisting of second-level evidence. Included interventions were specialty bottles (21%), alternative feeding delivery systems (14%), obturators (14%), and educational programs (14%). Specialty bottles and palatal obturators did not appear to offer any substantial growth advantages compared to traditional bottles or no intervention, respectively. Designated education programs for the mothers of infants with clefts had a positive impact on infant growth. Conclusions Overall evidence evaluating feeding interventions for infants with cleft palate was moderate to low. While it does not appear that specialized feeding delivery systems or palatal obturators significantly improve growth in infants with clefts compared to children without cleft conditions, education programs do appear to be beneficial.

A post GWAS association study of SNPs associated with cleft lip with or without cleft palate in submucous cleft palate

2015 ◽  
Vol 167 (3) ◽  
pp. 670-673 ◽  
Author(s):  
Rudolf Reiter ◽  
Sibylle Brosch ◽  
Ingrid Goebel ◽  
Kerstin U. Ludwig ◽  
Anja Pickhard ◽  
...  
Keyword(s):  
Cleft Palate ◽  
Association Study ◽  
Cleft Lip ◽  
Submucous Cleft Palate

scholarly journals Knowledge and practice of feeding plate obturators among medical doctors in Kanti children’s hospital

2021 ◽  
Vol 4 (1) ◽  
pp. 20-28
Author(s):  
B Pathak ◽  
KR Joshi ◽  
S Bhattarai ◽  
H Joshi
Keyword(s):  
Cleft Palate ◽  
Cleft Lip ◽  
Treatment Protocol ◽  
Medical Doctors ◽  
Feeding Difficulties ◽  
Children's Hospital ◽  
Children’S Hospital ◽  
Knowledge And Practice ◽  
Feeding Plate ◽  
Study Participants

Introduction: Cleft lip and cleft palate (CLCP) affects several systems and functions of the child and result in social and psychological problems.Therefore early repair of CLCP is imperative. Every cleft center follows its own surgical treatment protocol. Before closure of palatal defects, babies with cleft palate have great difficulty in feeding. To overcome this feeding difficulties, use of special bottles, nipples, initial palatal obturator therapy are used. The first exposure of those children are primarily the medical doctors including pediatricians from where they are generally referred to the concerned speciality for repair of CLCP. The aim of this study was to assess the knowledge and practice of orofacial clefts and feeding plate obturator among medical doctors working in Kanti Children’s Hospital (KCH). Method: This was a questionnaire based survey among medical doctors working in KCH. The pretested questionnaire with 7 questions each on the knowledge and practice of feeding plate obturator was distributed among the medical doctors and data was collected. The data collected were subjected to statistical analysis using frequency of responses and percentages. Results: Of the total 57 study participants, 32 (56.1%) were males and 25 (43.9%) were females. Majority i.e. 61.4% belonged to 31-40 years age group. 91.2% study participants faced the cleft lip/ palate related feeding difficulties 0-5 times/month while 5 (8.8%) faced this condition 6-10 times/ month. Majority of the infants who were less than 28 days (43.9%) attended the OPD due to difficultyin feeding/ swallowing (57.9%) followed by regurgitation/ aspiration (22.8%). 49.1% of the participants thought feeding plate oburator as the best way to feed a cleft patient on discharge from hospital. In their clinical practice, three fourth of paticipants (70.2%) had never seen a patient with feeding plate obturator, half of the participants (50.9%) didn’t advise for feeding plate obturator for patients withcleft palate and 89.5% were not aware of the replacement of feeding plate obturator. Conclusion: There is low exposure regarding the feeding plate obturator among medical doctors in KCH which needs to be reinforced through meaningful continuing education and training programs.

A Prospective Evaluation of the Prevalence of Submucous Cleft Palate in Patients with Isolated Cleft Lip versus Controls

1999 ◽  
Vol 103 (7) ◽  
pp. 1857-1863 ◽  
Author(s):  
Arun K. Gosain ◽  
Stephen F. Conley ◽  
Timothy D. Santoro ◽  
Arlen D. Denny
Keyword(s):  
Cleft Palate ◽  
Cleft Lip ◽  
Prospective Evaluation ◽  
Submucous Cleft Palate

THE PARENTS' REACTION TO THE BIRTH AND EARLY CARE OF CHILDREN WITH CLEFT PALATE

PEDIATRICS ◽  
1962 ◽  
Vol 30 (1) ◽  
pp. 86-90
Author(s):  
Veronica B. Tisza ◽  
Elizabeth Gumpertz
Keyword(s):  
Cleft Palate ◽  
Cleft Lip ◽  
Life Experiences ◽  
Medical Doctor ◽  
Emotional Understanding ◽  
Early Care ◽  
Parent Child Relationship ◽  
Feeding Difficulties ◽  
Child Relationship ◽  
Mother Child Relationship

From the beginning the life experiences of the baby born with cleft palate and cleft lip are different from those of normal infants. Following a discussion of the nature of the initial feeding difficulties, some parental anxieties related to the babies' malformation are enumerated. The birth of a congenitally damaged baby is experienced as a grievous loss by the mother. The length, depth, and nature of the resolution of her mourning reaction influences significantly the mother-child relationship. The key position of the medical doctor in relieving parental anxieties and alleviating grief is emphasized. His emotional understanding and continued support play an important part in the development of a relaxed and accepting parent-child relationship.

Cleft Lip and Palate in CHARGE Syndrome

2017 ◽  
Vol 55 (3) ◽  
pp. 342-347 ◽  
Author(s):  
Kathryn V. Isaac ◽  
Ingrid M. Ganske ◽  
Stephen A. Rottgers ◽  
So Young Lim ◽  
John B. Mulliken
Keyword(s):  
Hearing Loss ◽  
Cleft Palate ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Choanal Atresia ◽  
Semicircular Canals ◽  
Charge Syndrome ◽  
Velopharyngeal Insufficiency ◽  
Feeding Difficulties ◽  
Dentofacial Orthopedics

Objective: Infants with syndromic cleft lip and/or cleft palate (CL/P) often require more complex care than their nonsyndromic counterparts. Our purpose was to (1) determine the prevalence of CL/P in patients with CHARGE syndrome and (2) highlight factors that affect management in this subset of children. Design: This is a retrospective review from 1998 to 2016. Patients: Patients with CHARGE syndrome were diagnosed clinically and genetically. Main Outcomes Measures: Prevalence of CL/P was determined and clinical details tabulated: phenotypic anomalies, cleft types, operative treatment, and results of repair. Results: CHARGE syndrome was confirmed in 44 patients: 11 (25%) had cleft lip and palate and 1 had cleft palate only. Surgical treatment followed our usual protocols. Two patients with cardiac anomalies had prolonged recovery following surgical correction, necessitating palatal closure prior to nasolabial repair. One of these patients was too old for dentofacial orthopedics and underwent combined premaxillary setback and palatoplasty, prior to labial closure. Velopharyngeal insufficiency was frequent (n = 3/7). All patients had feeding difficulty and required a gastrostomy tube. All patients had neurosensory hearing loss; anomalies of the semicircular canals were frequent (n = 3/4). External auricular anomalies, colobomas, and cardiovascular anomalies were also common (n = 8/11). Other associated anomalies were choanal atresia (n = 4/11) and tracheoesophageal fistula (n = 2/11). Conclusions: CHARGE syndrome is an under-recognized genetic cause of cleft lip and palate. Hearing loss and speech and feeding difficulties often occur in these infants. Diagnosis can be delayed if the child presents with covert phenotypic features, such as chorioretinal colobomas, semicircular canal hypoplasia, and unilateral choanal atresia.

Cleft Palate, Cleft Lip, and Pierre Robin Sequence

2018 ◽  
Author(s):  
Michelle Keese Harvey ◽  
Ihab Ayad
Keyword(s):  
Cleft Palate ◽  
Airway Obstruction ◽  
Cleft Lip ◽  
Anesthetic Management ◽  
Treatment Options ◽  
Pierre Robin Sequence ◽  
Respiratory Compromise ◽  
Feeding Difficulties ◽  
Robin Sequence ◽  
Pierre Robin

Pierre Robin sequence (PRS) is characterized by micrognathia, glossoptosis, and airway obstruction. Often associated with cleft palate, PRS is usually an isolated finding but is associated with a syndrome one-third of the time. The micrognathia and glossoptosis lead to airway obstruction, respiratory compromise, and feeding difficulties. Severe cases and prolonged and repeated airway obstruction and respiratory distress can lead to failure to thrive, hypoxemia, pulmonary hypertension, cardiac arrest, and death. Treatment options for the management of airway obstruction in PRS depends on the degree of obstruction and any associated comorbidities and range from noninvasive respiratory support to surgical correction of the physical defect. Patients with PRS should be considered as challenging to ventilate and intubate, and the practitioner should be well prepared for the possibility of difficulty with airway management. Anesthetic management is tailored to minimize postoperative upper airway obstruction and avoid disruption of the integrity of the surgical repair.

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