scholarly journals Histological comparison of the alar nasal cartilages in unilateral cleft lip

2002 ◽  
Vol 57 (4) ◽  
pp. 143-146 ◽  
Author(s):  
Miguel Modolin ◽  
Glaucia Zeferino Baracat ◽  
Luiz Kamakura ◽  
Wilson Cintra Jr. ◽  
Luiz Gustavo Balaguer Cruz ◽  
...  
Keyword(s):  
Cleft Lip ◽  
Cartilage Matrix ◽  
Histological Evidence ◽  
Nasal Cartilages ◽  
Healthy Side ◽  
Lateral Portion ◽  
Hematoxylin And Eosin ◽  
Nasal Changes

Patients with unilateral cleft lip display characteristic nasal changes that are independent of the degree of deformity. Defenders of the intrinsic theory consider these deformities to be due to embryogenic alterations of the alar nasal cartilages. Those that propose the extrinsic theory defend the thesis that the deformity is due to disorganization of the perioral muscles deformed by the cleft. The purpose of this study is to contribute histological evidence to help clarify the issue. PATIENTS AND METHODS: Specimens of the lateral portion of both the healthy and the cleft side of the alar cartilages were obtained from 18 patients. These uniformly cut specimens were stained by hematoxylin and eosin. Samples from 2 patients were excluded due to imperfections. The same pathologist examined all the slides. He was unaware of the origins of the specimens; he counted the number of chondrocytes and quantified the cartilage matrixes. RESULTS: All data was analyzed statistically, and no significant statistical differences were apparent, either in the number of chondrocytes or the cartilage matrix between the healthy side and the cleft side. DISCUSSION: These results apparently support the group that defend the extrinsic theory; nevertheless, the doubt about the composition of the cartilage matrix remains, not only concerning the glycosaminoglycans that compose them, but also regarding elastin and collagen and its linkages that can cause different degrees of collagen consistency.

scholarly journals Three-Dimensional Soft Tissue Nasal Changes After Nasoalveolar Molding and Primary Cheilorhinoplasty in Infants With Unilateral Cleft Lip and Palate

2018 ◽  
Vol 56 (1) ◽  
pp. 31-38 ◽  
Author(s):  
Laura Mancini ◽  
Travis L. Gibson ◽  
Barry H. Grayson ◽  
Roberto L. Flores ◽  
David Staffenberg ◽  
...  
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Three Dimensional ◽  
Case Series ◽  
Midsagittal Plane ◽  
Retrospective Case ◽  
Anthropometric Measures ◽  
Nasal Tip ◽  
Nasoalveolar Molding ◽  
Nasal Changes

Objective: To quantify 3-dimensional (3D) nasal changes in infants with unilateral cleft lip with or without cleft palate (UCL±P) treated by nasoalveolar molding (NAM) and cheilorhinoplasty and compare to noncleft controls. Design: Retrospective case series of infants treated with NAM and primary cheilorhinoplasty between September, 2012 and July, 2016. Infants were included if they had digital stereophotogrammetric records at initial presentation (T1), completion of NAM (T2), and following primary cheilorhinoplasty (T3). Images were oriented in 3dMD Vultus software, and 16 nasolabial points identified. Patients: Twenty consecutively treated infants with UCL±P. Interventions: Nasoalveolar molding and primary cheilorhinoplasty. Main Outcome Measures: Anthropometric measures of nasal symmetry and morphology were compared in the treatment group between time points using paired Student t tests. Postsurgical nasal morphology was compared to noncleft controls. Results: Nasal tip protrusion increased, and at T3 was 2.64 mm greater than noncleft controls. Nasal base width decreased on the cleft side by 4.01 mm after NAM and by 6.73 mm after cheilorhinoplasty. Columellar length of the noncleft to cleft side decreased from 2:1 to 1:1 following NAM. Significant improvements in subnasale, columella, and nasal tip deviations from midsagittal plane were observed. Treatment improved symmetry of the alar morphology angle and the nasal base–columella angle between cleft and noncleft sides. Conclusions: Three-dimensional analysis of UCL±P patients demonstrated significant improvements in nasal projection, columella length, nasal symmetry, and nasal width. Compared to noncleft controls, nasal form was generally corrected, with overcorrection of nasal tip projection, columella angle, and outer nasal widths.

scholarly journals The Effectiveness of Maxillary Expansion in Wearers of Cleft Lip and Palate

2021 ◽  
Vol 8 ◽  
Author(s):  
Richard Togbedji Dahoue ◽  
Abdelali Halimi ◽  
Médard Antah Gbètoho Dohou ◽  
Rajae Elhaddaoui ◽  
Fatima Zaoui
Keyword(s):  
Systematic Review ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Transverse Dimension ◽  
Cochrane Library ◽  
Maxillary Expansion ◽  
Case Control Studies ◽  
Randomized Controlled Clinical Trials ◽  
Significant Difference ◽  
Healthy Side

Introduction: Cleft Lip and Palate (CLAP) is one of the most frequent craniofacial anomalies. The management of patients with CLAP requires several repair procedures for the soft palate, the primary and secondary bony palate, the alveolar ridge, the lips and the nose. These patients often present with a maxillary transverse deficit responsible for maxillary endognathy which must be corrected for a harmonious development of the maxillomandibular complex. The objective of our work was to evaluate the efficacy of slow, rapid and surgical maxillary expansion in patients with sequelae of CLAP following a systematic review protocol. Materials and methods: Four databases were searched: PubMed / MEDLINE, ScienceDirect, Cochrane Library and EBSCOhost, using the keywords present in the MeSH according to the equation [Maxillary expansion] AND [Cleft lip and palate]. The selection of articles included all studies published since January 2010 and for which the full text is available, such as meta-analyzes, randomized and non-randomized controlled clinical trials, case-control studies and prospective and retrospective studies. Results: Among 1107 references only 8 studies met our inclusion criteria. Following analysis of these, we concluded that there is no significant difference between rapid maxillary expansion and slow maxillary expansion in patients with unilateral CLAP, the expansion observed on the side of the cleft is larger than that seen on the healthy side. Surgically assisted expansion is much more reserved for subjects at the end of growth, having unilateral or bilateral CLAP and presenting anterior or posterior lateral crossbones. The results of our systematic review also showed that maxillary expansion in patients with CLAP results in substantial dentoalveolar compensation. Conclusion: The efficacy of maxillary expansion in patients with sequelae of CLAP is real and alone in some cases allows the restoration of a normal transverse dimension; sometimes in combination with maxillary protraction to correct the anteroposterior deficit.

Three-Dimensional Assessment of Early Surgical Outcome in Repaired Unilateral Cleft Lip and Palate: Part 1. Nasal Changes

2011 ◽  
Vol 48 (5) ◽  
pp. 571-577 ◽  
Author(s):  
Ashraf Ayoub ◽  
Ann Garrahy ◽  
Declan Millett ◽  
Adrian Bowman ◽  
J.P. Siebert ◽  
...  
Keyword(s):  
Surgical Outcome ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Three Dimensional ◽  
Dimensional Assessment ◽  
Nasal Changes

scholarly journals Profiling and Characterization of Localized Cytokine Response in Congenital Cleft Affected Lip Tissue

Life ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. 556
Author(s):  
Sophie Charlotte Reiser ◽  
Jonas Tellermann ◽  
Ilze Akota ◽  
Māra Pilmane
Keyword(s):  
Cleft Lip ◽  
Adaptive Immune Response ◽  
Interferon Γ ◽  
Necrosis Factor Alpha ◽  
Tnf Α ◽  
Inflammatory Processes ◽  
Congenital Cleft ◽  
Factor Alpha ◽  
Hematoxylin And Eosin ◽  
Ifn Γ

(1) Background: Despite cleft lips and palates belonging to the most common orofacial congenital anomalies, their morphopathogenesis is not yet fully understood. The study aimed to determine the distribution and relation of cytokines interferon-γ (IFN-γ), tumor necrosis factor-alpha (TNF-α), interleukin (IL)-2, IL-7, IL-12, and IL-13 in the cleft affected mucosa of the lip. (2) Materials and Methods: Twenty cleft lip (CL) mucosal samples and seven control tissues of oral cavity mucosa were included in the study. Specimen were obtained during reconstruction surgeries and processed by hematoxylin and eosin staining and immunohistochemistry for IFN-γ, TNF-α, IL-2, IL-7, IL-12, and IL-13. (3) Results: The distribution of cytokines was higher overall in the cleft affected epithelium compared to the connective tissue, with TNF-a, IL-2, and IL-12 displaying the highest number of immunopositive cells. With the exception of IL-2, CL specimen showed higher immunoreactivity. IFN-γ displayed only minor immunoreactivity, with no expression in the control epithelium. Correlation analysis was strongest between CL epithelial IL-13 and IFN-γ (z = 0.71, p < 0.0001). (4) Conclusions: The CLP affected epithelium displays high degrees of plasticity in expressing different cytokines, pointing towards the stimulation of a local adaptive immune response based on consistent inflammatory processes.

Nasal Changes after Presurgical Nasoalveolar Molding (PNAM) in the Unilateral Cleft Lip Nose

2012 ◽  
Vol 49 (6) ◽  
pp. 689-700 ◽  
Author(s):  
David F. Gomez ◽  
Sean T. Donohue ◽  
Alvaro A. Figueroa ◽  
John W. Polley
Keyword(s):  
Cleft Lip ◽  
Nasoalveolar Molding ◽  
Cleft Lip Nose ◽  
Nasal Changes

Three-Dimensional Nasal Changes following Nasoalveolar Molding in Patients with Unilateral Cleft Lip and Palate: Geometric Morphometrics

2005 ◽  
Vol 42 (4) ◽  
pp. 403-409 ◽  
Author(s):  
G. Dave Singh ◽  
Daniel Levy-Bercowski ◽  
Pedro E. Santiago
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Relative Size ◽  
Three Dimensional ◽  
Lateral Wall ◽  
Scaling Analysis ◽  
Prospective Longitudinal Study ◽  
Nasoalveolar Molding ◽  
Prospective Longitudinal ◽  
Nasal Changes

Objective To evaluate three-dimensional changes in nasal morphology in patients with unilateral cleft lip and palate treated with presurgical nasoalveolar molding (NAM) to correct naso-labio-alveolar deformity. Design This was a prospective, longitudinal study. Digital stereophotogrammetry was used to capture three-dimensional facial images, and x, y, and z coordinates of 28 nasal landmarks were digitized. Sample Ten patients with unilateral cleft lip and palate. Main Outcome Measures Nasal form changes between T1 (age: 28 ± 2 days, pre-NAM) and T2 (age: 140 ± 2 days, post-NAM), using conventional measurements and finite-element scaling analysis. Results Overall nasal changes were statistically different (p < .01), but no linear or curvilinear changes were found. Specifically, relative size increases were found on the noncleft side, involving the upper nose (30%), alar depth (20%), alar dome (30%), columella height (30%), and lateral wall of the nostril (17%). On the cleft side, the following showed a size increase: upper nose (8%), alar dome (5%), columella height (30%), and lateral wall of the nostril (30%). The cleft-side alar curvature, however, showed a large decrease in size (80%), but no changes on the noncleft side were found. Corresponding shape changes and angular changes were also found. Conclusions Using NAM, bilateral nasal symmetry in patients with unilateral cleft lip and palate was improved before surgical repair. Furthermore, slight overcorrection of the alar dome on the cleft side using pressure exerted by the nasal stent is indicated to maintain the NAM result.

Imaging of Cartilage and Mimic Muscles with MRI: Anatomic Study in Healthy Volunteers and Patients with Unilateral Cleft Lip and Palate

2001 ◽  
Vol 38 (4) ◽  
pp. 291-298 ◽  
Author(s):  
Johannes Kleinheinz ◽  
Ulrich Joos
Keyword(s):  
Healthy Volunteers ◽  
Cleft Lip ◽  
Soft Tissues ◽  
Preoperative Planning ◽  
Cleft Lip And Palate ◽  
Resonance Imaging ◽  
Anatomic Study ◽  
Nasal Cartilages ◽  
Magnetic Resonance Imaging Mri

Objective: The aim of the study was to visualize different soft tissues in the perioral, nasal, and paranasal region by means of magnetic resonance imaging (MRI) in patients with unilateral cleft lip and palate (UCLP). Design: In this descriptive study, images of different MRI systems were assessed and compared. Method: MRI was applied in five consecutive patients operated on for UCLP who underwent secondary lip and nasal correction, two patients who had not had UCLP operations, and five healthy volunteers as controls. The mimic muscles, vessels, and nasal cartilages were evaluated. Results: It was possible to visualize different parts of the paranasal and perioral mimic muscles and their interlacement in the upper lip. The nasal cartilages were also visible, and the changes after operation were demonstrated. Conclusions: MRI shows differentiated visualization of soft tissues in the cleft region and their changes after surgery. It is a valuable tool in the preoperative planning and postoperative follow-up in patients with UCLP.

scholarly journals REALISASI BAHASA INDONESIA PENDERITA BIBIR SUMBING SEBUAH STUDI KASUS

LITERA ◽  
2018 ◽  
Vol 17 (3) ◽  
Author(s):  
Rangga Asmara ◽  
Widya Ratna Kusumaningrum ◽  
Melita Sitangga
Keyword(s):  
Research Design ◽  
Cleft Lip ◽  
Bahasa Indonesia ◽  
Nasal Changes

AbstrakPenelitian ini bertujuan untuk mengidentifikasi realisasi dan perubahan fonem bahasa Indonesia berupa kata, frasa, dan kalimat yang diucapkan penderita bibir sumbing. Penelitian ini menggunakan pendekatan penelitian studi kasus. Objek dalam penelitian ini berupa (1) realisasi kata, frasa, dan kalimat bahasa Indonesia, perubahan fonem yang mengiringinya, dan fonem-fonem yang sulit diujarkan oleh penderita bibir sumbing. Sumber data (informan) dalam penelitian ini adalah dua orang penderita bibir sumbing (labiozchis) yang berusia 40 tahun dan 13 tahun. Penyediaan data menggunakan metode simak dan teknik (1) simak libat cakap, (2) rekam, (3) catat. Analisis data menggunakan metode padan dan teknik hubung banding menyamakan. Hasil penelitian menunjukan konsonan letupan, geseran, sampingan, geletar, dan sengauan mengalami perubahan fonem yang tidak konsisten. Artinya perubahan bergantung pada fonem yang menyertai.Kata kunci: fonetik, realisasi bahasa Indonesia, bibir sumbing, anak berkebutuhan khusus, studi kasus CLEFT LIP SUFFERERS AND ITS REALIZATION IN INDONESIAN LANGUAGE AbstractThe research aimed to identify the realization and phoneme changes in Indonesian language in the form of words, phrases and sentences uttered by cleft lip sufferers. The study used a case study as its research design. The objects in research are (1) the realization of words, phrases, and sentences, (2) the phoneme changes, and (3) difficult phonemes in Indonesian language uttered by cleft lip sufferers. The participants of the study are two cleft lip sufferer (labiozchis) with two different age level of 40 and 13 years old. For collecting the data, this study implemented some techniques: (1) observation (2) recording, and (3) notetaking. For analysing the data, this study used the connecting and comparing techniques. The result showed the fricative phonemes, as well as the lateral, trill, and nasal changes tended to be inconsisten. The changes depend on the preceding phonemes.Key word: phonetic, Indonesian language realization, cleft lip, childern with special need, case study

Changes to the Cleft Nose Esthetic After Le Fort I Advancement: A 3-Dimensional Analysis

FACE ◽  
2021 ◽  
pp. 273250162110469
Author(s):  
Fady P. Marji ◽  
Madeleine K. Bruce ◽  
Erin E. Anstadt ◽  
Irene T. Ma ◽  
Jonathan Y. Lee ◽  
...  
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Le Fort ◽  
3 Dimensional ◽  
Tip Projection ◽  
Alar Base ◽  
Nasolabial Angle ◽  
Le Fort I ◽  
Nasal Length ◽  
Nasal Changes

Background and Purpose: The study of nasal changes in cleft lip and palate (CLP) orthognathics is limited. This study aimed to determine differences in 3-dimensional (3D) nasal changes for unilateral cleft lip and palate (UCLP) and bilateral cleft lip and palate (BCLP) patients after Le Fort I advancement. Methods: This study was a retrospective cohort evaluation of 18 subjects (9 male, 9 female) treated at a single institution over a 5-year period who had class III skeletal and dentoalveolar malocclusion related to non-syndromic cleft lip and/or palate and underwent surgical correction via Le Fort I osteotomy. Patients underwent pre- and postoperative cephalometric measurements and 3D volumetric assessment for comparison to analyze nasal changes. Statistical analysis was performed to determine changes in nasal parameters using student’s t-test and multivariate analysis. Differences were considered significant for P-values ≤.05. Results: All nasal parameters except for nasolabial angle and nasal length changed significantly postoperatively in the entire cohort. Alar base and flare width both increased significantly (2.1 mm, P = .0002, 1.4 mm, P = .0005), while both relative and total tip projection decreased (−3.4 mm, P = .000004, −2.2 mm, P = .0008). An advancement of the entire nasal complex was seen postoperatively (1.0 mm, P = .0005). UCLP patients had a significantly larger decrease in total nasal tip projection following surgery relative to BCLP patients (−3.5 ± 1.2 mm, −0.8 ± 2.1 mm, P = .008). BCLP morphology increases the degree of 3D nasal surface area advancement relative to UCLP (1.2 mm ± 0.3, 0.8 mm ± 0.6, P = .028). Alar cinch stitch decreases nasolabial angle ( P = .024) but increases nasal length ( P = .004). Conclusion: Discrepancies exist in nasal changes after Le Fort I advancement between UCLP and BCLP patients. Increased understanding of outcomes for cleft patients undergoing Le Fort I can help improve the predictability of nasal esthetic changes in this patient population.

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