Treatment of an Infant with a Rare Cleft Resolved with Use of an Orthopedic Appliance

2003 ◽  
Vol 40 (6) ◽  
pp. 642-644 ◽  
Author(s):  
Martín Romero ◽  
Ralph Latham ◽  
Ana Romance ◽  
Rafael Salvan
Keyword(s):  
New Method ◽  
Secondary Palate ◽  
Primary Palate ◽  
Presurgical Orthopedics

Objective Cases of bilateral complete clefts of the primary palate and unaffected secondary palate are very rare. One of these cases as well as a new method of presurgical orthopedics to solve the protruding premaxilla protrusion is presented.

A New Approach to Classify Cleft Lip and Palate

2001 ◽  
Vol 38 (6) ◽  
pp. 545-550 ◽  
Author(s):  
M. R. Ortiz-Posadas ◽  
L. Vega-Alvarado ◽  
J. Maya-Behar
Keyword(s):  
Soft Palate ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Mathematical Expression ◽  
New Method ◽  
New Approach ◽  
Secondary Palate ◽  
Primary Palate ◽  
Incisive Foramen ◽  
Horizontal Portion

Objective: To propose a new method, which allows for a complete description of primary and secondary cleft palates, incorporating elements that are related to the palate, lip, and nose that will also reflect the complexity of this problem. Method: To describe the type of cleft, two embryonic structures were considered: (1) the primary palate, formed by the prolabium, premaxilla, and columella and (2) the secondary palate, which begins at the incisive foramen and is formed by a horizontal portion of the maxilla, the horizontal portion of the palatine bones, and the soft palate. Anatomical characteristics to be considered were defined, and a new method is proposed to more fully describe any cleft. Results: A description of five cases was made using the method proposed in this work and compared with other published methods for the classification and description of clefts. Conclusions: A mathematical expression was developed to characterize clefts of the primary palate, including the magnitude of palatal segment separation and the added complexity of bilateral clefts, yielding a numerical score that reflects overall complexity of the cleft. Clefts of the secondary palate are also considered in a separate score. Using this method, it is possible to incorporate elements that are not considered in other approaches and to describe all possible clefts that may exist.

Autoradiographic study of macromolecular synthesis in the fusion epithelium of the developing rat primary palate in vitro

Development ◽  
1979 ◽  
Vol 50 (1) ◽  
pp. 145-154
Author(s):  
Alvaro A. Figueroa ◽  
Robert M. Pratt
Keyword(s):  
Autoradiographic Study ◽  
Whole Embryo Culture ◽  
Glycoprotein Synthesis ◽  
Palate Development ◽  
Molecular Events ◽  
Secondary Palate ◽  
Primary Palate ◽  
Epithelial Fusion ◽  
Developing Rat

The facial processes involved in primary palate formation undergo epithelial fusion in a manner morphologically analogous to that observed during secondary palate formation. We have used whole embryo culture to analyze the synthesis of macromolecules (DNA, protein, glycoprotein) in the primary palate, based on the incorporation of various labeled precursors. The results of this study demonstrate that changes in the synthesis of macromolecules occur during the fusion of the facial processes, which resemble those previously reported to occur during secondary palate development. These changes include cessation of DNA synthesis in cells in a restricted zone of the epithelium, concomitant with maintenance of glycoprotein synthesis. These findings indicate that the molecular events underlying the development of the primary and secondary palate may be similar.

Palatal Morphology and Type of Clefting

1996 ◽  
Vol 33 (6) ◽  
pp. 477-482 ◽  
Author(s):  
Pauli V.J. Kilpeläinen ◽  
Maija T. Laine-Alava ◽  
Seppo Lammi
Keyword(s):  
Cleft Palate ◽  
Developmental Stage ◽  
Multiple Regression ◽  
Regression Analyses ◽  
Missing Teeth ◽  
Secondary Palate ◽  
Different Types ◽  
Primary Palate

In this study, the variation in palatal dimensions, particularly for height, width, and depth, were evaluated in subjects with different types of cleft palate using the moiré technique. The sample consisted of 95 subjects with cleft palate and 68 noncleft individuals. Effects of cleft type, gender, developmental stage of the dentition, missing teeth, and 11 skeletal and pharyngeal cephalometric variables on palatal dimensions were assessed using multiple-regression analyses. The typing of clefts had an effect on the all palatal dimensions. The palate was shallower in subjects with clefts involving the secondary palate than in other types of clefts or in none left individuals. The palatal width was decreased in subjects with cleft in the primary palate, and the palatal depth was affected by all cleft types except submucous cleft. Gender, developmental stage of the dentition, missing teeth, and some of the cephalometric variables also had a certain effect on the palatal dimensions.

The Course of the Palatine Arteries During Secondary Palate Development in the Rat

1973 ◽  
Vol 52 (6) ◽  
pp. 1273-1280 ◽  
Author(s):  
Virginia M. Diewert
Keyword(s):  
Blood Supply ◽  
Palate Development ◽  
Rat Fetuses ◽  
Secondary Palate ◽  
Primary Palate

The course of the palatine arteries was studied in 96 rat fetuses. The descending palatine arteries were a major blood supply to the incisive area of the primary palate. When shelves were elevated, the arteries became positioned more medially and changed from a semicircular to a V-shaped form in the pre-maxilla.

Comparison of Craniofacial Morphology in Patients with Bilateral Complete Cleft of Primary versus Secondary Palate

2002 ◽  
Vol 39 (3) ◽  
pp. 353-356 ◽  
Author(s):  
Yu-Fang Liao ◽  
Chiung-Shing Huang ◽  
M. Samuel Noordhoff
Keyword(s):  
Adverse Effect ◽  
Retrospective Analysis ◽  
Outcome Measures ◽  
Craniofacial Morphology ◽  
Cephalometric Analysis ◽  
Differential Effects ◽  
Secondary Palate ◽  
Primary Palate ◽  
Maxillary Incisors ◽  
Craniofacial Characteristics

Objective: To identify and compare the craniofacial morphology of patients with bilateral complete cleft of primary palate (BCCPP) and bilateral complete cleft of secondary palate (BCCSP). In addition, to evaluate the differential effects of lip repair and palatal repair on the craniofacial morphology in cleft patients. Subjects: Twenty-four children, 10 boys and 14 girls, mean age of 5.8 years, with BCCPP (BCCPP group). Twenty-five children, 10 boys and 15 girls, mean age of 5.6 years, with BCCSP (BCCSP group). Design: Retrospective analysis. Main Outcome Measures: Cephalometric analysis was used to determine the craniofacial morphology at about 5 years of age. Results: Compared with the BCCSP group, the BCCPP group demonstrated longer maxillary length, more protruded maxilla, more favorable jaw relation, more severely retroclined maxillary incisors, and larger overjet. Conclusions: The subjects with BCCPP had craniofacial characteristics that differed significantly from those with BCCSP. It could also be speculated that palatal repair had more adverse effect on the growth of the maxilla in length; however, that repair influenced less the anteroposterior position of maxillary incisors than lip repair did.

Buccinator Sandwich Pushback: A New Technique for Treatment of Secondary Velopharyngeal Incompetence

2004 ◽  
Vol 41 (3) ◽  
pp. 230-237 ◽  
Author(s):  
C. Hill ◽  
C. Hayden ◽  
M. Riaz ◽  
A. G. Leonard
Keyword(s):  
Velopharyngeal Insufficiency ◽  
Case Selection ◽  
Velopharyngeal Incompetence ◽  
Secondary Palate ◽  
Velopharyngeal Closure ◽  
Primary Palate ◽  
Speech Therapist ◽  
Palate Repair ◽  
A New Technique ◽  
Speech Assessment

Objective A small percentage of patients have inadequate velopharyngeal closure, or secondary velopharyngeal incompetence, following primary palatoplasty. Use of the buccinator musculomucosal flap has been described for primary palate repair with lengthening, but its use in secondary palate lengthening for the correction of insufficient velopharyngeal closure has not been described. This study presents the results of a series of patients who had correction of secondary velopharyngeal incompetence using bilateral buccinator musculomucosal flaps used as a sandwich. Patients In this prospective study between 1995 and 1998, a group of 16 patients with insufficient velopharyngeal closure as determined by speech assessment and videoradiography were selected. Nasopharyngoscopy was carried out in addition in a number of cases. Case selection was a result of these investigations and clinical examination in which the major factor in velopharyngeal insufficiency was determined to be short palatal length. Design The patients underwent palate lengthening using bilateral buccinator musculomucosal flaps as a sandwich. All patients were assessed 6 months postoperatively. The operative technique, postoperative course, and recorded postoperative complications including partial/total flap necrosis and residual velopharyngeal insufficiency were evaluated. Preoperative and postoperative speech samples were rated by an independent speech therapist. Results Ninety-three percent (15 of 16) had a significant improvement in velopharyngeal insufficiency, and 14 patients had no hypernasality postoperatively. Both cases of persistent mild hypernasality had had a recognized postoperative complication. Conclusion The sandwich pushback technique for the correction of persistent velopharyngeal incompetence was successful in achieving good speech results.

A Simple and Precise Classification for Cleft Lip and Palate: A Five-Digit Numerical Recording System

2007 ◽  
Vol 44 (5) ◽  
pp. 465-468 ◽  
Author(s):  
Qiang Liu ◽  
Ming-Liang Yang ◽  
Zeng-Jian Li ◽  
Xiao-Feng Bai ◽  
Xu-Kai Wang ◽  
...  
Keyword(s):  
Data Analysis ◽  
Classification System ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Maxillofacial Surgery ◽  
Recording System ◽  
New Classification ◽  
Secondary Palate ◽  
Primary Palate ◽  
Medical University

Objective: Numerous methods have been developed for recording cleft lip and palate deformities, but none has been universally accepted due to limitations, inadequate description of the cleft deformities, and varying complexity. Design: The classification system introduced in this article is designed to describe detailed information of the cleft deformities with five-digit codes. The anatomic description of the cleft components is denoted with five Arabic numerals in order of right lip, right alveolus and primary palate, secondary palate, left alveolus and primary palate, and left lip. The extent of the cleft deformities is recorded using the numerals 0 to 4 (i.e., from intact to complete). Setting: Department of Oral-Maxillofacial Surgery, The Affiliated Hospital of Stomatology, China Medical University. Results: This new classification system allows a numerical description of any kind of complete cleft, incomplete cleft, asymmetry, and complex clefts with an intervening intact segment (all simulated cases). Conclusions: The simplicity and precision of this five-digit classification system make it easy to understand, and it can be used for computerized data analysis.

Unilateral Cleft Lip with or without Cleft Palate and Handedness: Is There an Association?

1998 ◽  
Vol 35 (1) ◽  
pp. 46-51 ◽  
Author(s):  
John Daskalogiannakis ◽  
Kari L. Kuntz ◽  
Albert E. Chudley ◽  
R. Bruce Ross
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Chi Square ◽  
Children's Hospital ◽  
Secondary Palate ◽  
Children’S Hospital ◽  
Primary Palate ◽  
The Difference ◽  
Sick Children ◽  
The Right

Objective The purpose of this study was to investigate the possibility of a relationship between the side of occurrence of unilateral clefting of the lip and/or palate and handedness, also taking into account the type of the initial cleft condition, a factor that has not been adequately assessed in previous studies. Design This was a retrospective study. Setting Division of Orthodontics, The Hospital for Sick Children, Toronto, Canada, and Cleft Lip and Palate Program, Children's Hospital, Winnipeg, Canada. Participants Subjects were 289 patients (176 males and 113 females) 9 years of age or older presenting with a history of unilateral clefts of the lip with or without the palate. Of these patients, 217 were recruited from the patient pool of the Orthodontic Clinic at the Hospital for Sick Children in Toronto. The remaining 72 were selected from the registry of the Cleft Lip and Palate Program of the Children's Hospital in Winnipeg. Any syndromic cases were excluded from the sample. Main outcome Measures Assessment of handedness was performed by asking the patients to fill out a multi-item questionnaire in which patients were asked to identify which hand they would use for different tasks. The side and type of the initial cleft condition were identified by reviewing each patient's hospital chart and by cross-referencing with clinical examination. Statistical evaluation of the results was performed by using the chi-square test. Results There was a significantly larger number of left-sided clefts (198) in the sample than right-sided clefts (91), (p < .001). The proportion of left-sided clefts among left-handers (84.6%) was higher than that among right-handers (66.8%). However, the relationship between side of cleft and handedness was not statistically significant (p = .185). Clefts of the primary palate only seemed to occur on the left side 3.5 times more often than on the right, whereas the corresponding ratio of left:right manifestation for clefts of the primary and secondary palate was 1.8:1. The difference was statistically significant (p < .05). Conclusion The findings of this study confirm the affinity of unilateral clefts for the left side but suggest that there are differences between clefts of the primary palate only and clefts of the primary and secondary palate. Also, non-right-handed patients show a greater predilection for having a cleft on the left side than do right-handed patients.

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