Nasal Airway Dimensions of Adults with Cleft Lip and Palate: Differences among Cleft Types

2005 ◽  
Vol 42 (4) ◽  
pp. 396-402 ◽  
Author(s):  
Ana Paula Fukushiro ◽  
Inge Elly Kiemle Trindade
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Mean Value ◽  
Nasal Airway ◽  
Cross Sectional ◽  
Different Types ◽  
The Mean ◽  
Level Of Significance ◽  
Isolated Cleft Palate ◽  
Airway Dimensions

Objective To determine the nasal airway dimensions in adults with repaired cleft lip and palate by rhinomanometry and to analyze the reduction associated with different types of clefts. Model A prospective analysis comparing three types of previously repaired clefts: bilateral cleft lip and palate (BCLP), unilateral cleft lip and palate (UCLP), and isolated cleft palate (CP) at the 5% level of significance. Setting Laboratory of Physiology, Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, Bauru, Brazil. Participants Fifty-three subjects aged 18 to 35 years (17 BCLP, 16 UCLP, 20 CP) and a group of 20 individuals without cleft (N). Variables Minimum cross-sectional nasal area assessed by posterior (PR) and anterior (AR) rhinomanometry and nasopharyngeal area assessed by modified AR. Results Mean (± 1 SD) nasal areas obtained by PR were: 0.47 ± 0.16 cm2 (BCLP), 0.57 ± 0.19 cm2 (UCLP), 0.61 ± 0.13 cm2 (CP), and 0.60 ± 0.10 cm2 (N). The mean value for the BCLP group was significantly smaller than that for the N and CP groups. The remaining values did not differ from one another. The proportion of subjects with subnormal areas obtained by PR was 41%, 19%, and 0% for groups BCLP, UCLP, and CP, respectively. Similar results were obtained by AR. All subjects presented a nasopharyngeal area larger than 0.80 cm2, denoting absence of obstruction in the nasopharynx. Conclusions In adulthood BCLP is the type of cleft associated with a greater reduction of nasal airway, compared with UCLP and CP, suggesting that adults with BCLP are at a greater risk for nasal obstruction.

Prevalence of Palatal and Alveolar Cysts in Babies with Cleft Lip and Palate

2004 ◽  
Vol 41 (5) ◽  
pp. 490-493 ◽  
Author(s):  
Karina Mirela Ribeiro Pinto Alves ◽  
Virginia Peixoto ◽  
Márcia Ribeiro Gomide ◽  
Cleide Felíciode Carvalho Carrara ◽  
Beatriz Costa
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Sao Paulo ◽  
São Paulo ◽  
Craniofacial Anomalies ◽  
Cross Sectional ◽  
Significant Difference ◽  
Different Types ◽  
Low Prevalence ◽  
Posterior Area

Objective To evaluate the prevalence of palatal and alveolar cysts in babies with cleft lip and/or palate. Design Cross-sectional. Setting Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo (HRAC-USP), Bauru, São Paulo, Brazil. Participants Two hundred ninety-one Caucasian babies divided into four groups according to the type of cleft: cleft lip with or without cleft alveolus (70), complete unilateral cleft lip and palate (112), complete bilateral cleft lip and palate (56), and cleft palate (53). Results A low prevalence of palatal and alveolar cysts was observed among patients with the four different types of clefts, with no statistically significant difference between genders. The maxilla and the anterior area of the mouth were more affected than the mandible and the posterior area. Conclusions The low prevalence of palatal and alveolar cysts in the four groups of babies with clefts included in this study may have been due to the high mean age of the sample.

Incidence of Cleft Lip and Palate and Risks of Additional Malformations

1998 ◽  
Vol 35 (1) ◽  
pp. 40-45 ◽  
Author(s):  
Catharina Hagberg ◽  
Ola Larson ◽  
Josef Milerad
Keyword(s):  
Birth Weight ◽  
Birth Defects ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Live Births ◽  
Different Types ◽  
Mother’S Age ◽  
Rate Ratios ◽  
Isolated Cleft Palate ◽  
Similar Incidence

Objective and Methods Children with cleft lip and/or palate (n = 251) born between 1991 and 1995 in the county of Stockholm, Sweden, were studied with reference to incidence and rate ratios (RRs) of different types of clefts, gender, birth weight, mother's age, and length of pregnancy. Children who had clefts and additional malformations were compared with children who had clefts but no additional malformations. Results The incidence of clefts was 2.0/1000 live births, and it was higher among males than among females. The RR, an index of relative risk, was 1.58. The main groups, children with isolated cleft lip, children with cleft lip and palate, and children with isolated cleft palate, showed similar incidence values (0.6-0.7/1000 live births). Children with bilateral clefts had an incidence of 0.3/1000 live births. Additional malformations were found in approximately every sixth newborn with a cleft when children with Robin sequence were excluded. There was a tendency for newborns with bilateral clefts to have additional malformations (RR = 1.36; confidence interval = 0.74-2.49). Children with clefts and additional malformations had lower birth weight and were born earlier than children with clefts only. Conclusion Preterm cleft children with low birth weight should be screened for the presence of other birth defects.

scholarly journals Nasal Airway Dimensions of Children with Repaired Unilateral Cleft Lip and Palate

2015 ◽  
Vol 52 (5) ◽  
pp. 512-516 ◽  
Author(s):  
Inge Elly Kiemle Trindade ◽  
Adriana De Oliveira Camargo Gomes ◽  
Marilyse De Bragança Lopes Fernandes ◽  
Sergio Henrique Kiemle Trindade ◽  
Omar Gabriel Da Silva Filho
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Nasal Airway ◽  
Airway Dimensions

Benchmarking Speech, Velopharyngeal Function Outcomes and Surgical Characteristics Following the Sommerlad Protocol and Palate Repair Technique

2020 ◽  
Vol 57 (10) ◽  
pp. 1197-1215 ◽  
Author(s):  
Lauren Baillie ◽  
Debbie Sell
Keyword(s):  
Cleft Lip ◽  
Speech Therapy ◽  
Cleft Lip And Palate ◽  
District General Hospital ◽  
Muscle Quality ◽  
Consecutive Series ◽  
Cross Sectional ◽  
Flap Repair ◽  
Velopharyngeal Function ◽  
Isolated Cleft Palate

Objective: To report speech and velopharyngeal function (VPF) outcomes, and surgical characteristics, at age 5 following early complete palate closure using the Sommerlad protocol. Design: A retrospective, descriptive, cross-sectional consecutive series. Setting: A regional twin site center; a district general hospital and tertiary children’s hospital. Participants: Between 1993 and 2006, 877 participants underwent surgery; 712 (81%) were eligible for inclusion; 391 (55%) were included, 321 (45%) excluded. Thirteen percent had bilateral cleft lip and palate (CLP), 40% unilateral CLP, and 47% isolated cleft palate. Intervention: Lip and vomerine flap repair at 3 months of age (BCLP, UCLP) with soft palate closure using radical muscle dissection and retropositioning at a mean age of 6.6 months, range 4 to 23 months, as described and undertaken by Sommerlad. Outcome Measures: Velopharyngeal Composite (VPC) CAPS-A and articulation summary scores derived from analysis using the Cleft Audit Protocol for Speech-Augmented. Results: A VPC-SUM CAPS-A score of “0” was found in 97% reflecting adequate VPF; 73% had no cleft articulation difficulties. The BCLP group had the poorest articulation. Secondary speech surgery rate was 2.6% and 10.7% had fistula repair. Levator muscle quality and degree of retropositioning was associated with speech outcomes related to VPF. 2.6% had current features of VPI. Conclusions: Complete palate closure by around 6 months of age by the surgeon who described the technique led to excellent perceived VPF and very good speech outcomes at age 5, with less speech therapy and secondary speech surgery than commonly reported. These findings serve as a benchmark for the Sommerlad protocol and technique.

scholarly journals Study of the distribution of different types of cleft lip and palate and associated anomalies

2014 ◽  
Vol 03 (04) ◽  
pp. 203-208
Author(s):  
Alpana Barman ◽  
B C Dutta ◽  
J K Sarkar
Keyword(s):  
Cleft Palate ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Type I ◽  
Type Ii ◽  
Associated Anomalies ◽  
Type Iii ◽  
Congenital Deformities ◽  
Different Types ◽  
Isolated Cleft Palate

Abstract Background : Cleft lip and palate are some of the most common congenital deformities. They frequently occur as isolated deformities, but can be associated with other medical conditions and anomalies. Aim of the study: To study the distribution of different types of cleft lip and palate and associated anomalies. Materials and methods: Forty patients of cleft lip and palate were studied. Relevant history was taken, clinical examination done and recorded with photography with consent. The cases were classified as per Nagpur Classification. Results: In our study 24 cases (60%) were cleft lip and palate (type III) and 10 cases (25%) of cleft palate alone (type II) and 6 cases (15%) of cleft lip alone (type I). Males were found to predominate in type I and III. Females predominated in type II. Among the cleft lip, left side is found to be involved in most of the cases. In our study, out of 40 cases, 8 cases (20%) had other associated anomalies. Most of these were associated with cleft lip and palate (type III) and isolated cleft palate (type II). Conclusion: The typical universal distribution of cleft types and associated anomalies tallies with our results.

scholarly journals Self-perceived health related quality of life in adolescents with repaired cleft lip and palate

2017 ◽  
Vol 4 (4) ◽  
pp. 1263
Author(s):  
Aparajit Ravikumar ◽  
Rajesh Balan ◽  
Padmasani Venkatramanan
Keyword(s):  
Quality Of Life ◽  
Physical Health ◽  
Social Relationship ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Peer Group ◽  
Mean Value ◽  
Early Years ◽  
The Mean

Background: Cleft lip and palate is one of the most frequent birth defects and is associated co-morbidities such as facial abnormalities, difficulty in feeding, speech impairments and hearing difficulties. The psychological consequences of this anomaly are often not addressed effectively resulting in silent suffering for these individuals. The dissatisfaction with surgical outcome as well as the stigma and discrimination may affect the quality of life for both patients and their family. The study evaluates the self-perceived quality of life in children with repaired cleft lip/palate.Methods: Adolescents between the age of 11-18 years who were operated for cleft lip and palate in their early years were administered the WHO QOL-BREF questionnaire and their response were analysed in 4 domains, Physical health, Psychological, Social relationship and environmental.Results: Among the 46 children enrolled, 29 were boys and 17girls. The mean scores across each domain were as follows: Physical health-68.5, psychological-66, social relationship-88.5 and environmental-79.1.  The psychological stressors frequently encountered were: teasing by their peer group, unattractive physical appearance and dissatisfaction with facial features post-surgery.Conclusions: Among the 4 domains, the mean value of domain 3 (Social relationship) was the highest-88.5 and the mean value of domain 2 (Psychosocial) is the lowest-66. Continued psychological counselling and support during the turbulent adolescent years will help these children face the challenge of integrating with the society.

scholarly journals Kajian faktor-faktor yang berhubungan dengan skor nasalance pada pasien celah palatum

2016 ◽  
Vol 45 (2) ◽  
pp. 131
Author(s):  
Duhita Yassi ◽  
Dini Widiarni ◽  
Tri Juda Airlangga ◽  
Lestaria Aryanti ◽  
Muchtarudin Mansyur
Keyword(s):  
Cleft Palate ◽  
Otitis Media ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Otitis Media With Effusion ◽  
Group Analysis ◽  
Cross Sectional ◽  
Purposive Sampling ◽  
Significant Difference ◽  
The Mean

Latar belakang: Celah bibir dan palatum merupakan kelainan proses pertumbuhan area orofasial yang menimbulkan permasalahan kompleks. Penelitian ini menitikberatkan permasalahanyang terkait dengan fungsi bicara. Tujuan: Penelitian ini melaporkan gambaran skor nasalance padacelah palatum, hubungan antara skor nasalance percontoh celah palatum dan tanpa celah palatum sertafaktor-faktor yang berhubungan dengan skor nasalance. Metode: Desain penelitian adalah comparativecross sectional. Pengambilan percontoh dilakukan dengan purposive sampling. Dilakukan wawancara,pengisian kuesioner, pemeriksaan THT, audiometri, timpanometri, nasoendoskopi, dan nasometri.Hasil: Didapatkan gambaran rerata skor nasalance percontoh celah palatum. Terdapat  perbedaanbermakna antara skor nasalance percontoh celah palatum dan tanpa celah palatum pada Uji Gajah danUji Hantu (p<0,001). Pada analisis multivariat secara keseluruhan faktor-faktor yang berhubungandengan skor nasalance (adenoid, otitis media efusi, serta gangguan pendengaran) dan keberadaancelah palatum berpengaruh secara signifikan terhadap skor nasalance untuk semua uji nasalance(p<0,05) pada pengujian terhadap kedua kelompok percontoh. Bila dilihat secara parsial faktor adenoidberpengaruh secara signifikan terhadap skor semua uji nasalance baik pada analisis kedua kelompokpercontoh maupun pada percontoh celah palatum saja. Kesimpulan: Rerata skor nasalance kelompokcelah palatum lebih tinggi daripada kelompok tanpa celah palatum. Didapatkan peran faktor yangberpengaruh terhadap skor nasalance, khususnya adenoid. Diperlukan penelitian lebih lanjut terhadappercontoh sesudah operasi sehingga bisa dijadikan sebagai evaluasi terhadap keberhasilan tindakan. Kata kunci: celah palatum, skor nasalance, tonsil, adenoid, otitis media efusi, gangguan pendengaran ABSTRACTBackground: Cleft lip and palate is an orofacial malformation and associated with many problems. This study concerned in speech problem in cleft palate patients. Purpose: This study reportednasalance score in cleft palate patients, the correlation between nasalance score in cleft palate and noncleft palate groups and also some factors related with nasalance score in cleft palate patients. Methods:The design of this study was comparative cross sectional, with purposive sampling. Data was collectedwith interview, questioner apllication, ENT examination, audiometry, tympanometry, nasoendoscopy,and nasometry. Results: The result of this study reported the mean of nasalance score in cleft palatepatients. There was significant difference in nasalance score between cleft palate and non cleft palatepatients in Uji Gajah and Uji Hantu (p>0,05). In multivariate analysis, in general the factors relatedwith nasalance score (adenoid, otitis media with effusion, and hearing loss) and cleft palate  itself weresignificantly correlated with nasalance score in all nasalance test (p<0,05) in both groups analysis butno signifficant correlation in cleft palate group analysis. Partially, adenoid  was significantly correlated in both group analysis and cleft palate group analysis. Conclusion: The mean of nasalance score incleft palate group was higher than non cleft group. Some factors in this study, especially adenoid had corelations with nasalance score. It needs further study to evaluate the nasalance score patients withcleft palate after surgery to compare the results. Keywords: cleft palate, nasalance score, tonsil, adenoid, otitis media with effusion, hearing disturbance

Voice Quality in Adults Treated for Unilateral Cleft Lip and Palate

2018 ◽  
Vol 55 (8) ◽  
pp. 1103-1114
Author(s):  
Staffan Morén ◽  
Per Åke Lindestad ◽  
Mats Holmström ◽  
Maria Mani
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Voice Quality ◽  
Cross Sectional Study ◽  
University Hospital ◽  
Velopharyngeal Insufficiency ◽  
Control Group ◽  
Cross Sectional ◽  
Mean Values ◽  
The Mean

Objectives: The aim of the current study was to assess voice quality among adults treated for unilateral cleft lip and palate (UCLP), after one- or two-stage palate closure, and compare it to a noncleft control group. Study Design: Cross-sectional study of patients with UCLP with long-term follow-up and noncleft controls. Participants: Patients with UCLP born between 1960 and 1987, treated at Uppsala University Hospital, Sweden, were examined (n = 73) at a mean of 35 years after primary surgery. Forty-seven (64%) patients had been treated with 1-stage palate closure and 26 with 2-stage closure (36%). The noncleft control group consisted of 63 age-matched volunteers. Main Outcome Measures: Ratings of perceptual voice characteristics from blinded voice recordings with Swedish Voice Evaluation Approach method. Acoustic voice analysis including pitch and spectral measures. Results: Among the patients, the mean values for the 12 evaluated variables on a visual analog scale (0 = no abnormality, 100 = maximal abnormality) ranged between 0.1 and 17, and the mean for all was 6 mm. Voice variables were similar between patients and controls, except the total mean of all the perceptual voice variables, as well as “vocal fry”; both slightly lower among patients ( P = .018 and P = .009). There was no difference in any variable between patients treated with 1-stage and 2-stage palate closure. No clear relationship was found between velopharyngeal insufficiency and dysphonia. Conclusions: The voice characteristics among adults treated for UCLP in childhood are not different from those of individuals without cleft.

Occurrence of Cleft Lip and Palate in the Faroe Islands and Greenland from 1950 to 1999

2003 ◽  
Vol 40 (4) ◽  
pp. 426-430 ◽  
Author(s):  
Linda P. Jakobsen ◽  
Kirsten Mølsted ◽  
Kaare Christensen
Keyword(s):  
Cleft Palate ◽  
Cleft Lip ◽  
Genetic Factors ◽  
Cleft Lip And Palate ◽  
Faroe Islands ◽  
Hearing Disorders ◽  
Live Births ◽  
Time Period ◽  
The Mean ◽  
Isolated Cleft Palate

Objective To describe the occurrence of cleft lip with or without cleft palate (CL/P) and isolated cleft palate (CP) in the Faroe Islands and Greenland over a 50-year time period that has included substantial changes in lifestyle. Design A prevalence study based on patient records obtained from the Institute of Speech and Hearing Disorders in Copenhagen, Denmark, at which the treatment of patients with CP and CL/P from Greenland, the Faroe Islands, and Denmark is coordinated. Participants All live-born children in the Faroe Islands, Greenland, and Denmark with CL/P or CP born in the period 1950 to 1999 (Faroe Islands and Greenland) and 1950 to 1987 (Denmark). Results and Conclusion The mean prevalence of CL/P in the Faroe Islands and Greenland during the period 1950 to 1999 was 1.0 and 0.6 per 1000 live births, respectively. This is significantly lower than the mean prevalence of 1.4 (p < .05 and p < .001) per 1000 live births found in Denmark. The mean prevalence of CP in the Faroe Islands and Greenland was 1.5 and 1.1 per 1000 live births, respectively, which is significantly higher than the Danish prevalence of 0.5 per 1000 live births (p < .001 in both tests). There was no clear time trend in the prevalence, indicating that genetic factors or timetable environmental factors play a dominating role in the etiology of CL/P and CP in the Faroe Islands and Greenland.

scholarly journals Refractive Errors and Strabismus In Patients with Orofacial Clefts

2021 ◽  
Author(s):  
Camille Catarina Artuso ◽  
Ana Kelly Fernandes ◽  
Luisa Moreira Hopker ◽  
Ricardo Mokross Fernandes ◽  
Renato da Silva Freitas ◽  
...  
Keyword(s):  
Refractive Error ◽  
Medical Records ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Refractive Errors ◽  
Orofacial Clefts ◽  
Significant Difference ◽  
Eye Examination ◽  
The Mean ◽  
Isolated Cleft Palate

Abstract Purpose: To evaluate the prevalence of refractive errors and strabismus in patients with orofacial clefts. Methods: This retrospective study analyzed the medical records of 54 patients with orofacial clefts between August 2018 and March 2020. A complete eye examination was performed, including visual acuity assessment on a logMAR scale, anterior biomicroscopy, cycloplegic refraction, eye motility examination, and indirect ophthalmoscopy. Results: The mean age of the patients at presentation was 9.47 years. Twentythree (42.59%) patients had isolated cleft palate (CP), 10 (18.52%) had cleft lip (CL), and 21 (38.89%) had cleft lip and palate (CLP). The mean spherical equivalent was 1.30D (±1.56) in CL, 0.32D (±2.24) in CLP, and 0.62D (±3.76) in CP. The prevalence of refractive error, either spherical or cylinder >0.5 was 88%. The most common refractive error was hyperopia (60%), followed by astigmatism (54%) and myopia (16%). Overall, 52.63% of the patients were prescribed glasses. No statistically significant difference was observed between the groups with respect to the need for prescription of glasses (p=0.6753). There were 15 patients with some type of strabismus, and other ophthalmological changes were observed in 13 patients. Conclusion: In this population with orofacial clefts, the prevalence of refractive errors and strabismus was 88% and 22%, respectively.

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