The Effect of Preoperative Use of an Orthopedic Plate on Articulatory Function in Children with Cleft Lip and Palate

2006 ◽  
Vol 43 (4) ◽  
pp. 406-414 ◽  
Author(s):  
Keiko Suzuki ◽  
Yasuharu Yamazaki ◽  
Kouichiro Sezaki ◽  
Nobuaki Nakakita
Keyword(s):  
Oral Cavity ◽  
Cleft Palate ◽  
Outcome Measures ◽  
Negative Pressure ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Control Group ◽  
Bilateral Cleft Lip ◽  
Tongue Movements ◽  
Continuous Use

Objective To evaluate the effect of preoperative use of an orthopedic plate (OP) on postoperative articulatory function in children with cleft lip and palate. Subjects The subjects had complete unilateral or bilateral cleft lip and palate and were scheduled for a one-stage palatoplasty. Main Outcome Measures Tongue movements during sucking were analyzed by ultrasonography. Postoperative articulatory behavior was also assessed at 5 years 4 months of age. Results There was an excessive downward excursion of the rear portion of the tongue during sucking regardless of the use or nonuse of the OP. This indicated that infants with cleft palate could not create negative pressure in the oral cavity, even with the OP. However, the OP appeared effective for preventing irregular movements of the tongue during sucking. The proportion of subjects obtaining excellent articulation was significantly higher in the group using the OP until palatoplasty than in the group who did not continue using the OP. The proportion of subjects with disturbed articulatory function in the latter group was comparable with that in the control group, who never used the OP. Conclusions Continuous use of the OP up to the time of palatoplasty appeared to be effective for the postoperative articulatory function in children with complete cleft lip and palate. Inhibiting irregular movements of the tongue, the OP might assist in preventing “palatalized articulation.”

Dermatoglyphics and Cheiloscopy as Key Tools in Resolving the Genetic Correlation of Inheritance Patterns in Cleft Lip and Palate Patients: An Assessment of 160 Patients

2017 ◽  
Vol 54 (5) ◽  
pp. 588-594 ◽  
Author(s):  
Priyankar Singh ◽  
Dipesh B. Nathani
Keyword(s):  
Cleft Palate ◽  
Outcome Measures ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Control Group ◽  
Study Group ◽  
Healthy Children ◽  
Type Ii ◽  
Type Iii ◽  
Group B

Objective The objective of this study was to correlate dermatoglyphics and cheiloscopy with genetic inheritance in cleft lip and cleft palate patients. Design and Setting This was a case-control study to look for asymmetry in finger and lip print patterns. All of the participants were divided into two equal groups (40 mothers and 40 fathers in each group). The data were analyzed by three evaluators who were blind to the study to avoid any chances of error. Patients/Participants A sample of 160 sporadic participants were identified and evaluated. Group A was composed of 80 healthy parents not affected by cleft lip and cleft palate but had at least one child born with nonsyndromic cleft. Group B consisted of 80 healthy parents not affected by cleft lip and cleft palate and had healthy children without cleft lip and cleft palate. Main Outcome Measures Main outcome measures were marked dermatoglyphic asymmetry and specific lip print pattern in the study group. Results We found marked asymmetry in various fingerprints and specific type II and type III lip print in the study group when compared with the control group. It was observed that groove count on the lip was significantly more frequent in study group parents. Conclusion Our study determined that there is a significant correlation between increased dermatoglyphic asymmetry and specific type II and type III lip print pattern in parents of children born with cleft. This could act as an important screening marker for the prediction of cleft lip and cleft palate inheritance.

Perceptual Speech Outcomes After Early Primary Palatal Repair in Ugandan Patients With Cleft Palate

2020 ◽  
pp. 105566562098024
Author(s):  
Kim Bettens ◽  
Laura Bruneel ◽  
Cassandra Alighieri ◽  
Daniel Sseremba ◽  
Duncan Musasizib ◽  
...  
Keyword(s):  
Cleft Palate ◽  
Cleft Lip ◽  
Speech Therapy ◽  
Cleft Lip And Palate ◽  
Control Group ◽  
English Speaking ◽  
And Gender ◽  
Early Primary ◽  
Velopharyngeal Function ◽  
Normal Speech

Objective: To provide speech outcomes of English-speaking Ugandan patients with a cleft palate with or without cleft lip (CP±L). Design: Prospective case–control study. Setting: Referral hospital for patients with cleft lip and palate in Uganda. Participants: Twenty-four English-speaking Ugandan children with a CP±L (15 boys, 9 girls, mean 8.4 years) who received palatal closure prior to 6 months of age and an age- and gender-matched control group of Ugandan children without cleft palate. Interventions: Comparison of speech outcomes of the patient and control group. Main Outcome Measures: Perceptual speech outcomes including articulation, resonance, speech understandability and acceptability, and velopharyngeal composite score (VPC-sum). Information regarding speech therapy, fistula rate, and secondary surgery. Results: Normal speech understandability was observed in 42% of the patients, and 38% were judged with normal speech acceptability. Only 16% showed compensatory articulation. Acceptable resonance was found in 71%, and 75% of the patients were judged perceptually to present with competent velopharyngeal function based on the VPC-sum. Additional speech intervention was recommended in 25% of the patients. Statistically significant differences for all these variables were still observed with the control children ( P < .05). Conclusions: Overall, acceptable speech outcomes were found after early primary palatal closure. Comparable or even better results were found in comparison with international benchmarks, especially regarding the presence of compensatory articulation. Whether this approach is transferable to Western countries is the subject for further research.

scholarly journals Speech in a consecutive series of children born with cleft lip and palate with and without syndromes and/or additional malformations

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Kristina Klintö ◽  
Maria Sporre ◽  
Magnus Becker
Keyword(s):  
Cleft Palate ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Consecutive Series ◽  
Total Group ◽  
One Stage ◽  
Audio Recordings ◽  
Bilateral Cleft Lip ◽  
Palatal Surgery ◽  
Group Comparisons

Abstract Background When evaluating speech in children with cleft palate with or without cleft lip (CP/L), children with known syndromes and/or additional malformations (CP/L+) are usually excluded. The aim of this study was to present speech outcome of a consecutive series of 5-year-olds born with CP/L, and to compare speech results of children with CP/L + and children with CP/L without known syndromes and/or additional malformations (CP/L-). Methods One hundred 5-year-olds (20 with CP/L+; 80 with CP/L-) participated. All children were treated with primary palatal surgery in one stage with the same procedure for muscle reconstruction. Three independent judges performed phonetic transcriptions and rated perceived velopharyngeal competence from audio recordings. Based on phonetic transcriptions, percent consonants correct (PCC) and percent non-oral errors were investigated. Group comparisons were performed. Results In the total group, mean PCC was 88.2 and mean percent non-oral errors 1.5. The group with bilateral cleft lip and palate (BCLP) had poorer results on both measures compared to groups with other cleft types. The average results of PCC and percent non-oral errors in the CP/L + group indicated somewhat poorer speech, but no significant differences were observed. In the CP/L + group, 25 % were judged as having incompetent velopharyngeal competence, compared to 15 % in the CP/L- group. Conclusions The results indicated relatively good speech compared to speech of children with CP/L in previous studies. Speech was poorer in many children with more extensive clefts. No significant differences in speech outcomes were observed between CP/L + and CP/L- groups.

Craniofacial Morphology in Children with Complete Bilateral Cleft Lip and Palate: Does Infantile Size of the Premaxilla Predetermine Outcome?

2004 ◽  
Vol 41 (4) ◽  
pp. 410-415 ◽  
Author(s):  
Yu-Fang Liao ◽  
Chiung-Shing Huang ◽  
Ya-Yu Tsai ◽  
M. Samuel Noordhoff
Keyword(s):  
Retrospective Study ◽  
Outcome Measures ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Craniofacial Morphology ◽  
University Hospital ◽  
Cephalometric Analysis ◽  
Bilateral Cleft Lip ◽  
Dental Cast ◽  
Craniofacial Characteristics

Objective To evaluate the possible association between the size of the premaxilla in infants and craniofacial morphology in children with complete bilateral cleft lip and palate (CBCLP) and identify the characteristics of craniofacial morphology in children with CBCLP with median facial dysplasia (MFD). Design Retrospective study. Setting A university hospital craniofacial center. Subjects Thirty-four patients with nonsyndromic CBCLP, 24 boys and 10 girls, had large premaxilla (LP group). Thirty-six patients with nonsyndromic CBCLP, 16 boys and 20 girls, had small premaxilla (SP group). Thirteen CBCLP patients with MFD, five boys and eight girls (MFD group). Main Outcome Measures Infant maxillary dental cast at the age of 1 year was used to measure the size of the premaxilla. Cephalometric analysis was used to determine craniofacial morphology in children at the age of 5 years. Results The size of the premaxilla in infants with CBCLP varied greatly. The LP group tended to have a longer maxilla and a more protruded maxilla, producing a better interjaw relation. The opposite phenomena were observed in the MFD group; the SP group yielded results between those of the LP and the MFD groups. Conclusion The size of the premaxilla in infants with CBCLP can be used to predetermine subsequent craniofacial morphology at the age of 5 years. Children with nonsyndromic CBCLP had craniofacial characteristics that differed significantly from those of children with CBCLP with median facial dysplasia.

Results of Multidisciplinary Management of Bilateral Cleft Lip and Palate at the Iowa Cleft Palate Center

1992 ◽  
Vol 89 (3) ◽  
pp. 419-432 ◽  
Author(s):  
Janusz Bardach ◽  
Hughlett L. Morris ◽  
William H. Olin ◽  
Steven D. Gray ◽  
David L. Jones ◽  
...  
Keyword(s):  
Cleft Palate ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Multidisciplinary Management ◽  
Bilateral Cleft Lip

Breast Feeding for Cleft Lip and Palate Patients, Using the Hotz-Type Plate

1997 ◽  
Vol 34 (4) ◽  
pp. 351-353 ◽  
Author(s):  
Mikihiko Kogo ◽  
Gen Okada ◽  
Shouichirou Ishii ◽  
Megumi Shikata ◽  
Seiji Iida ◽  
...  
Keyword(s):  
Oral Cavity ◽  
Outcome Measures ◽  
Breast Feeding ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Lateral View ◽  
Bottle Feeding ◽  
Oral Airway

Objective: Oral-cavity feeding movements were analyzed during sucking and used to modify a Hotz-type plate to facilitate sucking in infants with cleft lip and palate. Design: Sucking movements were analyzed using lateral view cine radiography as three adults fed from a bottle. A Hotz-type plate was then modified to better isolate the oral cavity and to occlude the oral airway. The plate was then utilized indirect breast feeding by 10 babies. Outcome Measures: Sucking rate, amount of milk taken, and duration of use of the plate were assessed. Results: Wearing this plate, four babies with cleft lip and palate could suck their mother's breast, drinking about 22 g/trial. Conclusions: Although supplemental bottle feeding was required to provide enough nourishment, this is the first step to reaching ideal breast feeding situation for these patients.

Objective, Noninvasive Evaluation of Velopharyngeal Function in Cleft and Noncleft Patients

1998 ◽  
Vol 35 (1) ◽  
pp. 35-39 ◽  
Author(s):  
Martin Kunkel ◽  
Ulrich Wahlmann ◽  
Wilfried Wagner
Keyword(s):  
Cleft Palate ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Noninvasive Evaluation ◽  
Control Group ◽  
Pharyngeal Muscles ◽  
Pharyngeal Flap ◽  
The Difference ◽  
Acoustic Pharyngometry ◽  
Velopharyngeal Function

Objective The purpose of this study was to investigate a new diagnostic method that provides an approach to noninvasive, objective measurement of velopharyngeal movement by acoustic determination of epipharyngeal volume changes with velopharyngeal muscle function. Design This was a case control study, using consecutive samples. Setting This study took place at the Cleft Palate Rehabilitation Center of the University of Mainz, Germany. Patients Subjects were 29 consecutive cleft lip and palate (CLP) patients and 31 controls (21 patients with dysgnathia and 10 healthy volunteers). Intervention A series of transnasal acoustic measurements (pressure wave: 55 dB for 2 milliseconds) of epipharyngeal volume were performed with the pharyngeal muscles relaxed in end-expiration and while the velopharyngeal orifice was closed, with the difference in volume representing maximal pharyngeal movement. Results Cleft palate patients yielded significantly lower values of velopharyngeal movement (6.5 cm3) than did the control group (8.0 cm3)(p < .05; Mann-Whitney U test). Overlapping ranges of values were measured for the C(L)P and control groups. The least mobility (4.75 cm3) was measured in patients who had undergone pharyngeal flap surgery. Different patterns of restriction were observed in patients with and without a pharyngeal flap. Conclusion Acoustic pharyngometry may provide access to noninvasive quantitative measurement of velopharyngeal movement and a better understanding of the pattern of movement in C(L)P-patients. We expect it to be a helpful tool in objectively monitoring the progress of logopedic therapy.

Early Lexical Characteristics of Toddlers with Cleft Lip and Palate

2014 ◽  
Vol 51 (6) ◽  
pp. 622-631 ◽  
Author(s):  
Mary Hardin-Jones ◽  
Kathy L. Chapman
Keyword(s):  
Cleft Palate ◽  
Outcome Measures ◽  
Cleft Lip ◽  
Alternative Explanation ◽  
Cleft Lip And Palate ◽  
Expressive Vocabulary ◽  
Lexical Development ◽  
Communicative Development ◽  
Macarthur Communicative Development Inventory ◽  
Language Sample

Objective To examine development of early expressive lexicons in toddlers with cleft palate to determine whether they differ from those of noncleft toddlers in terms of size and lexical selectivity. Design Retrospective. Patients A total of 37 toddlers with cleft palate and 22 noncleft toddlers. Main Outcome Measures The groups were compared for size of expressive lexicon reported on the MacArthur Communicative Development Inventory and the percentage of words beginning with obstruents and sonorants produced in a language sample. Differences between groups in the percentage of word initial consonants correct on the language sample were also examined. Results Although expressive vocabulary was comparable at 13 months of age for both groups, size of the lexicon for the cleft group was significantly smaller than that for the noncleft group at 21 and 27 months of age. Toddlers with cleft palate produced significantly more words beginning with sonorants and fewer words beginning with obstruents in their spontaneous speech samples. They were also less accurate when producing word initial obstruents compared with the noncleft group. Conclusions Toddlers with cleft palate demonstrate a slower rate of lexical development compared with their noncleft peers. The preference that toddlers with cleft palate demonstrate for words beginning with sonorants could suggest they are selecting words that begin with consonants that are easier for them to produce. An alternative explanation might be that because these children are less accurate in the production of obstruent consonants, listeners may not always identify obstruents when they occur.

scholarly journals Incidence of Bilateral Cleft Lip And Palate In A University Hospital Setting-A Retrospective Study

2020 ◽  
Vol 11 (SPL3) ◽  
pp. 363-367
Author(s):  
Monisha K ◽  
Senthil Murugan P ◽  
Aravind Kumar
Keyword(s):  
Cleft Palate ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Hospital Setting ◽  
Neck Region ◽  
University Hospital ◽  
High Prevalence ◽  
Bilateral Cleft Lip ◽  
Male Patients ◽  
One Year

Cleft lip and palate (CLP) is one of the most prevalent malformations occurring in the head and neck region. Cleft lip and palate is the second most birth defect in the US after club foot. The incidence of Cleft lip and cleft palate is also very common in Indian Population with the rate of 1 in 700 births approximately. In India, the main reason for the formation of Cleft Lip and cleft palate is consanguineous marriage due to less awareness among people. Cleft lip can be unilateral or bilateral and may involve or palate. Again it can be further classified as Complete or Incomplete cleft lip and /or Cleft palate. Most of the patients were deprived of treatment, mainly due to their unawareness and their lower status. Cleft patients need comprehensive, cleft care management. So the aim of this study is to find the incidence of bilateral cleft lip or palate in patients who reported toSaveetha Dental College and Hospital, Chennai. This study is done with 76 patients40 males, 36 females)who visited a Saveetha Dental College during one year between June 2019-April 2020. All available data were extracted from patients case sheets and results were obtained through SPSS analysis. In this study, we observed that 90.5 % of patients reported with unilateral cleft lip and palate, where only 9.1% of patients reported with bilateral cases. Males were having high prevalence with 52.6 % and females 47.4%. conclusion, male patients had higher cleft lip and palate compared to females. The incidence of bilateral cases seen among cleft lip and palate is fewer in males.

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