Antenatal Transabdominal Ultrasound Detection of Cleft Lip and Palate in Western Australia from 1996 to 2003

2006 ◽  
Vol 43 (1) ◽  
pp. 61-66 ◽  
Author(s):  
M. Hanikeri ◽  
J. Savundra ◽  
D. Gillett ◽  
M. Walters ◽  
W. McBain
Keyword(s):  
Cleft Palate ◽  
Western Australia ◽  
Gestational Age ◽  
Detection Rate ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Patient Records ◽  
Antenatal Ultrasound ◽  
Bilateral Cleft Lip ◽  
Isolated Cleft Palate

Objective To determine the frequency of detection of cleft lip with or without cleft palate and isolated cleft palate from antenatal ultrasound examinations conducted on mothers of infants born with cleft lip and/or palate and isolated cleft palate in Western Australia from 1996 to 2003. Design Review of patient records and purpose-designed questionnaire sent to parents of children born with cleft lip and/or palate and isolated cleft palate. Results There were 308 infants born with cleft lip and/or palate and isolated cleft palate in the study period. Of the 293 parents, 218 responses were available for the study (70.7%), and 2.9 ± 1.8 SD antenatal ultrasound scans were performed on 216 women. No such scans were performed on two women. Cleft lip and/or palate was detected in 22.2% of cases. There was no detection prior to 15 weeks gestational age in the 137 women screened. Between 15 and 19 weeks gestational age, 174 scans detected 30 cases. Between 20 and 29 weeks gestational age, 84 scans detected 11 cases. Between 30 and 40 weeks gestational age, 66 scans detected 7 cases. The detection rate for bilateral cleft lip and/or palate was 44.4% and for unilateral cleft lip and/or palate, 40.6%. Detection rate for isolated cleft lip was 33.3%. Antenatal ultrasound failed to detect any infants with an isolated cleft palate (n = 95). The rate of detection of cleft lip and/or palate increased through the study period. Conclusions The rate of detection of cleft lip and/or palate in Western Australia is comparable to that for referral centers worldwide and is increasing. The rate of detection of the various types of cleft anomalies using antenatal ultrasound ranged from 0% to 44%.

Antenatal Ultrasound Detection of Cleft in Western Australia from 2003 to 2012: A Follow-Up Study

2017 ◽  
Vol 54 (3) ◽  
pp. 321-326
Author(s):  
W. Nicholls ◽  
R. Jennings ◽  
Y. Yeung ◽  
M. Walters ◽  
B. Hewitt
Keyword(s):  
Western Australia ◽  
Detection Rate ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Detection Rates ◽  
Oral Clefts ◽  
Princess Margaret Hospital ◽  
Antenatal Counseling ◽  
Antenatal Detection ◽  
Isolated Cleft Palate

Aim To investigate trends in the rate of antenatal detection of cleft lip and palate (CLP) patients referred to the CLP Unit at Princess Margaret Hospital for Children in Perth, Western Australia during the period 2003-2012 and compare data with a previously published report covering the years 1996-2003. Methods This is a single-center, retrospective survey of antenatal transabdominal ultrasound screenings of mothers of infants born between July 1, 2003 and June 30, 2012 that were referred to the CLP Unit at Princess Margaret Hospital. Results Detection rates of oral clefts increased significantly when compared with outcomes reported in the same population between 1996 and 2003 ( P < .05). An overall detection rate of 71.7% (165/230) was achieved for clefts involving lip and palate. Detection of isolated cleft palate (1/99) and microform (0/8) remained elusive. Most detections (76.5%) were achieved at 15 to 20 weeks of gestational age, corresponding with routine anatomical screening. A further 16.8% were detected post-20 weeks of gestation. Scans were performed by specialist obstetricians, and sonography clinics reported a detection rate of 84.6% (55/65), whereas nonspecialist clinics reported a detection rate of only 67.1% (110/164). Conclusion The antenatal detection rates of oral clefts involving the lip have improved to the extent that the majority of mothers are now being referred to a cleft unit in Western Australia prior to the births of their children. As a result of this improvement, antenatal counseling is now a common facet of cleft management.

scholarly journals Prenatal Diagnosis of Fetal Cleft Lip and Palate with Three-Dimensional Ultrasound Information Technology

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Xinglong Deng ◽  
Suhui He ◽  
Qiumei Wu ◽  
Zongjie Weng ◽  
Minmin Yang ◽  
...  
Keyword(s):  
Prenatal Diagnosis ◽  
Cleft Palate ◽  
Detection Rate ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Ultrasound Examination ◽  
Three Dimensional ◽  
Two Dimensional ◽  
Bilateral Cleft Lip ◽  
Cleft Lip Palate

Objective. To evaluate the three-dimensional ultrasound paper cleft lip and palate deformities in applications in prenatal diagnosis. Methods. 25 cases of cleft lip and palate fetus, 20–32 weeks of gestational age, with the maternal age of 22–44 years, were examined by prenatal ultrasound in our hospital; conventional two-dimensional ultrasound examination was performed after a cleft lip, and the application of three-dimensional ultrasound imaging surface and a transparent imaging showed the alveolar process and the palate of the fetus. Also, the results of two-dimensional ultrasound and postnatal (or after induction) results were compared. Results. Of the 25 cases, there were 6 cases of postpartum induction or simply unilateral cleft lip, 17 cases of unilateral cleft palate, and two cases of bilateral cleft lip palate. There was no significant ( P > 0.05 ) difference of two- and three-dimensional ultrasound detection rate of pure cleft lip; two-dimensional ultrasound cleft palate detection rate was 36.8% (7/19), and three-dimensional ultrasound cleft palate detection rate was 89.5% (17/19). The two methods showed a statistically significant ( P < 0.05 ) difference in the detection rate of cleft palate. Conclusion. Three-dimensional ultrasound can significantly improve the diagnostic accuracy of prenatal cleft palate.

Pharyngeal Flaps after One- and Two-stage Repair of the Cleft Palate: A 25-Year Review of 520 Patients

1995 ◽  
Vol 32 (3) ◽  
pp. 206-216 ◽  
Author(s):  
Sigfrid Vedung
Keyword(s):  
Cleft Palate ◽  
Surgical Procedure ◽  
Hard Palate ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Two Stage ◽  
One Stage ◽  
Bilateral Cleft Lip ◽  
Pharyngeal Flap ◽  
Isolated Cleft Palate

Between 1962 and 1976, a one-stage surgical procedure was performed on 328 cases of cleft lip and palate or isolated cleft palate. From 1977 to 1986, a two-stage surgical procedure was performed on 192 patients. After one-stage repair, 22 (6.7%) required a pharyngeal flap at the age of 6 years, and 13 (7%) required a flap after two-stage repair. When the patients were 14 years or older, 56 (17%) needed a flap after one-stage repair, and 14 (24%) required a flap after two-stage repair. Two-stage repair at 24 months and 5.2 years resulted in more patients in need of pharyngeal flaps than those who had repair at 12 to 18 months and 3 years. In both groups, at age 10, the incidence of flaps was approximately 20% after closure of isolated cleft palate involving the hard palate, with 11 to 12% in patients with unilateral cleft lip and palate (UCLP) or clefts of the soft palate only, and 14 to 16% in patients with bilateral cleft lip and palate (BCLP). The pharyngeal flap was more often used in girls than in boys, especially in cases with CP only. Approximately 85% of the flaps were carried out before the age of 10 years, and only a few flaps may have been related to involution of the adenoid. The incidence of fistulas was higher after one-stage repair of cleft lip and palate (CLP) (p < .05) and lower in patients with CP only (p < .05), compared with the results after two-stage repair. Pharyngeal flaps were slightly more common after two-stage repair. The possible advantages of two-stage repair in relationship to maxillary growth, which may justify the second operation, will be investigated when the patients are older.

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.

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

Orthodontic-Surgical Approach for Treating Skeletal Class III Malocclusion With Severe Maxillary Deficiency in Isolated Cleft Palate

2018 ◽  
Vol 56 (3) ◽  
pp. 400-407 ◽  
Author(s):  
Kohei Nakatsugawa ◽  
Hiroshi Kurosaka ◽  
Kiyomi Mihara ◽  
Susumu Tanaka ◽  
Tomonao Aikawa ◽  
...  
Keyword(s):  
Cleft Palate ◽  
Surgical Approach ◽  
Orthodontic Treatment ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Class Iii ◽  
Maxillary Expansion ◽  
Rapid Palatal Expansion ◽  
Isolated Cleft Palate ◽  
Maxillary Deficiency

Orthodontic treatment in patients with orofacial cleft such as cleft lip and palate or isolated cleft palate is challenging, especially when the patients exhibit severe maxillary growth retardation. To correct this deficiency, maxillary expansion and protraction can be performed in the first phase of orthodontic treatment. However, in some cases, the malocclusion cannot be corrected by these procedures, and thus, skeletal discrepancy remains when the patients are adolescents. These remaining problems occasionally require various orthognathic treatments according to the degree of the discrepancy. Here, we describe one case of a female with isolated cleft palate and hand malformation who exhibited severe maxillary deficiency until her adolescence and was treated with multiple orthognathic surgeries, including surgically assisted maxillary expansion (surgically assisted rapid palatal expansion), LeFort I osteotomy, and bilateral sagittal split osteotomy in order to correct severe skeletal discrepancy and malocclusion. The treatment resulted in balanced facial appearance and mutually protected occlusion with good stability. The purpose of this case report is to show the orthodontic treatment outcome of 1 patient who exhibited isolated cleft palate and subsequent severe skeletal deformities and malocclusion which was treated by an orthodontic-surgical approach.

Pattern of Cleft Lip and Palate in Hospital-Based Population in Saudi Arabia: Retrospective Study

2008 ◽  
Vol 45 (6) ◽  
pp. 592-596 ◽  
Author(s):  
Aziza Aljohar ◽  
Kandasamy Ravichandran ◽  
Shazia Subhani
Keyword(s):  
Saudi Arabia ◽  
Cleft Palate ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Tertiary Care ◽  
Positive Family History ◽  
Care Hospital ◽  
Associated Anomalies ◽  
Cleft Lip Palate ◽  
Isolated Cleft Palate

Objective: To report the patterns of cleft lip and/or cleft palate in Saudi Arabia from data collected at a tertiary care hospital. Design and Setting: King Faisal Specialist Hospital and Research Center, Riyadh. Patients: All the cleft lip and/or cleft palate patients registered in the Cleft Lip/Palate and Craniofacial Anomalies Registry from June 1999 to December 2005. Results: Retrospectively, 807 cases of cleft lip and/or palate were registered. There were 451 boys and 356 girls. Cleft lip and palate was more common (387) than isolated cleft palate (294) and isolated cleft lip (122). Boys predominated in cleft lip and palate and cleft lip; whereas, girls predominated in isolated cleft palate, with boy to girl ratios of 1.6:1, 1.2:1, and 0.9:1 for cleft lip and/or palate, isolated cleft lip, and isolated cleft palate, respectively. The Riyadh region had more cases (32.0%) than the Asir (15.6%) and Eastern (14.6%) regions. Parents of 439 individuals had consanguineous marriages. A positive family history of cleft was seen in 224 cases. Of 238 cases with associated anomalies, 91 had congenital heart disease. Of the children with isolated cleft palate, 40.5% had associated anomalies, whereas only 23.0% of the children with isolated cleft lip or cleft lip and palate had associated malformations. Conclusion: The pattern of cleft observed in this study does not differ significantly from those reported in the literature for Arab populations.

Birth weight and gestational age of newborns with cleft lip with or without cleft palate and with isolated cleft palate

2004 ◽  
Vol 27 (2) ◽  
pp. 185-190 ◽  
Author(s):  
Diego Wyszynski ◽  
Andrea Sarkozi ◽  
Peter Vargha ◽  
Andrew Czeizel
Keyword(s):  
Birth Weight ◽  
Cleft Palate ◽  
Gestational Age ◽  
Premature Birth ◽  
Cleft Lip ◽  
Very Low Birth Weight ◽  
Elevated Risk ◽  
Healthy Controls ◽  
Oral Clefts ◽  
Isolated Cleft Palate

The birth weight and gestational age of 1368 newborns with isolated cleft lip with or without cleft palate and 582 with isolated cleft palate were compared to those of matched healthy controls. The results indicate that fetuses with oral clefts are at elevated risk of having low and very low birth weight, but not of having a premature birth. Speculations on a relationship between these findings and the presence of oral clefts are presented.

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