Sucking Performance of Babies with Cleft Conditions

2007 ◽  
Vol 44 (3) ◽  
pp. 312-320 ◽  
Author(s):  
Julie Reid ◽  
Sheena Reilly ◽  
Nicky Kilpatrick
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Management Strategies ◽  
Bottle Feeding ◽  
Group Differences ◽  
Feeding Management ◽  
Ability Groups ◽  
Pressure Changes ◽  
Changes Over Time ◽  
Over Time

Objective: To describe the sucking performance of bottle-fed babies with cleft conditions. Participants: Forty 2-week-old-babies with cleft lip (CL; n = 8), cleft palate (CP; n = 22), and cleft lip and palate (CLP; n = 10) were examined. Methods: Suction, compression, and other sucking parameters were measured during bottle-feeding and compared to determine if they varied with cleft condition or feeding ability. Results: All babies with CL and one with CLP demonstrated suction. Thirteen of 22 babies with CP demonstrated suction but only three maintained regular pressure changes over time. Between-group differences in the amplitude of suction and compression were associated with cleft condition. Cleft lip participants demonstrated the greatest amplitude of suction followed by those with CP and CLP. Cleft lip and CP participants generated similar amplitudes of compression. This was greater than their counterparts with CLP. Good feeders (n = 15) generated high levels of suction, while satisfactory (n = 15) and poor feeders (n = 10) did not generate any during bottle-feeding. Conclusion: Between-group differences in intra-oral pressures were confirmed when babies were examined by cleft condition. Babies with smaller clefts (i.e., CL or minor soft palate clefts) were more likely to generate normal levels of suction and compression compared to their counterparts with larger clefts. Since good feeders were more likely to have smaller clefts it was not surprising that they demonstrated higher suction pressures than babies with satisfactory or poor feeding ability. Compression values were not significantly different across the feeding ability groups. These data may inform feeding management strategies.

Outcome assessment in cleft lip and palate surgery

2021 ◽  
pp. 761-766
Author(s):  
Marc C. Swan ◽  
Conrad J. Harrison ◽  
Tim E.E. Goodacre
Keyword(s):  
Outcome Assessment ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Outcome Evaluation ◽  
Future Trends ◽  
Facial Growth ◽  
Patient Reported ◽  
Patient Reported Measures ◽  
High Degree ◽  
Over Time

Outcome assessment for cleft management is complex due to the diverse elements of function affected by the condition, and the variation in effect on patients over time. Methods of assessment are broadly separated into objectively measurable variables that can be independently validated, and patient-reported measures that are necessarily more subjective. Validated tools to evaluate outcomes are now widely adopted for speech and facial growth, with other areas of outcome presenting greater problems in development of suitable measures. In recent years, the emphasis of outcome evaluation has turned towards greater reliance on patient-reported measures that require extensive preliminary research to develop if a high degree of validity is to be ensured. Existing outcome measures that are widely used are described in this chapter, along with a perspective for future trends and a forthcoming internationally applicable tool for comparative studies (ICHOM).

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.

Tracking the development of co-management: using network analysis in a case from the Canadian Arctic

Polar Record ◽  
2014 ◽  
Vol 51 (4) ◽  
pp. 422-431 ◽  
Author(s):  
John-Erik Kocho-Schellenberg ◽  
Fikret Berkes
Keyword(s):  
Network Analysis ◽  
Management Strategies ◽  
Land Claims ◽  
Joint Management ◽  
Management Processes ◽  
Functional Problem ◽  
Changes Over Time ◽  
Over Time ◽  
Indigenous Land

ABSTRACTTo understand the interplay of factors that shape changes in management strategies, we tracked the evolution of beluga whale co-management involving the Department of Fisheries and Oceans Canada, the Fisheries Joint Management Committee (FJMC), and the Tuktoyaktuk Hunter and Trapper Committee from its beginnings in the mid-1980s to the present. The objective was to analyse changes over time in the communication network involved in dealing with the Husky Lakes beluga entrapment issue, using social network analysis (SNA). Along with qualitative information, the use of SNA provided quantitative data to document the development of co-management over time. According to both government and indigenous parties, a fully functional problem-solving partnership developed over the course of two decades. Using the beluga case as the illustration, we traced the development of joint management processes, overcoming some of the initial obstacles and accommodating the needs of the various parties. This case demonstrates the importance of legal arrangements (the indigenous land claims agreement), the role of key individuals and the bridging organisation (FJMC) created by the agreement, and the maturation of co-management over time.

Clinical study: Changes in interface pressure and stump shape over time: Preliminary results from a transtibial amputee subject

2000 ◽  
Vol 24 (2) ◽  
pp. 163-168 ◽  
Author(s):  
J. E. Sanders ◽  
J. M. Greve ◽  
C. Clinton ◽  
B. J. Hafner
Keyword(s):  
Clinical Study ◽  
Soft Tissue ◽  
Interface Pressure ◽  
Preliminary Results ◽  
Tissue Identification ◽  
Pressure Changes ◽  
Interface Pressures ◽  
Changes Over Time ◽  
Over Time ◽  
Increased Pressure

Interface stresses and stump shape were measured during sessions over a twomonth interval on a transtibial amputee subject. Results from thirteen transducer sites monitored during four sessions showed greater interface pressure changes over time at anterior sites than at lateral or posterior locations. There was a trend of decreased pressure with stump swelling and increased pressure for stump atrophy. During one session in which stump shape was monitored over a 23.1 min interval after ambulation, stump swelling was localised. Swelling tended to increase in the regions of initial enlargement, as opposed to redistributing through different areas over time. Regions of swelling were anterior lateral and posterior proximal, areas of thick underlying soft tissue. Identification of localised areas of swelling and atrophy and understanding of their effects on interface pressures could be used to improve individual socket design.

The Prevalence of Anomalies of the Upper Cervical Vertebrae in Subjects with Cleft Lip, Cleft Palate, or Both

2001 ◽  
Vol 38 (5) ◽  
pp. 498-503 ◽  
Author(s):  
Dilek A. Uğar ◽  
Gunvor Semb
Keyword(s):  
Cleft Palate ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Cervical Vertebrae ◽  
Group Differences ◽  
Posterior Arch ◽  
Retrospective Comparison ◽  
Upper Cervical ◽  
Vertebral Anomalies ◽  
University Of Oslo

Objective: The purpose of this study was to examine the prevalence of cervical vertebral anomalies in individuals with cleft palate only (CPO) and bilateral (BCLP) and unilateral (UCLP) complete cleft lip and palate and make a comparison with a group without cleft. Setting: This retrospective comparison was performed at the Dental Unit, Department of Plastic Surgery, National Hospital and at the Department of Orthodontics, Faculty of Dentistry, University of Oslo, Oslo, Norway. Material and Methods: Six hundred eleven subjects (334 boys, 277 girls) with three different cleft subtypes at age 6 years or older and 264 children (121 boys, 143 girls) without clefts were included in this study. Their lateral cephalometric radiographs were studied for cervical vertebral anomalies and categorized into posterior arch deficiencies or fusions. Results: In the total cleft sample, 111 subjects (18.2%) had cervical vertebral anomalies; of these, 10 subjects had more than one anomaly. Posterior arch deficiency was found in 7.7% and fusions in 12.1%. In the sample without cleft, 9.1% had cervical vertebral anomalies, 5% posterior arch deficiency, and 4.1% fusions. When the cleft sample was divided into the three cleft subtypes, the prevalence of cervical vertebral anomalies was 25.6% in the CPO group, 16.3% in the BCLP group, and 11.1% in the UCLP group. Differences were statistically significant between the CPO and the group without cleft for both posterior arch deficiency and fusion anomalies (p < .01). Conclusion: Cervical vertebral anomalies occur more frequently in individuals with clefts as compared with those without clefts. This was statistically significant for the CPO group.

Reliability and Predictive Validity of Dental Arch Relationships Using the 5-Year-Olds’ Index and the GOSLON Yardstick to Determine Facial Growth

2020 ◽  
pp. 105566562096097
Author(s):  
Marie Pegelow ◽  
Sara Rizell ◽  
Agneta Karsten ◽  
Hans Mark ◽  
Jan Lilja ◽  
...  
Keyword(s):  
Predictive Validity ◽  
Predictive Value ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Age Groups ◽  
Dental Arch ◽  
Facial Growth ◽  
Prediction Rate ◽  
Group 3 ◽  
Over Time

Aims: To determine reliability and predictive validity of the 5-year-olds’(5YO) Index and GOSLON Yardstick in 119 patients born with unilateral cleft lip and palate at 5, 7/8, 10, 15/16, and 19 years. Methods: Five hundred thirty-four dental study models were appraised by 2 teams in 2 centers, twice in each center. Intrateam and interteam reliability in scoring the models was calculated using κ. Dental arch prediction rates were calculated as the proportion of models remaining in the same category (good–scores 1 and 2; fair–score 3; poor–scores 4 and 5) over time. Results: Intrateam and interteam κ statistics ranged from 0.74 to 0.89 and from 0.74 to 0.81, respectively. The 5YO Index and GOSLON Yardstick at 5 years produced almost identical results. The prediction rate of 19-year-old (n = 106) outcome was >80% for those in groups 1 and 2 at 5 years, while for those in groups 4 and 5 prediction was poor (<40%). Prediction of groups 4 and 5 remained poor until 10 years when it increased to 77%. At 15/16 years prediction rate was 93% for those in groups 4 and 5. Prediction of cases in group 3 was very poor at all ages. Conclusions: These results question the predictive value of “poor” dental arch relationships before 10 years of age. However, the predictive value of “good” dental arch relationship scores over time is good in all age groups. This has implications for audit policies to predict facial growth outcomes.

Infant Orthopedics in UCLP: Effect on Feeding, Weight, and Length: A Randomized Clinical Trial (Dutchcleft)

2005 ◽  
Vol 42 (2) ◽  
pp. 171-177 ◽  
Author(s):  
Charlotte Prahl ◽  
Anne M. Kuijpers-Jagtman ◽  
Martin A. Van't Hof ◽  
Birte Prahl-Andersen
Keyword(s):  
The Netherlands ◽  
Cleft Palate ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Controlled Trial ◽  
Bottle Feeding ◽  
Mean Values ◽  
Z Scores ◽  
Infant Orthopedics ◽  
Weight For Age

Objective To study the effects of infant orthopedics (IO) on feeding, weight, and length. Design Prospective two-arm randomized controlled trial in three academic Cleft Palate Centers. Treatment allocation was concealed and performed by means of a computerized balanced allocation method. Setting Cleft Palate Centers of Amsterdam, Nijmegen, and Rotterdam, the Netherlands. Patients Infants with complete unilateral cleft lip and palate (UCLP), no other malformations. Interventions One group (IO+) wore passive maxillary plates during the first year of life, but the other group (IO−) did not. All other interventions were the same for both groups. Main Outcome Measures Bottle feeding velocity (mL/min) at intake, 3, 6, 15, and 24 weeks (T0 to T24); weight-for-age, length-for-age, and weight-for-length using z scores; reference values from the Netherlands’ third nationwide survey on growth. Results Feeding velocity increased with time from 2.9 to 13.2 mL/min in the IO− group and from 2.6 to 13.8 mL/min in the IO+ group; no significant differences were found between groups. Weight-for-age, length-for-age, and weight-for-length (z scores) did not differ significantly between groups, but overall the infants with unilateral cleft lip and palate in both groups had significantly lower mean z scores for weight-for-age and height-for-age than the reference during the first 14 months, and had lower mean values for weight-for-length after soft palate closure. Conclusion Infant orthopedics with the aim of improving feeding and consequent nutritional status in infants with unilateral cleft lip and palate can be abandoned.

Are Infants with Orofacial Clefts at Risk for Insecure Mother-Child Attachments?

2000 ◽  
Vol 37 (3) ◽  
pp. 257-265 ◽  
Author(s):  
Catherine L. Maris ◽  
Marya C. Endriga ◽  
Matthew L. Speltz ◽  
Karen Jones ◽  
Michelle Deklyen
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Attachment Security ◽  
Comparison Group ◽  
Diagnostic Group ◽  
Group Differences ◽  
Attachment Behavior ◽  
Orofacial Clefts ◽  
Strange Situation ◽  
Previous Theory

Objective Several risk factors in the early lives of children with clefts are believed to interfere with their development of secure attachments to parents; however, this possibility has rarely been studied empirically. This study compared 12- and 24-month attachment classifications of infants with cleft palate (CP), infants with cleft lip and palate (CLP), and a comparison group of unimpaired infants (COMP). Method Twenty-two CP infants, 24 CLP infants, and 61 matched COMP infants were assessed at 12 and 24 months of age in an urban children's hospital. At both visits, mothers and infants participated in the Strange Situation, which was videotaped and subsequently coded for patterns of attachment behavior. Results CP infants displayed a lower rate of 12-month attachment security than infants in the CLP or COMP groups. By 24 months, no diagnostic group differences in attachment classification were found. Stable 12- to 24-month attachment classifications were less likely in the CP group (36.3%) than in the COMP (62.3%) group. CP infants who were insecure at 12 months were more likely to become secure by 24 months than were CLP or COMP group infants. Conclusions In contrast to previous theory and clinical speculation, the facial appearance of infants with CLP does not appear to affect the early mother-infant relationship adversely. The infancy period is marked by attachment instability for infants with CP, who demonstrated lower-than-expected rates of security at 12 months. However, these problems resolved in nearly all cases by 24 months of age. Most infants with clefts emerged from the first 2 years of life with secure maternal attachments.

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