Presurgical Orthopedics and Satisfaction in Motherhood: A Randomized Clinical Trial (dutchcleft)

2008 ◽  
Vol 45 (3) ◽  
pp. 284-288 ◽  
Author(s):  
Charlotte Prahl ◽  
Birte Prahl-Andersen ◽  
Martin A. Van't Hof ◽  
Anne M. Kuijpers-Jagtman
Keyword(s):  
Cleft Palate ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Controlled Trial ◽  
First Year ◽  
Balanced Allocation ◽  
The Individual ◽  
First Year Of Life ◽  
Presurgical Orthopedics ◽  
Infant Orthopedics

Objective: To study the effect of infant orthopedics on satisfaction in motherhood. Design: Prospective two-arm randomized controlled trial in parallel with three participating academic cleft palate centers. Treatment allocation was concealed and was performed by means of a computerized balanced allocation method. Setting: Cleft palate centers of Amsterdam, Nijmegen, and Rotterdam, the Netherlands. Patients: Two groups of infants with complete unilateral cleft lip and palate and no other malformations. Interventions: Group IO+ (n  =  27) wore passive maxillary plates during the first year of life, group IO− (n  =  27) did not. Main Outcome Measure(s): Mean satisfaction scores were obtained from completed questionnaires at 6, 24, and 58 weeks of age. A 4-point scale was used (1  =  very satisfactory to 4  =  very unsatisfactory). Results: The range of the mean scores for the individual items on the questionnaires for both groups ranged between 1.1 and 2.4. No differences were found between groups. Mothers appear to be satisfied in motherhood, least satisfied with the available time for themselves, and very satisfied with hugging and walking their babies. No differences were found between groups. Conclusions: Results from the present study show that infant orthopedics, with a passive plate during the first year of life, in children with a unilateral cleft lip and palate has no influence on the mothers’ satisfaction in motherhood.

Infant Orthopedics and Facial Appearance: A Randomized Clinical Trial (Dutchcleft)

2006 ◽  
Vol 43 (6) ◽  
pp. 659-664 ◽  
Author(s):  
Charlotte Prahl ◽  
Birte Prahl-Andersen ◽  
Martin A. van't Hof ◽  
Anne M. Kuijpers-Jagtman
Keyword(s):  
Cleft Palate ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Controlled Trial ◽  
First Year ◽  
Facial Appearance ◽  
Visual Analog Scales ◽  
Z Scores ◽  
Full Face ◽  
Infant Orthopedics

Objective: To study the effect of infant orthopedics on facial appearance. Design: Prospective two-arm randomized controlled trial in parallel with three participating 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, no other malformations. Interventions: One group (IO+) wore passive maxillary plates during the first year, the other group (IO−) did not. Main Outcome Measure(s): Two metrical response modalities were used (i.e., visual analog scales and reference scores) to score facial appearance. Full face and cropped photographs were compared with reference photographs and were judged. The photographs were judged by 45 judges, 24 laypeople, and 21 professionals. Transformation of the scores into z scores was applied to compare and to pool both response modalities. The validity of each individual judge was evaluated, as was the reliability of the scales. Differences between the treatment groups were evaluated by means of t tests. Results: Photographs were available of 41 subjects, 21 with and 20 without infant orthopedics. No significant differences were found between groups. Mean z-score values for the full-face photographs were: group IO+ = 0.10 (SD = 0.73) and group IO− = −0.03 (SD = 0.48); for the cropped photographs were: group IO+ = 0.12 (SD = 0.71) and group IO− = −0.06 (SD = 0.55). Conclusions: Infant orthopedics have no effect on facial appearance.

A Randomized Prospective Clinical Trial of the Effect of Infant Orthopedics in Unilateral Cleft Lip and Palate: Prevention of Collapse of the Alveolar Segments (Dutchcleft)

2003 ◽  
Vol 40 (4) ◽  
pp. 337-342 ◽  
Author(s):  
Charlotte Prahl ◽  
Anne M. Kuijpers-Jagtman ◽  
Martin A. van't Hof ◽  
Birte Prahl-Andersen
Keyword(s):  
Cleft Palate ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Controlled Trial ◽  
Significant Group ◽  
Arch Form ◽  
Arch Forms ◽  
First Year Of Life ◽  
Infant Orthopedics ◽  
Maxillary Arch

Objective To study the effect of infant orthopedics (IO) on maxillary arch form and position of the alveolar segments. Design Prospective two-arm randomized, controlled trial in parallel with three participating academic cleft palate centers. Treatment was assigned by means of a computerized balanced allocation method. Setting Cleft palate centers of Amsterdam, Nijmegen, and Rotterdam, the Netherlands. Patients, Participants Infants with complete unilateral cleft lip and palate and no other malformations. Interventions One group (IO+) wore passive maxillary plates during the first year of life; the other group (IO−) did not. All other interventions were the same. Main Outcome Measure(s) The presence of contact and/or overlap (collapse) between the maxillary segments at maxillary casts made shortly after birth, at 15, 24, 48, 58, and 78 weeks. Survival experience of contact and collapse with time as well as the frequencies of different arch forms and severity of collapse were evaluated. Results Comparable arch forms with no contact or overlap of the maxillary segments were seen at birth in both groups. With time the frequency of collapse increased, with no significant differences between groups. No significant group differences were found with respect to the survival experience of contact and collapse or for the severity of collapse at the end of the observational period. Conclusions Infant orthopedics does not prevent collapse and can be abandoned as a tool to improve maxillary arch form.

Hospitalization, Breast-Milk Feeding, and Growth in Infants with Cleft Palate and Cleft Lip and Palate Born in Denmark

2008 ◽  
Vol 45 (6) ◽  
pp. 628-632 ◽  
Author(s):  
Lisa H. V. Smedegaard ◽  
Dorthe R. N. Marxen ◽  
Jette H. V. Moes ◽  
Eva N. Glassou ◽  
Cand Scientsan
Keyword(s):  
Breast Milk ◽  
Cleft Palate ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
First Year ◽  
Health Visitors ◽  
Facial Clefts ◽  
Growth References ◽  
First Year Of Life ◽  
Milk Feeding

Objective: To evaluate if the duration of postpartum hospitalization, duration of breast-milk feeding, and growth during the first year of life in infants with cleft lip and palate (CLP) and cleft palate (CP) are comparable to infants without facial clefts. Design: Prospective data collection using a registration chart developed by the authors. Setting: Special health care of infants with CLP/CP born in Denmark. Participants: All mature infants with CLP/CP born in 2003 and 2004 were included. Of 165 infants, 115 participated in the study. Intervention: In Denmark, parents of children with CLP/CP receive counseling. This counseling is managed by specially trained health visitors/nurses and is initiated at birth. The counseling seeks to support parents’ confidence in having an infant with CLP/CP and to initiate a relationship between the infant and the parents. Main Outcome Measures: Duration of postpartum hospitalization, duration of breast-milk feeding, and weight and length at birth, 5 months of age, and 12 months of age. Results: Hospitalization was 4 days and comparable to that of infants without CLP/CP. The infants with CLP/CP received breast milk but for a shorter period compared with infants without CLP/CP. Weights at birth, 5 months of age, and 12 months of age were identical with Danish growth references. Conclusion: The authors find the results satisfactory and believe that the counseling provided by the health visitors/nurses plays a part in the results.

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.

scholarly journals Language Skills of Young Children with Unilateral Cleft Lip and Palate following Infant Orthopedics: A Randomized Clinical Trial

2003 ◽  
Vol 40 (4) ◽  
pp. 356-362 ◽  
Author(s):  
Emmy M. Konst ◽  
Toni Rietveld ◽  
Herman F. M. Peters ◽  
Anne Marie Kuijpers-Jagtman
Keyword(s):  
Clinical Trial ◽  
Language Development ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Language Skills ◽  
Expressive Language ◽  
Receptive Language ◽  
First Year ◽  
First Year Of Life ◽  
Infant Orthopedics

Objective To investigate the effects of infant orthopedics (IO) on the language skills of children with complete unilateral cleft lip and palate (UCLP). Design In a prospective randomized clinical trial (Dutchcleft), two groups of children with complete UCLP were followed up longitudinally: one group was treated with IO based on a modified Zurich approach in the first year of life (IO group); the other group did not receive this treatment (non-IO group). At the ages of 2, 2½, 3, and 6 years, language development was evaluated in 12 children (six IO and six non-IO). Receptive language skills were assessed using the Reynell test. Expressive language skills of the toddlers were evaluated by calculating mean length of utterance (MLU) and mean length of longest utterances (MLLU); in the 6-year-olds, the expressive language skills were measured using standardized Dutch language tests. Patients The participants had complete UCLP without soft tissue bands or other malformations. Results IO did not affect the receptive language skills. However, the expressive language measures MLU and MLLU were influenced by IO. At age 2½ and 3 years, the IO group produced longer utterances than the non-IO group. In the follow-up, the difference in expressive language between the two groups was no longer significant. Conclusions Children treated with IO during their first year of life produced longer sentences than non-IO children at the ages of 2½ and 3 years. At 6 years of age, both groups presented similar expressive language skills. Hence, IO treatment did not have long-lasting effects on language development.

scholarly journals Weight Gain in Children with Cleft Lip and Palate without Use of Palatal Plates

2012 ◽  
Vol 2012 ◽  
pp. 1-4 ◽  
Author(s):  
Renato da Silva Freitas ◽  
Andrey Bernardo Lopes-Grego ◽  
Helena Luiza Douat Dietrich ◽  
Natacha Regina de Moraes Cerchiari ◽  
Tabatha Nakakogue ◽  
...  
Keyword(s):  
Weight Gain ◽  
Cleft Palate ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
World Health ◽  
First Year ◽  
Average Weight ◽  
Syndromic Diagnosis ◽  
Health Organization ◽  
First Year Of Life

Goals/Background. To evaluate children’s growth in the first year of life, who have cleft palate and lip, without the use of palatal plates. Materials/Method. Chart review was conducted, retrospectively, in the Center for Integral Assistance of Cleft Lip and Palate (CAIF), in Brazil, between 2008 and 2009. Results for both genders were compared to the data published by the World Health Organization (WHO) regarding average weight gain in children during their first year of life. Results. Patients with syndromic diagnosis and with cleft classified as preforamen were excluded, resulting in a final number of 112 patients: 56 male and 56 female. Similar patterns were seen comparing the two genders. Although it was observed weight gain below the average until the 11th month in male patients and until 9 months in female patients, both genders remained at the 50th percentile (p50) and improved after the 4th month of age for boys and the 9th month of age for girls. Conclusion. Children with cleft palate weigh less than regular children during their first months of life. At the end of the first year, weight gain is similar comparing normal and affected children. However, factors that optimized weight gain included choosing the best treatment for each case, proper guidance, and multiprofessional integrated care.

scholarly journals Phonological Development of Toddlers with Unilateral Cleft Lip and Palate who were treated with and without Infant Orthopedics: A Randomized Clinical Trial

2003 ◽  
Vol 40 (1) ◽  
pp. 32-39 ◽  
Author(s):  
Emmy M. Konst ◽  
Toni Rietveld ◽  
Herman F.M. Peters ◽  
Birte Prahl-Andersen
Keyword(s):  
Clinical Trial ◽  
Randomized Clinical Trial ◽  
Soft Palate ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
First Year ◽  
Phonological Development ◽  
Phonological Processes ◽  
First Year Of Life ◽  
Infant Orthopedics

Objective To investigate the phonological development of toddlers from 2 to 3 years of age with complete unilateral cleft lip and palate (UCLP) treated during the first year of life with and without infant orthopedics (IO). Design In a randomized clinical trial (Dutchcleft), two groups of children were followed up: one treated with IO (IO group) and another that did not receive IO (non-IO group). Phonological skills were analyzed at 2, 2.5, and 3 years of age using a system for assessing phonological development of Dutch children (Fonologische Analyse van het Nederlands: FAN). The analysis included number of acquired consonants, order of phonological development, use of phonological processes, and occurrence of nasal escape. Patients Criteria for inclusion were complete UCLP, no soft tissue bands, no other malformations, parents fluent in Dutch, birth weight of a minimum of 2500 g, and gestation time of a minimum of 38 weeks. Interventions IO treatment based on a modified Zurich approach was started within 2 weeks after birth and used until soft palate closure at 12 months of age. Children in the non-IO group visited the clinic for an extra check-up at 6 weeks as well as before and after lip repair and soft palate closure. All other interventions were the same across groups. Results Phonological development of most 2.5-year-old IO children was normal or delayed. Most children in the non-IO group followed an abnormal developmental pattern. At age 3, the children in the IO group had acquired more initial consonants. There were no group differences in the use of phonological processes or the occurrence of nasal escape. Conclusions Children treated with IO during their first year of life followed a more normal path of phonological development between 2 and 3 years of age.

Infant Orthopedics Has No Effect on Maxillary Arch Dimensions in the Deciduous Dentition of Children with Complete Unilateral Cleft Lip and Palate (Dutchcleft)

2006 ◽  
Vol 43 (6) ◽  
pp. 665-672 ◽  
Author(s):  
Catharina A. M. Bongaarts ◽  
Martin A. van't Hof ◽  
Birte Prahl-Andersen ◽  
Iris V. Dirks ◽  
Anne M. Kuijpers-Jagtman
Keyword(s):  
Cleft Palate ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Medical Center ◽  
Vertical Position ◽  
Controlled Clinical Trial ◽  
Deciduous Dentition ◽  
Surgical Closure ◽  
Infant Orthopedics ◽  
Maxillary Arch

Objective: Evaluation of the effect of infant orthopedics on maxillary arch dimensions in the deciduous dentition in patients with unilateral cleft lip and palate. Design: Prospective two-arm randomized controlled clinical trial with three participating cleft palate centers. Setting: Cleft palate centers of the Radboud University Nijmegen Medical Center, Academic Center of Dentistry Amsterdam, and University Medical Center Rotterdam, the Netherlands. Patients: Children with complete unilateral cleft lip and palate (n = 54) were included. Interventions: Patients were randomly divided into two groups. Half of the patients (IO+) had a presurgical orthopedic plate until surgical closure of the soft palate at the age of 52 weeks; the other half (IO−) did not undergo presurgical orthopedics. Mean outcome measures: Maxillary arch dimensions were assessed on dental casts at 4 and 6 years of age with measurements for arch width, arch depth, arch length, arch form, and the vertical position of the lesser segment. Contact and collapse were assessed also. Results: There were no clinically significant differences found between IO+ and IO− for any of the variables. Conclusions: Infant orthopedics had no observable effect on the maxillary arch dimensions or on the contact and collapse scores in the deciduous dentition at the ages of 4 and 6 years. Considering the Dutchcleft results to date, there is no need to perform infant orthopedics for unilateral cleft lip and palate patients.

Treatment Outcome after One-Stage Repair in Children with Complete Unilateral Cleft Lip and Palate Assessed with the Goslon Yardstick

2009 ◽  
Vol 46 (4) ◽  
pp. 374-380 ◽  
Author(s):  
Piotr Fudalej ◽  
Maria Hortis-Dzierzbicka ◽  
Barbara Obloj ◽  
Dorota Miller-Drabikowska ◽  
Zofia Dudkiewicz ◽  
...  
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Pearson Correlation ◽  
Interrater Agreement ◽  
Dental Arch ◽  
First Year ◽  
Kappa Statistics ◽  
One Stage ◽  
First Year Of Life ◽  
Plaster Models

Objective: To compare results of Golson Yardstick measurement of dental arch relationships in a sample of 10-year-old Polish children with results of the Golson measurement in published reports. Materials and Methods: Plaster models of 28 consecutively treated subjects with unilateral cleft lip and palate (UCLP) that was repaired with a one-stage simultaneous closure performed in the first year of life. All individuals were born between 1994 and 1995. The Goslon score (categories 1 to 5) was allocated. Intra- and interrater agreement was assessed with kappa statistics and Pearson correlation coefficient. Independent t tests were employed to detect difference between the score in the present and other published samples. Results: Mean Goslon score equaled 2.44; 57% of the patients were allocated Goslon category 1 or 2, 32% were rated Goslon 3, and 11% of the patients were assigned category 4 or 5. Intrarater agreement was between 0.75 and 0.77. Interrater agreement was 0.79. Conclusions: Dental arch relationship following one-stage repair was comparable with the results of the centers with the best outcome.

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