scholarly journals Oral Clefts and Academic Performance in Adolescence: The Impact of Anesthesia-Related Neurotoxicity, Timing of Surgery, and Type of Oral Clefts

2017 ◽  
Vol 54 (4) ◽  
pp. 371-380 ◽  
Author(s):  
Nicola G. Clausen ◽  
Dorthe A. Pedersen ◽  
Jacob K. Pedersen ◽  
Susanne E. Møller ◽  
Dorthe Grosen ◽  
...  
Keyword(s):  
Academic Performance ◽  
Cleft Palate ◽  
Birth Cohort ◽  
Cleft Lip ◽  
Ninth Grade ◽  
Mean Difference ◽  
Control Group ◽  
Oral Clefts ◽  
Oral Cleft ◽  
The Impact

Objective Early life exposure to anesthesia and surgery is suspected to associate with cognitive impairment later in life. We compared academic achievement among adolescents with cleft lip only (CL), cleft palate only (CP), and cleft lip and cleft palate (CLP) with a noncleft control group to investigate whether outcome depends on timing and number of operations during childhood and/or type of oral cleft. Design Nationwide register-based follow-up study. Setting Danish birth cohort 1986 to 1990. Participants Five hundred fifty-eight children with isolated CL (n = 171), CLP (n =222), or CP (n = 195), of which 509 children had been exposed to anesthesia and one or more cleft operation(s), and a 5% sample of the birth cohort (n = 14,677). Main Outcome Measure(s) Test score in the Danish standardized ninth-grade exam and proportion of nonattainment, defined as “results for ninth-grade exam unavailable.” Data adjusted for sex, birth weight, parental age, and parental level of education. Results Compared to controls, children with CL achieved higher scores (mean difference 0.12, 95% CI –0.05; 0.29) and children with CLP presented with lower scores (mean difference –0.06, 95% CI –0.21; 0.09), albeit both statistically insignificant. Children with CP achieved significantly lower scores, mean difference –0.20 (95% CI –0.38; –0.03). Odds ratios for nonattainment at final exam were: CL 0.79 (95% CI 0.46; 1.35), CLP 1.07 (95% CI 0.71; 1.61), CP 2.59 (95% CI 1.78; 3.76). Conclusions Oral cleft type rather than number and timing of anesthesia and operations associate to poorer academic performance. Although a potential neurotoxic effect due to anesthetic agents is not reflected in the data, it cannot be completely excluded.

scholarly journals Dental anomalies in the deciduous dentition of non-syndromic oral clefts patients

2020 ◽  
Vol 20 (1) ◽  
pp. 257-263
Author(s):  
Adriana Boeri Freire Tamburini ◽  
Ygor Henrique Pereira Rodrigues ◽  
Daniella Reis Barbosa Martelli ◽  
Letízia Monteiro de Barros ◽  
Rodrigo Soares de Andrade ◽  
...  
Keyword(s):  
Cleft Palate ◽  
Clinical Examination ◽  
Cleft Lip ◽  
Control Group ◽  
Case Group ◽  
Dental Anomalies ◽  
Deciduous Dentition ◽  
Oral Clefts ◽  
Healthy Control ◽  
Definition Of

Abstract Objectives: to investigate the prevalence of dental anomalies in complete deciduous dentition of children with NSCL/P. Methods: this study included 75 children with NSCL/P and 286 healthy control. In both groups the children had deciduous dentition with ages varying from 4 to 6 years. Clinical examination, panoramic and periapical radiographies were performed and dental anomalies of number and shape were considered. Results: there was a higher prevalence of dental anomalies in the case group, compared to the control group. In all, 42 dental anomalies were identified, 25.33% in the case group and 8.04% in control group (p<0.001). Therewas a higher frequency of dental anomalies in NSCL/P (47.36%), followed by non-syndromic cleft lip (31.57%) and non-syndromic cleft palate (21.05%). The occurrence of agenesis (p= 0.005) and twinning (p = 0.029) were higher in the case group. Conclusions: the occurrence of agenesis and dental twinning was more frequent in the case group and may contribute to the definition of oral cleft subphenotype.

Epidemiology of cleft lip with or without cleft palate in Thais

2017 ◽  
Vol 10 (4) ◽  
pp. 335-338 ◽  
Author(s):  
Rungnapa Ittiwut ◽  
Pichit Siriwan ◽  
Kanya Suphapeetiporn ◽  
Vorasuk Shotelersuk
Keyword(s):  
Family History ◽  
Cleft Palate ◽  
Cleft Lip ◽  
Epidemiological Studies ◽  
Retrospective Case ◽  
Oral Clefts ◽  
Oral Cleft ◽  
History Of ◽  
Maternal Consumption ◽  
Genetic And Environmental Factors

Abstract Background Oral clefts, including cleft lip (CL), CL with cleft palate (CL/CP), and cleft palate only (CPO), are among the most common birth defects, and if left untreated can cause significant morbidity. Causes are complex and involve both genetic and environmental factors. Several studies have demonstrated the highest prevalence of oral clefts being in Asian, white, and African populations. However, there have been very few epidemiological studies of oral clefts in Thais. Objectives To describe the epidemiology and factors associated with oral clefts in Thais. Methods This retrospective case-control observational study included individuals from numerous regions in Thailand. We reviewed data regarding 784 patients with an oral cleft collected in questionnaires as part of the Thai nationwide Smart Smile and Speech Project from 2006 to 2014. Data regarding patients with oral clefts were analyzed, and compared with data regarding 187 unaffected controls. Results Of 784 cases, CL/CP accounted for 59.8%, CPO 21.9%, and CL 18.3%. A family history of oral clefts was detected in all 3 types (P < 0.001). Maternal use of any drugs or herbal medicine not prescribed by physicians during pregnancy in cases of CPO (P = 0.049) and maternal consumption of alcohol during pregnancy in cases of CL/CP (P = 0.047) were significantly higher than that by mothers of controls. Conclusions CL/CP is the most common type of oral cleft. A family history of oral clefts, and maternal consumption of alcohol or nonprescribed drugs are positively associated with oral clefts in Thais.

scholarly journals Family Environment of Individuals with Oral Clefts in Argentina

2005 ◽  
Vol 42 (2) ◽  
pp. 185-191 ◽  
Author(s):  
Diego F. Wyszynski ◽  
Claudia Perandones ◽  
Patricia Yannibelli ◽  
Ricardo D. Bennun
Keyword(s):  
Cleft Palate ◽  
Social Environment ◽  
Family Environment ◽  
Cleft Lip ◽  
Family Relationship ◽  
Control Group ◽  
Oral Clefts ◽  
Recreational Activities ◽  
The Social ◽  
Different Types

Objective The purpose of this investigation was to study the social environment of families of children with different types of nonsyndromic oral clefts (OC) and to compare these groups with a control population of families of children without clefts. Design The study compared three nonsyndromic oral cleft groups and the control group using the Moos Family Environment Scale, which examines cohesion, expressiveness, conflict, independence, achievement-orientation, intellectual-cultural orientation, active-recreational orientation, moral-religious emphasis, organization, and control. Setting All parents of children with nonsyndromic oral clefts from a large craniofacial clinic in Buenos Aires, Argentina, were identified and were enrolled in this study between June 2000 and August 2001. Control families were ascertained from the pediatrics service of a hospital located in the vicinity of the craniofacial clinic. Participants One hundred and sixty-five parents were selected, based on having a child with nonsyndromic unilateral cleft lip with or without cleft palate (UCL/P), bilateral cleft lip with or without cleft palate (BCL/P), or isolated cleft palate (ICP). One hundred and eighty control parents with no family history of congenital anomalies were selected, as well. Results There was no major difference in the social environment of families of children with different types of nonsyndromic oral clefts. When compared with families in the control group, families of children with nonsyndromic oral clefts scored better in all three subdimensions of family relationship, revealed a high level of independence, and showed better structure and organization than control families did; however, families of children with nonsyndromic oral clefts reported participating in fewer recreational activities. Conclusions Overall, families of children with nonsyndromic oral clefts displayed a good social environment. Efforts should be focused to involve them in recreational activities.

An Epidemiologic Study of Oral Clefts in Iran: Analysis of 1669 Cases

2000 ◽  
Vol 37 (2) ◽  
pp. 191-196 ◽  
Author(s):  
Mohammad Hossain Rajabian ◽  
Mehdi Sherkat
Keyword(s):  
Cleft Palate ◽  
Cleft Lip ◽  
Epidemiologic Study ◽  
Maternity Hospital ◽  
Control Group ◽  
Normal Children ◽  
Cross Sectional ◽  
Oral Clefts ◽  
Genetic Features ◽  
Associated Malformations

Objective The objective of this study was to assess the epidemiology and some genetic aspects of oral clefting in Iran. Design The study was a 15-year cross-sectional (prevalence) study from August 1976 to September 1991. Setting The setting for the study was two plastic surgery departments, both mostly referral centers, and a maternity hospital in Iran. Participants The participants were 1669 consecutive surgical cases with oral clefts (79% between 1 day and 18 months of age), registered in two centers. In a parallel study, 19,369 livebirths born in a maternity hospital within the same period were surveyed to ascertain prevalence of clefting at birth. Normal children of this population were used as the control group. Samples were analyzed by prevalence of clefting at birth, type of oral cleft, side of clefting, sex ratio, associated malformations, clefts in relatives, and parental consanguinity. Results The prevalence of clefts was 1.03 per 1000 births. Cleft lip (without cleft palate) had a higher (34.9%) and cleft palate alone had a significantly lower prevalence (17.4%) than expected. Cleft lip (without cleft palate) was more common in females (53.6%) than in males (46.4%). The rate of associated malformations in cleft patients (7.73%) was higher than in controls (0.093%). Association between clefting and consanguinity was significant (45.8% in cases versus 43.1% in controls). Occurrence of noncleft congenital malformations among first-degree relatives of our cases (2.77%) was nearly two times that of controls (1.55%). Conclusion Our study reveals that the population incidence of oral clefts in Iran is much closer to Europian than Arab-African or South East Asian countries. However, significant variations in other epidemiologic and some genetic features were observed.

Maternal Cigarette Smoking and Oral Clefts: A Meta-analysis

1997 ◽  
Vol 34 (3) ◽  
pp. 206-210 ◽  
Author(s):  
Diego F. Wyszynski ◽  
David L. Duffy ◽  
Terri H. Beaty
Keyword(s):  
Cigarette Smoking ◽  
Cleft Palate ◽  
Cleft Lip ◽  
Meta Analysis ◽  
First Trimester ◽  
Case Control Studies ◽  
Oral Clefts ◽  
Oral Cleft ◽  
Maternal Cigarette Smoking ◽  
Increased Risk

Objective A meta-analysis was performed to estimate the association between maternal cigarette smoking and the risk of having a child with a nonsyndromic oral cleft (NSOC). Design Studies published from 1966 through 1996 were retrieved using MEDLINE, Current Contents, bibliographies, and other sources. MEDLINE and Current Contents search terms included “oral clefts,” “cigarette smoking,” “birth defects,” and “congenital malformations.” Cohort and case-control studies that enrolled oral cleft patients [cleft lip with or without cleft palate (CL/P), cleft palate (CP), or both] and controls, and presented information on maternal cigarette exposure during pregnancy were included in the analysis. Descriptive and outcome data from each study were independently abstracted by two authors. Results The overall odds ratio of the 11 studies satisfying criteria was 1.29 [95% confidence interval (CI), 1.18 to 1.42] for CL/P and 1.32 (95% CI: 1.10 to 1.62) for CP, Indicating a small increased risk of having a child with either a CL/P or a CP for mothers who smoke during the first trimester of the pregnancy. Conclusions These analyses suggest a small but statistically significant association between maternal cigarette smoking during the first trimester of gestation and increased risk of having a child with a CL/P or CP.

Structural Birth Defects Associated with Oral Clefts in Hawaii, 1986 to 2001

2006 ◽  
Vol 43 (3) ◽  
pp. 356-362 ◽  
Author(s):  
Mathias B. Forrester ◽  
Ruth D. Merz
Keyword(s):  
Cleft Palate ◽  
Birth Defects ◽  
Cleft Lip ◽  
Single Ventricle ◽  
Lower Limbs ◽  
Upper Limbs ◽  
Oral Clefts ◽  
Oral Cleft

Objective To identify structural birth defects that occur in association with oral clefts. Methods Data were obtained from a birth defects registry and included all infants and fetuses with cleft palate without cleft lip or cleft lip with or without cleft palate delivered from 1986 to 2001. For 47 specific structural birth defects, rates among oral cleft cases were compared with the rates among all infants and fetuses with major birth defects, excluding those with oral clefts. Results Among cleft palate only cases, the rates were significantly higher than expected for encephalocele, microcephaly, and syndactyly. Among cases of cleft lip with or without cleft palate, the rates were significantly higher than expected for anophthalmia/microphthalmia, single ventricle, reduction deformity of upper limbs, and reduction deformity of lower limbs. When cases of cleft palate only and cleft lip with or without cleft palate were compared as to the rates for particular birth defects, the rates of the defects were either higher or lower than expected in both oral cleft categories for 38 (81%) of the defects. Conclusions Certain birth defects were more frequently associated with oral clefts than might be expected. For the majority of defects, their patterns of association were similar between cleft palate without cleft lip and cleft lip with or without cleft palate.

Birth Prevalence of Oral Clefting in Northern Iran

2007 ◽  
Vol 44 (4) ◽  
pp. 378-380 ◽  
Author(s):  
Mohammad Jafar Golalipour ◽  
Arezo Mirfazeli ◽  
Naser Behnampour
Keyword(s):  
Cleft Palate ◽  
Cleft Lip ◽  
Birth Date ◽  
Northern Iran ◽  
Oral Clefts ◽  
Oral Cleft ◽  
Birth Prevalence ◽  
Parental Consanguinity ◽  
Live Births ◽  
Isolated Cleft Palate

Objective: To explore the prevalence of oral clefting in northern Iran. Setting: In the Dezyani hospital 37,951 live births from 1998 through 2003 were screened for oral clefts. Clinical and demographic factors of diagnosed cases, including birth date, ethnicity, type of oral cleft, parental consanguinity, and coexisting anomalies, were recorded for analysis. Results: The overall prevalence of oral clefting was 0.97 per 1000 live births. The prevalence of cleft lip with or without cleft palate and isolated cleft palate was 0.60 and 0.37 per 1000, respectively. The prevalence of oral clefting was 1.08 per 1000 male births and 0.86 per 1000 female births. With respect to parental ethnicity, the prevalence of oral clefting was 0.86, 0.88, and 1.47 per 1000 in Fars, Turkman, and Sistani, respectively. Conclusions: The prevalence of oral cleft among live births in the Dezyani hospital is similar to that reported in the previous studies for Iran and whites.

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.

Reduced Socioeconomic Disparities in Cleft Care After Implementing a Cleft Nurse Navigator Program

2021 ◽  
pp. 105566562110056
Author(s):  
Connor Wagner ◽  
Carrie E. Zimmerman ◽  
Carlos Barrero ◽  
Christopher L. Kalmar ◽  
Paris Butler ◽  
...  
Keyword(s):  
Cleft Palate ◽  
Cleft Lip ◽  
Care Center ◽  
Tertiary Care ◽  
Multidisciplinary Care ◽  
Socioeconomic Disparities ◽  
Outpatient Appointment ◽  
Nurse Navigator ◽  
Insured Patients ◽  
The Impact

Objective: To evaluate the impact of a Cleft Nurse Navigator (CNN) program on care for patients with cleft lip and cleft palate and assess the programs efficacy to reduce existing socioeconomic disparities in care. Design: Retrospective review and outcomes analysis (n = 739). Setting: Academic tertiary care center. Patients: All patients presenting with cleft lip and/or cleft palate (CL/P) born between May 2009 and November 2019 with exclusions for atypical clefts, submucous cleft palates, international adoption, and very late presentation (after 250 days of life). Interventions: Multidisciplinary care coordination program facilitated by the CNN. Main Outcome Measures: Patient age at first outpatient appointment and age at surgery, reported feeding issues, weight gain, and patient-cleft team communications. Results: After CNN implementation, median age at outpatient appointment decreased from 20 to 16 days ( P = .021), volume of patient-cleft team communications increased from 1.5 to 2.8 ( P < .001), and frequency of reported feeding concerns decreased (50% to 35%; P < .001). In the pre-CNN cohort, nonwhite and publicly insured patients experienced delays in first outpatient appointment ( P < .001), cleft lip repair ( P < .011), and cleft palate repair ( P < .019) compared to white and privately insured patients, respectively. In the post-CNN cohort, there were no significant differences in first appointment timing by race nor surgical timing on the basis of racial identity nor insurance type. Conclusions: A variety of factors lead to delays in cleft care for marginalized patient populations. These findings suggest that a CNN can reduce disparities of access and communication and improve early feeding in at-risk cohorts.

scholarly journals The impact of participation in genetic research for families with cleft lip with and without cleft palate: a qualitative study

2014 ◽  
Vol 5 (3) ◽  
pp. 249-256 ◽  
Author(s):  
Lynley J. Donoghue ◽  
Margaret A. Sahhar ◽  
Ravi Savarirayan ◽  
Supriya Raj ◽  
Nicky M. Kilpatrick ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Cleft Palate ◽  
Cleft Lip ◽  
Genetic Research ◽  
The Impact
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