Cranial Base in Newborns with Complete Cleft Lip and Palate: Radiographic Study

1995 ◽  
Vol 32 (3) ◽  
pp. 199-205 ◽  
Author(s):  
Kirsten Mølsted ◽  
Inger Kjær ◽  
Erik Dahl
Keyword(s):  
Temporal Bone ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Test Group ◽  
Cranial Base ◽  
Sphenoid Bone ◽  
Control Group ◽  
Petrous Portion ◽  
A Minor ◽  
Base Width

In a 1993 study, Mølsted and colleagues found an increased width of the sphenooccipital synchondrosis in newborns with complete clefts of the lip, alveolus, and palate compared with newborns with incomplete clefts. As the spheno-occipital synchondrosis represents remnants of the early chondrocranium that later ossifies and incorporates in the cranial base, it is possible that an inborn alteration, such as a deviant growth of cartilage, or a delayed maturation in the early development of the cartilaginous cranial base, can affect not only the length and the width of the cranial base, but also the petrous portion of the temporal bone and the nasal septum, as these structures also have a cartilaginous origin. The purpose of the present study was to measure the cranial base width, including the width of the maxilla, and to measure the bilateral angulation of the petrous portion of the temporal bone and the sphenoid bone in 3-month-old children with complete clefts and in 3-month-old children with an incomplete cleft of the lip, and to compare the two groups. Fifty-two children with complete clefts (CLP) without associated malformations comprised the test group. Forty-eight children with a minor, incomplete cleft lip (CL) constituted the control group. The results of the comparison showed marked differences between the CLP and CL groups. In the CLP children, the cranial base width and the bilateral angulation of the sphenoid bone increased. An increased angulation was also seen between left and right sides of the pars petrosa. Furthermore, increased maxillary width was found. This confirms that cleft lip and palate is not an isolated malformation localized to the jaws but a malformation, which also involves the cartilaginous cranial base.

Spheno-Occipital Synchondrosis in Three-Month-Old Children with Clefts of the Lip and Palate: A Radiographic Study

1993 ◽  
Vol 30 (6) ◽  
pp. 569-573 ◽  
Author(s):  
Kirsten Mølsted ◽  
Inger Kjaer ◽  
Erik Dahl
Keyword(s):  
Early Development ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Cranial Base ◽  
Radiographic Study ◽  
Superior Part ◽  
Growth Center ◽  
A Minor

The literature has been focused on differences in craniofacial form and dimension in cleft lip and palate patients. No attention has been given to possible alterations in the spheno-occipital synchondrosis although the synchondrosis is regarded as an important maturity and growth center. The purpose of the present investigation was to examine if the spheno-occipital synchondrosis in children born with major complete clefts differs on lateral radiographs from that of children born with minor incomplete clefts. Fifty-seven three-month-old children with complete clefts of the lip, alveolus and palate and 42 three-month-old children with minor incomplete clefts of the lip were included In the study. The results of the comparison showed that children with complete major clefts had a broader spheno-occlpltal synchondrosis compared to children with a minor incomplete cleft of the lip, and that the distance from the superior part of the synchondrosis to the sella point was shorter in children with complete clefts. These findings could be related to a defect or a delay in maturity in the early development of the cartilaginous cranial base in children with major clefts.

scholarly journals Horizontal and vertical maxillary osteotomy stability, in cleft lip and palate patients, using allogeneic bone graft

2013 ◽  
Vol 18 (5) ◽  
pp. 84-90 ◽  
Author(s):  
Kelston Ulbricht Gomes ◽  
Wilson Denis Benato Martins ◽  
Marina de Oliveira Ribas
Keyword(s):  
Bone Graft ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Test Group ◽  
Control Group ◽  
Cephalometric Analysis ◽  
Allogeneic Bone ◽  
Le Fort I Osteotomy ◽  
Le Fort ◽  
Le Fort I

OBJECTIVE: This study was carried out to evaluate maxillary stability after orthodontic-surgical treatment of patients with cleft lip and palate. Cephalometric analysis was applied to two different groups, with and without allogeneic bone graft. METHODS: The sample comprised 48 patients with cleft lip and palate. The test group comprised 25 patients who, after correction of maxillary position, received allogeneic bone graft at the gap created by Le Fort I osteotomy. The control group comprised 23 patients and its surgical procedures were similar to those applied to the test group, except for the use of bone graft. Manual cephalometric analysis and comparison between lateral teleradiographs, obtained at the preoperative phase, immediate postoperative phase and after a minimum period of six months, were carried out. RESULTS: An higher horizontal relapse was observed in the control group (p<0.05). There were no statistically significant differences in vertical relapses between test and control groups (p>0.05). CONCLUSION: The use of allogeneic bone graft in cleft lip and palate patients submitted to Le Fort I osteotomy contributed to increase postoperative stability when compared to surgeries without bone graft.

Nasopharyngeal Characteristics in Children with Cleft Lip and Palate

1992 ◽  
Vol 29 (3) ◽  
pp. 282-286 ◽  
Author(s):  
Zbyněk Šmahel ◽  
Iva Müllerova
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Middle Cranial Fossa ◽  
Cranial Base ◽  
The Body ◽  
Control Group ◽  
Normal Limits ◽  
Anterior Cranial Base ◽  
Adjacent Structures ◽  
Male Patients

Cephalometrlc assessment of the nasopharynx and its adjacent structures was carried out in two experimental groups of 5-year-old male patients with unilateral cleft lip and palate. The first group Included individuals who had not had surgery, and the second was comprised of Individuals who were at least 1 year post-palatoplasty with primary pharyngeal flap. They were compared with a control group of boys of comparable average age who did not have clefts. Both groups of patients with clefts showed a reduction of the nasopharyngeal bony framework related to the posterior position and decreased posterior height of the maxilla without hypertrophy of the adenoids. The smaller nasopharyngeal airway was consistent with the reduction of the size of the bony nasopharynx. There was shortening of the anterior cranial base located In the region of the middle cranial fossa. The height of the body of the sphenoid bone was reduced, but the angle of the cranial base was within normal limits.

Mandibular Morphology and Spatial Position following One-Stage Simultaneous Repair of Complete Unilateral Cleft Lip and Palate

2008 ◽  
Vol 45 (3) ◽  
pp. 272-277 ◽  
Author(s):  
Piotr Fudalej ◽  
Barbara Obloj ◽  
Zofia Dudkiewicz ◽  
Maria Hortis-Dzierzbicka
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Cranial Base ◽  
Spatial Position ◽  
Control Group ◽  
Gonial Angle ◽  
One Stage ◽  
Irregularity Index ◽  
Lateral Cephalograms ◽  
Mandibular Body

Objective: To assess mandibular structure and spatial position following one-stage simultaneous repair of the unilateral cleft lip and palate. Design: Forty boys and 17 girls with complete unilateral cleft lip and palate who underwent one-stage simultaneous repair of the cleft by the same surgeon at the age of 9.23 months (standard deviation  =  1.74) were selected. Lateral cephalograms taken at the age of approximately 10 years were analyzed and were compared with a sex- and age-matched control group that consisted of individuals with Angle Class I, no crossbite, positive overbite <5 mm, mild crowding (Incisor Irregularity Index <3.5 mm), and harmonious facial build. Results: No intergroup differences were demonstrated regarding structure of the cranial base. The mandible was found to be retruded and at a larger inclination to the cranial base as compared with controls. Both total mandibular length (ArGn) and length of the mandibular body were larger in the control group, at <2 mm. Height of the ramus and gonial angle were similar in both groups. Intergender comparison showed few significant differences in control subjects only (SN, SGo, and NMe variables). Conclusions: The mandible, following a one-stage simultaneous repair of cleft, was found to be retrusive, and the length of mandibular body was <2 mm shorter than that of the controls.

Craniofacial Morphology in Adult Patients with Unoperated Complete Bilateral Cleft Lip and Palate

1998 ◽  
Vol 35 (2) ◽  
pp. 111-119 ◽  
Author(s):  
Omar Gabriel Da Silva Filho ◽  
Rita De Cássia Moura Carvalho Lauris ◽  
Leopoldino Capelozza Filho ◽  
Gunvor Semb
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Cranial Base ◽  
Craniofacial Morphology ◽  
Striking Difference ◽  
Control Group ◽  
Gonial Angle ◽  
Face Height ◽  
Lateral Cephalograms ◽  
And Gender

Objective This report is a retrospective study that compares the craniofacial morphology of adult subjects with unoperated bilateral complete cleft lip and palate (BCLP) with that of a noncleft group. Methods The study was performed on standardized lateral cephalograms obtained at the Hospital for Research and Rehabilitation of Cleft Lip and Palate, University of São Paulo, Brazil. The research group consisted of 28 subjects (20 males, 8 females) with unoperated BCLP, ranging in age from 15 to 41 years. The control group was matched to the cleft group with regard to gender and age. The findings were analyzed on the basis of the two-way analysis of variance (ANOVA) for cleft and gender. Results The most striking difference between the groups was the extremely prominent premaxilla in the cleft group that gave the BCLP face a very convex profile. The mandible exhibited a vertical growth pattern that resulted in a steep mandibular plane, an obtuse gonial angle and a long lower face height. The posterior face height was reduced. The cranial base dimensions were smaller, but there was no difference in cranial base angulation. Conclusions These findings confirm that in subjects with unoperated BCLP, the initial characteristics of the cleft malformation persist during growth.

Vertical Facial Skeletal Asymmetry and Occlusal Cant Relationship in Patients With Unilateral Cleft Lip and Palate

2020 ◽  
pp. 105566562097457
Author(s):  
Bengisu Akarsu-Guven ◽  
Ezgi Atik ◽  
Hande Gorucu-Coskuner ◽  
Muge Aksu
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Pearson Correlation ◽  
Facial Asymmetry ◽  
Cranial Base ◽  
Control Group ◽  
Lower Face ◽  
Significant Difference ◽  
Angular Measurements ◽  
Cleft Lip Palate

Objective: To evaluate the maxillary and mandibular vertical skeletal asymmetries, and the correlation between these asymmetries and occlusal cant in patients with unilateral cleft lip–palate (UCLP). Methods: Anteroposterior radiographs of 25 patients with UCLP (UCLP group, mean age: 20.98 ± 4.88 years) and 25 subjects without cleft (control group, mean age: 19 ± 2.86 years) were included. Independent samples t test, Mann-Whitney U test and Pearson correlation analysis were performed based on linear and angular measurements. Results: Lower facial horizontal asymmetry did not show statistically significant difference between the UCLP and control groups. However, vertical asymmetry of (a) the lateral cranial base ( P = .014), (b) the nasomaxillary region ( P < .001), (c) the maxillary dentoalveolus ( P = .001), and (d) the lower face ( P = .038) were all found to be significantly greater in UCLP group. The occlusal cant angle was also significantly greater in patients with UCLP compared to the controls ( P = .016). While the occlusal cant angle was found to be correlated with the vertical asymmetry of the occlusal cant ( r = 0.931, P < .001), maxillary cant angle was found to be correlated with the vertical asymmetry of the maxillary dentoalveolus ( r = 0.655, P < .001). Conclusions: There was no correlation between the occlusal cant and the vertical and horizontal skeletal asymmetries. Vertical asymmetries of the lower face and the medial cranial base were negatively correlated with the horizontal lower facial asymmetry.

Examination of Craniofacial Morphology in Children with Unilateral Cleft Lip and Palate

1996 ◽  
Vol 33 (1) ◽  
pp. 32-36 ◽  
Author(s):  
Yildiz Öztürk ◽  
Nil Cura
Keyword(s):  
Orthodontic Treatment ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Cranial Base ◽  
Craniofacial Morphology ◽  
Control Group ◽  
Turkish Children ◽  
Gonial Angle ◽  
Facial Height ◽  
Mandibular Plane

Craniofacial morphology of children with and without clefts has been reported to differ because of a combination of factors including, morphogenetic pattern, adaptive changes, and lip and palate management. The purpose of this study was to make a cephalometric evaluation of possible differences in craniofacial morphology of Turkish children with and without unilateral cleft lip and palate (UCLP). Twenty UCLP children (7 girls, 13 boys) with a mean age of 10.75 years (SD = 2.58 years) were compared with a control group of children without UCLP, who were matched for age (mean = 10.64 years, SD = 2.58 years) and sex. No patient had received orthodontic treatment. Linear and angular variables were measured from tracings of lateral cephalometric radiographs and the resulting data were evaluated statistically. Compared with children in the control group, the children in the cleft palate group demonstrated a greater flattening of the cranial base, a more retrognathic and posteriorly inclined maxilla with decreased length, a larger mandibular plane and gonial angle, larger anterior facial height, and decreased posterior and upper-posterior facial heights.

Sri Lankan Cleft Lip and Palate Study Model Analysis: Clefts of the Secondary Palate

1993 ◽  
Vol 30 (2) ◽  
pp. 227-230 ◽  
Author(s):  
Andrew Mccance ◽  
David Roberts-Harry ◽  
Martyn Sherriff ◽  
Michael Mars ◽  
William J.B. Houston
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Model Analysis ◽  
Control Group ◽  
Tooth Size ◽  
Sri Lankan ◽  
Control Groups ◽  
Secondary Palate ◽  
Comparable Control ◽  
And Control

The study models of a group of adult Sri Lankan patients with clefts of the secondary palate were investigated. Tooth-size and arch-dimension comparisons were made with a comparable control group. Significant differences were found between the cleft and control groups in tooth sizes, chord lengths, and arch widths. The cleft group dimensions were generally smaller than those of the control group. Overjets were larger in the cleft group.

Oral Health-Related Quality of Life Among Sudanese Children Treated for Cleft Lip and Palate

2021 ◽  
pp. 105566562098769
Author(s):  
Mecheala Abbas Ali ◽  
Alwaleed Fadul Nasir ◽  
Shaza K. Abass
Keyword(s):  
Quality Of Life ◽  
Oral Health ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Control Group ◽  
Arabic Version ◽  
Health Related Quality ◽  
Related Quality ◽  
Health Related

Objective: This study compared the oral health-related quality of life (OHRQoL) among children with a cleft lip with or without a cleft palate (CL±P) and a group of their peers. The reliability of the Arabic version of the Child Oral Health Impact Profile Questionnaire (COHIP) was also assessed. Design: A cross-sectional study. Settings: Cleft clinic in a private dental college in Omdurman City, Sudan. Patients: In all, 75 children (mean age 11.3 ± 2.5 years) with a history of CL±P and a group of 150 school children without CL±P (mean age 11.4 ± 2.6 years). Main Outcome Measures: Overall and subscale scores on the Arabic version of the COHIP. Results: Test–retest reliability of COHIP in Arabic was high with an interclass correlation coefficient >0.8. Cronbach α value internal consistency was 0.8 for the total scale and between 0.7 and 0.8 for the subscales. The COHIP score was 89.41 ± 19.97 in children with CL±P and 122.82 ± 9.45 for the control group. Children with CL±P had significantly lower scores on the overall and all subscales when compared to children without CL±P ( P ≤ .001). Among the children with CL±P, there were no statistically significant differences on the COHIP based on age and/or gender ( P ≥ .05). Conclusions: Children with CL±P had a relatively high OHRQoL, which was lower than that of their peers without CL±P in both the overall scale and all subscales. Gender and age differences had no significant impact on the OHRQoL. The COHIP Arabic version showed appropriate reliability.

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.

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