Early Palatal Changes after Initial Palatal Surgery in Children with Cleft Lip and Palate

1996 ◽  
Vol 33 (2) ◽  
pp. 104-111 ◽  
Author(s):  
Gem J.C. Kramer ◽  
Jan B. Hoeksma ◽  
Birte Prahl-Andersen
Keyword(s):  
Soft Palate ◽  
Growth And Development ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Timing Of Surgery ◽  
Normal Children ◽  
Anterior Arch ◽  
Arch Width ◽  
Different Types ◽  
Palatal Surgery

Early palatal growth and development after primary palatal closure was studied in children with different types of cleft lip and palate (CLP). Palatal dimensions were measured on dental casts taken at fixed ages, from 9 months to 4 years of age. The results showed that soft and hard palatal closure in one stage had a significant impeding influence on posterior sagittal palatal growth compared to closure of the soft palate only. Timing of surgery possibly had a small temporary restrictive effect on posterior transverse palatal growth and development. Type and severity of the oral cleft had a significant effect on transverse palatal development and anterior sagittal dimensions. Anterior arch width was reduced in children with a complete unilateral (U) CLP or bilateral (B) CLP. The palates of the latter children had consistently larger anterior arch depths. Compared to normal children, palates of cleft children changed anteriorly from wider at 9 months of age to narrower at 4 years of age. Arch depths were smaller in cleft children except for anterior arch depths in children with complete BCLP.

Prediction of Early Palatal Growth and Development in Children with Cleft Lip and Palate

1996 ◽  
Vol 33 (2) ◽  
pp. 112-117 ◽  
Author(s):  
Gem. J.C. Kramer ◽  
Jan B. Hoeksma ◽  
Birte Prahl-Andersen
Keyword(s):  
Growth Velocity ◽  
Growth And Development ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Arch Width ◽  
The Individual ◽  
The Relationship ◽  
Palatal Surgery ◽  
Average Development ◽  
Group 1

With the use of multilevel modeling of longitudinal data, the relationship between the developmental status of the palate at 4 years of age and early palatal growth and development from birth to 1.5 years of age was studied. A model to predict palatal depths and widths at 4 years of age was developed and tested. The sample consisted of 130 children with cleft lip and/or palate. They were divided into three groups according to surgical treatment; (1) no palatal surgery, (2) soft palatal surgery, and (3) soft and hard palatal surgery. Results showed that in groups 1 and 2, the total arch depth at 4 years of age is strongly related to the initial arch depth at birth. No or low correlations were found between palatal depth at 4 years of age and the growth velocity at birth. The anterior arch width in groups 2 and 3 at 4 years of age appeared to be strongly related to the early growth velocity. In group 1, a moderate correlation with the palatal width and growth velocity at birth was observed. The results of the individual predictions of arch depths and arch widths were reasonable to fair. It was concluded that prediction of individual arch variables at 4 years of age is possible, although within limits. Clinically this means that extreme development can be discriminated from more average development.

Evaluation of the Effects of Cheiloplasty on Maxillary Arch in UCLP Infants Using Three-Dimensional Digital Models

2019 ◽  
Vol 56 (8) ◽  
pp. 1013-1019 ◽  
Author(s):  
Thanawut Kongprasert ◽  
Kengkart Winaikosol ◽  
Araya Pisek ◽  
Aggasit Manosudprasit ◽  
Amornrut Manosudprasit ◽  
...  
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
High Reliability ◽  
Anterior Part ◽  
Intraclass Correlation ◽  
Dental Arch ◽  
Posterior Arch ◽  
Anterior Arch ◽  
Arch Width ◽  
Significant Difference

Objective: To analyze and identify changes in the maxillary dental arch before and after cheiloplasty in a group of unilateral complete cleft lip and palate (UCLP) infants. Design: This is a cohort study. Material and Method: Study models from 16 infants with nonsyndromic UCLP, who were treated at Khon Kaen University, were taken before (T1) and after cheiloplasty (T2). The dental models underwent a process of scanning through a 3D scanner, from which 9 linear and 2 angular landmarks were evaluated. Paired t test was used to compare the measurement statistically between T1 and T2. Results: Alveolar cleft gap (G-L), anterior basal angle (∠GC-CC′), and anterior arch curvature angle on greater segment (∠GIC) were significantly decreased ( P < .05). Contrarily, anterior ridge length of greater segment (C-I), anterior ridge length of lesser segment (L-C′), and posterior arch width (T-T′) were significantly increased ( P < .05) after cheiloplasty. While, anterior portion of greater segment (I-G), anterior arch width (C-C′), anterior arch depth (I⊥CC′), arch length (G⊥TT′), and arch circumference (T-C-I-G-L-C′-T′) showed no significant difference. The measurements were tested using the Intraclass correlation coefficient. The coefficients indicated high reliability. Conclusion: Cleft gap significantly decreased after lip repair, and the anterior part of maxillary dental arch was also bent palatally after cheiloplasty without any other intervention except cheiloplasty. More studies are needed to assess the amount of lip pressure. If any convincing force is presented, an appliance to prevent undesirable pressure is indicated.

One- or Two-Stage Palate Closure in Patients with Unilateral Cleft Lip and Palate: Comparing Cephalometric and Occlusal Outcomes

2007 ◽  
Vol 44 (1) ◽  
pp. 13-22 ◽  
Author(s):  
Silke Stein ◽  
Anton Dunsche ◽  
Nils-Claudius Gellrich ◽  
Franz Härle ◽  
Irmtrud Jonas
Keyword(s):  
Surgical Treatment ◽  
Soft Palate ◽  
Hard Palate ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Facial Growth ◽  
Arch Width ◽  
One Stage ◽  
Lateral Cephalograms ◽  
Cast Analysis

Objective: To assess facial growth and dentoalveolar development in two groups of patients with complete unilateral cleft lip and palate. Primary surgical treatment differed in the timing of hard palate closure. Design: Forty-three patients with unilateral cleft lip and palate were examined. Twenty-two patients underwent early one-stage closure of the hard and soft palate cleft (mean age 23.0 ± 4.7 months); in 21 patients, the hard palate closure was delayed to 86.3 ± 39.2 months of age. Lateral cephalograms and dental casts were consecutively analyzed at four stages between 6 and 18 years of age. Results: Lateral cephalometric analysis revealed no significant intergroup differences in the sagittal and vertical craniofacial dimensions at any time. Dental cast analysis showed constriction of the upper anterior arch width at the ages of 6 and 10 years in patients with one-stage surgical palate closure, but a difference could no longer be verified at the ages of 15 and 18 years. Conclusions: The transverse distances in the upper jaw developed initially more positively in the group with delayed hard palate closure, but it became apparent later that the transverse deficiency after one-stage palate closure could be compensated for. When considering surgical treatment in general, the advantages of the delayed hard palate closure must be weighed against criteria favoring the early one-stage closure of the hard and soft palate.

Maxillary Arch Dimensions in Bilateral Cleft Lip and Palate from Birth until Four Years of Age in Boys

1998 ◽  
Vol 35 (3) ◽  
pp. 233-239 ◽  
Author(s):  
Kiki L.W.M. Heidbuchel ◽  
Anne M. Kuijpers-Jagtman ◽  
Gem J.C. Kramer ◽  
Birte Prahl-Andersen
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
University Hospital ◽  
Control Group ◽  
Posterior Arch ◽  
Anterior Arch ◽  
Arch Width ◽  
Bilateral Cleft Lip ◽  
The University ◽  
Maxillary Arch

Objective To describe the development of maxillary arch dimensions in children with bilateral cleft lip and palate (BCLP) during the first 4 years of life and to compare it with that in noncleft children. Design This was a retrospective, mixed-longitudinal study. Setting The study was conducted at the Cleft Palate Center of the University Hospital of Nijmegen. Subjects The sample consisted of 26 boys with BCLP who were born between 1976 and 1990 and treated at the University Hospital of Nijmegen. Data for a control group of 34 noncleft boys were collected at the University Hospital of Amsterdam. Method Palatal arch dimensions were digitized on dental casts. A comparison between BCLP and noncleft dimensions was made at fixed time intervals. Results At birth, anterior and posterior arch widths as well as arch depths were significantly larger in children with BCLP. After 7 months (lip closure), anterior arch width and arch depth diminished considerably in the cleft group. After 12 months (palatoplasty), a slight decrease in posterior arch width was observed, and arch depths showed slight catch-up growth. At 4 years of age, anterior arch width was significantly narrower and anterior arch depth was shorter in children with BCLP than in control subjects. Posterior arch width was significantly wider. Conclusions During the first 4 years of life, maxillary arch dimensions in children with BCLP show a unique development that is significantly different from that in noncleft children.

scholarly journals Evaluation of Prognostic Factors for Palatal Fistulas after Cleft Lip and Palate Surgery in a North-Western Romanian Population over a 10-Year Period

2021 ◽  
Vol 18 (14) ◽  
pp. 7305
Author(s):  
Daiana Antoaneta Opris ◽  
Horia Opris ◽  
Cristian Dinu ◽  
Simion Bran ◽  
Grigore Baciut ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Retrospective Study ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Timing Of Surgery ◽  
Surgical Correction ◽  
County Hospital ◽  
Occurrence Rate ◽  
Surgical Corrections ◽  
North Western

Cleft lip and palate is the most frequent birth anomaly, with increasing reported rates of complications, such as palate fistulae. Current studies concerning the occurrence rate of cleft lip and palate (CLP) report 2 to 10 cases in 10,000 births. The purpose of this study was to investigate the existence of factors that could predict the occurrence of fistulae after cleft lip and palate surgery. A retrospective study was performed by collecting and analyzing data from all patients who were operated for cleft lip and/or palate in the Maxillo-Facial Department of the Emergency Clinical County Hospital of Cluj-Napoca, Romania, between 2010 and 2020. We investigated the existing evidence for possible links between the number of fistulae observed after the primary palatoplasty and the age at which the primary palatoplasty was performed, the sex of the patient, the type of cleft, the timing of the surgical corrections, and the presence of comorbidities. A total of 137 cases were included for analysis. A significant link between the number of fistulae and the type of cleft was found (with fistulae occurring more frequently after the surgical correction of CLP—p < 0.001). No evidence was found for the existence of significant links between the number of fistulae and the patient’s sex, the timing of surgery, or the presence of comorbidities. This study concluded that the incidence of palatal fistulae appears to be influenced by the type of cleft (CLP), but not by the sex of the patient, the timing of surgery, or the presence of comorbidities.

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.

Phonological Profile of Patients With Velopharyngeal Dysfunction and Palatal Anomalies

2021 ◽  
pp. 1-15
Author(s):  
Ariela Nachmani ◽  
Muhamed Masalha ◽  
Firas Kassem
Keyword(s):  
Cleft Palate ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Age Groups ◽  
Phonological Process ◽  
Phonological Processes ◽  
Process Error ◽  
Submucous Cleft Palate ◽  
Different Types

Purpose This purpose of this study was to assess the frequency and types of phonological process errors in patients with velopharyngeal dysfunction (VPD) and the different types of palatal anomalies. Method A total of 808 nonsyndromic patients with VPD, who underwent follow-up at the Center for Cleft Palate and Craniofacial Anomalies, from 2000 to 2016 were included. Patients were stratified into four age groups and five subphenotypes of palatal anomalies: cleft lip and palate (CLP), cleft palate (CP), submucous cleft palate (SMCP), occult submucous cleft palate (OSMCP), and non-CP. Phonological processes were compared among groups. Results The 808 patients ranged in age from 3 to 29 years, and 439 (54.3%) were male. Overall, 262/808 patients (32.4%) had phonological process errors; 80 (59.7%) ages 3–4 years, 98 (40, 0%) ages 4.1–6 years, 48 (24.7%) 6.1–9 years, and 36 (15.3%) 9.1–29 years. Devoicing was the most prevalent phonological process error, found in 97 patients (12%), followed by cluster reduction in 82 (10.1%), fronting in 66 (8.2%), stopping in 45 (5.6%), final consonant deletion in 43 (5.3%), backing in 30 (3.7%), and syllable deletion and onset deletion in 13 (1.6%) patients. No differences were found in devoicing errors between palatal anomalies, even with increasing age. Phonological processes were found in 61/138 (44.20%) with CP, 46/118 (38.1%) with SMCP, 61/188 (32.4%) with non-CP, 70/268 (26.1%) with OSMCP, and 25/96 (26.2%) with CLP. Phonological process errors were most frequent with CP and least with OSMCP ( p = .001). Conclusions Phonological process errors in nonsyndromic VPD patients remained relatively high in all age groups up to adulthood, regardless of the type of palatal anomaly. Our findings regarding the phonological skills of patients with palatal anomalies can help clarify the etiology of speech and sound disorders in VPD patients, and contribute to general phonetic and phonological studies.

Longitudinal Study on the Changes of Maxillary Arch Dimensions in Japanese Children with Cleft Lip and/or Palate: Infancy to 4 Years of Age

1995 ◽  
Vol 32 (2) ◽  
pp. 149-155 ◽  
Author(s):  
Yasuo Honda ◽  
Akira Suzuki ◽  
Masamichi Ohishi ◽  
Hideo Tashiro
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Lateral Displacement ◽  
Growth Patterns ◽  
Posterior Displacement ◽  
Arch Width ◽  
Dental Hospital ◽  
Growth Changes ◽  
Isolated Cleft Palate ◽  
Maxillary Arch

The focus of this study was an analysis of maxillary arch growth changes prior to the time of cheiloplasty up to 4 years of age. Serial dental casts were obtained and measured in 95 children with cleft lip and palate, or both: 7 unilateral cleft lip and alveolus (CLA), 52 unilateral cleft lip and palate (UCLP), 24 bilateral cleft lip and palate (BCLP), and 12 isolated cleft palate (CP). The children were treated at the Kyushu University Dental Hospital. The results are as follows: (1) Prior to cheiloplasty, the maxillary buccal segments in the subjects with cleft lip and palate showed lateral displacement. The premaxilla in BCLP subjects was protruded. (2) Cheiloplasty influenced maxillary anterior arch width, but not posterior width. The operation caused posterior displacement of the premaxilla in BCLP subjects. (3) Palatoplasty affected the growth of the maxillary arch in the transverse and anteroposterior dimensions. (4) A variety of growth patterns observed in the patients (e.g., increasing or decreasing of the maxillary arch dimensions) suggests that maxillary arch dimensions were affected not only by surgery, but also by other individual factors such as genetic facial pattern and severity of the cleft.

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