Refractive Errors and Strabismus In Patients with Orofacial Clefts

Abstract Purpose: To evaluate the prevalence of refractive errors and strabismus in patients with orofacial clefts. Methods: This retrospective study analyzed the medical records of 54 patients with orofacial clefts between August 2018 and March 2020. A complete eye examination was performed, including visual acuity assessment on a logMAR scale, anterior biomicroscopy, cycloplegic refraction, eye motility examination, and indirect ophthalmoscopy. Results: The mean age of the patients at presentation was 9.47 years. Twentythree (42.59%) patients had isolated cleft palate (CP), 10 (18.52%) had cleft lip (CL), and 21 (38.89%) had cleft lip and palate (CLP). The mean spherical equivalent was 1.30D (±1.56) in CL, 0.32D (±2.24) in CLP, and 0.62D (±3.76) in CP. The prevalence of refractive error, either spherical or cylinder >0.5 was 88%. The most common refractive error was hyperopia (60%), followed by astigmatism (54%) and myopia (16%). Overall, 52.63% of the patients were prescribed glasses. No statistically significant difference was observed between the groups with respect to the need for prescription of glasses (p=0.6753). There were 15 patients with some type of strabismus, and other ophthalmological changes were observed in 13 patients. Conclusion: In this population with orofacial clefts, the prevalence of refractive errors and strabismus was 88% and 22%, respectively.

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Comprehension of Online Educational Material Regarding Orofacial Clefts

The Cleft Palate-Craniofacial Journal ◽

10.1177/1055665619839576 ◽

2019 ◽

Vol 56 (9) ◽

pp. 1206-1212

Author(s):

Diana S. Jodeh ◽

Aleshia J. Pringle ◽

S. Alex Rottgers

Keyword(s):

Web Sites ◽

Web Site ◽

Cleft Lip ◽

Cleft Lip And Palate ◽

The United States ◽

Educational Material ◽

Reading Level ◽

Significant Difference ◽

The Mean ◽

American Society

Background:Cleft lip and palate are among the common birth defects in the United States. Management is complex and may be difficult for parents and patients to understand. The goal of this study was to evaluate the readability of online educational material provided by the American Society of Plastic Surgeons (ASPS) and the American Cleft Palate-Craniofacial Association (ACPA) websites regarding cleft lip and palate and to assess parents’ comprehension.Methods:Parents of children younger than 10 years of age presenting to the plastic and reconstructive surgery clinic at Johns Hopkins All Children’s Hospital for conditions other than cleft lip and palate were recruited for participation. Parents were given the literature published on the ASPS and ACPA web sites to review and were asked to complete a 5-question test specifically targeted to the content of the passage they reviewed. We tested the readability of the 2 online passages using Readability Studio software (Oleander Software Solutions Ltd).Results:Sixty parents completed the study. Across all groups, the mean score was 4.35 of a possible 5. The mean score was 4.4 for the ASPS web site and 4.29 for the ACPA web site. Fifty-three percent of participants answered all questions correctly. No significant difference in scores was noted between web sites ( P = .48).Conclusions:Despite containing content of varying reading-level difficulty, the literature posted on the ACPA and ASPS web sites concerning cleft lip and palate conveyed information equally well to the target parent demographic with high levels of comprehension.

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Does Unilateral Cleft Lip and Palate Affect the Maxillary Sinus Volume?

The Cleft Palate-Craniofacial Journal ◽

10.1177/1055665617726991 ◽

2017 ◽

Vol 55 (2) ◽

pp. 168-172 ◽

Cited By ~ 6

Author(s):

Omer Demirtas ◽

Fahrettin Kalabalik ◽

Asim Dane ◽

Ali Murat Aktan ◽

Ertugrul Ciftci ◽

...

Keyword(s):

Maxillary Sinus ◽

Cleft Lip ◽

Cleft Lip And Palate ◽

Control Group ◽

Maxillary Sinus Volume ◽

Intergroup Comparison ◽

Significant Difference ◽

The Mean ◽

And Gender ◽

The Right

Objective: The purposes of this study were to evaluate and compare the maxillary sinus volume (MSV) of patients with a unilateral cleft lip and palate (UCLP) between the cleft side and noncleft side and between adolescent patients with UCLP and a control (noncleft) group using cone beam computed tomography (CBCT). Methods: CBCT images of 44 UCLP patients (29 males and 15 females, with a mean [SD] age of 13.5 [5.0] years) and 44 (22 males and 22 females, with a mean [SD] age 14.9 [4.2] years) age- and sex-matched controls were evaluated in this study. Each maxillary sinus was assessed 3-dimensionally, segmented, and its volume was calculated. Results: There were no statistically significant differences between the age and gender distributions of the groups. There was a statistically significant difference in the MSVs of the cleft (10996.78±3522.89 mm3) versus the noncleft side (10382.3±3416.2 mm3; P < .05)] but no significant difference between the MSVs of the right and left sides ( P > .05). In the intergroup comparison, the mean MSVs of the UCLP patients (10701.52±3369.33 mm3) were significantly smaller than those of the control group (16054.08 ± 5293.96 mm3; P < .001). Conclusions: The MSVs of the UCLP patients showed a statistically significant decrease compared to those of the controls ( P < .001). There was also a significant difference in the MSVs of the cleft and noncleft sides of the UCLP patients ( P < .05).

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Nasal Airway Dimensions of Adults with Cleft Lip and Palate: Differences among Cleft Types

The Cleft Palate-Craniofacial Journal ◽

10.1597/03-081.1 ◽

2005 ◽

Vol 42 (4) ◽

pp. 396-402 ◽

Cited By ~ 46

Author(s):

Ana Paula Fukushiro ◽

Inge Elly Kiemle Trindade

Keyword(s):

Cleft Lip ◽

Cleft Lip And Palate ◽

Mean Value ◽

Nasal Airway ◽

Cross Sectional ◽

Different Types ◽

The Mean ◽

Level Of Significance ◽

Isolated Cleft Palate ◽

Airway Dimensions

Objective To determine the nasal airway dimensions in adults with repaired cleft lip and palate by rhinomanometry and to analyze the reduction associated with different types of clefts. Model A prospective analysis comparing three types of previously repaired clefts: bilateral cleft lip and palate (BCLP), unilateral cleft lip and palate (UCLP), and isolated cleft palate (CP) at the 5% level of significance. Setting Laboratory of Physiology, Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, Bauru, Brazil. Participants Fifty-three subjects aged 18 to 35 years (17 BCLP, 16 UCLP, 20 CP) and a group of 20 individuals without cleft (N). Variables Minimum cross-sectional nasal area assessed by posterior (PR) and anterior (AR) rhinomanometry and nasopharyngeal area assessed by modified AR. Results Mean (± 1 SD) nasal areas obtained by PR were: 0.47 ± 0.16 cm2 (BCLP), 0.57 ± 0.19 cm2 (UCLP), 0.61 ± 0.13 cm2 (CP), and 0.60 ± 0.10 cm2 (N). The mean value for the BCLP group was significantly smaller than that for the N and CP groups. The remaining values did not differ from one another. The proportion of subjects with subnormal areas obtained by PR was 41%, 19%, and 0% for groups BCLP, UCLP, and CP, respectively. Similar results were obtained by AR. All subjects presented a nasopharyngeal area larger than 0.80 cm2, denoting absence of obstruction in the nasopharynx. Conclusions In adulthood BCLP is the type of cleft associated with a greater reduction of nasal airway, compared with UCLP and CP, suggesting that adults with BCLP are at a greater risk for nasal obstruction.

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The Influence of Orthodontic Treatment on the Goslon Score of Unilateral Cleft Lip and Palate Patients

The Cleft Palate-Craniofacial Journal ◽

10.1597/10-096 ◽

2012 ◽

Vol 49 (2) ◽

pp. 215-220 ◽

Cited By ~ 11

Author(s):

Peter Southall ◽

Mark Walters ◽

Steven Singer

Keyword(s):

Retrospective Study ◽

Treatment Group ◽

Surgical Outcome ◽

Orthodontic Treatment ◽

Cleft Lip ◽

Cleft Lip And Palate ◽

Favorable Outcome ◽

Dental Arch ◽

Significant Difference ◽

The Mean

Objective To assess the effect of orthodontic treatment on Goslon Yardstick outcome. Design Retrospective study. Patients A series of 66 consecutive patients born with a complete unilateral left lip and palate. Patients were sorted into a nontreatment group (n = 47) and a treatment group (n = 19). Method Three assessors trained in the use of the Goslon Yardstick ranked the dental arch relationships of study casts taken at 6 and 9 years. Results There was only a fair agreement (κ = .33) between 6- and 9-year Goslon Yardstick scores for the cohort of 66 patients, with a significant (p < .05) difference in the mean score at 6 years (3.17 ± 0.8) and at 9 years (2.88 ± 1.0). Removal of 19 subjects who had orthodontic inventions prior to taking of the 9-year-old study cast improved the agreement to moderate (κ = .52). There was no significant difference (p > .05) in mean scores at 6 and 9 years (3.13 ± 0.9 and 3.17 ± 1.03, respectively). The treatment group exhibited significant differences (p < .001) with mean Goslon Yardstick scores of 3.0 ± 0.9 at 6 and 2.25 ± 0.45 at 9 years. Conclusions The inclusion of patients who had received orthodontic treatment prior to taking of study casts being used for Goslon Yardstick scoring can result in a more favorable outcome. Patients who have received active orthodontic treatment prior to taking of dental casts should be excluded or accounted for in audits to assess primary cleft surgical outcome in patients with a unilateral cleft lip and palate.

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Evaluation of Eustachian tube function in patients of cleft palate and effects of palatoplasty on these findings

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20213282 ◽

2021 ◽

Vol 7 (9) ◽

pp. 1473

Author(s):

Lalit Kochar ◽

Deepak V. Chauhan ◽

S. P. Bajaj ◽

Akash Juneja

Keyword(s):

Cleft Palate ◽

Eustachian Tube ◽

Cleft Lip ◽

Cleft Lip And Palate ◽

Care Hospital ◽

Eustachian Tube Function ◽

Significant Difference ◽

Tube Function ◽

Isolated Cleft Palate ◽

Palatal Surgery

Background: Isolated cleft palate and cleft palate and cleft lip patients have poor Eustachian tube function which results in hearing impairment that too in the speech formative years. Aim of study was to evaluate tympanometric findings in patient of cleft palate and effect of palatoplasty on both short term and long term postoperatively.Methods: The subjects consisted of patients attending the cleft lip and palate clinic. This was a combined clinic consisting of department of plastic surgery, department of ENT and department of dental surgery held every month at a tertiary care hospital in Delhi. Study consisted of three groups of patients namely preoperative group, postoperative group and pre-postoperative group.Results: No significant difference was observed in tympanometric abnormalities in cases of combined cleft lip and palate as compared to isolated cleft palate. After age of 5 months once changes of OME has set in there was no significant change in middle ear findings irrespective of palatal repair.Conclusions: There is a very high prevalence of otitis media with effusion in these patients. The changes do resolve spontaneously after age of seven, this perhaps is due to combined effect, growth, development and l maturity of Eustachian tube and palatal surgery rather than palatal surgery alone.

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Oral Habits in Children With Orofacial Clefts: A Comparative Study

The Cleft Palate-Craniofacial Journal ◽

10.1177/1055665620969570 ◽

2020 ◽

pp. 105566562096957

Author(s):

Ikenna Gerald Isiekwe ◽

Taofeek Olalekan Ligali ◽

Mohammed Adam Sheikh Abdullahi ◽

Wasiu Lanre Adeyemo

Keyword(s):

Comparative Study ◽

Cleft Lip ◽

Cleft Lip And Palate ◽

Institutional Review Boards ◽

Control Group ◽

Orofacial Clefts ◽

Cross Sectional ◽

Oral Habits ◽

Wide Range ◽

Significant Difference

Background and Aim: Children with cleft lip and palate present with a wide range of dental and occlusal anomalies as a result of the cleft defect. These patients also present with oral habits which may affect their quality of life. The aim of this study was to compare the prevalence of oral habits in these children, with children without orofacial clefts. Methodology: This was a cross-sectional comparative study comparing children with repaired cleft lip and/or palate aged 3 to 12 years, with children without orofacial clefts. Ethical approval for the study was obtained from the institutional review boards of both centers. Data collection was via interviewer administered questionnaires given to the parents/guardians of the children in each group. Data analysis was carried out using SPSS version 23. The level of significance was set at P < .05. Results: A total of 107 respondents participated in the study, comprising 53 children with repaired cleft lip and/or palate 54 children without orofacial clefts. The mean age for the children with Cleft lip and/or palate/ was 6.81 (standard deviation [SD] 1.898) years, while that for the control group was 7.78 (SD 1.68) years. Two oral habits recorded a significantly higher prevalence ( P < .05) in the children with repaired clefts as compared to controls and these were lip sucking and bruxism. No significant difference in prevalence was recorded for all the other oral habits surveyed. Conclusion: A significantly higher prevalence ( P < .05) was observed in lip sucking and bruxism among children with cleft lip and palate, as compared to the children without orofacial clefts.

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Kajian faktor-faktor yang berhubungan dengan skor nasalance pada pasien celah palatum

Oto Rhino Laryngologica Indonesiana ◽

10.32637/orli.v45i2.117 ◽

2016 ◽

Vol 45 (2) ◽

pp. 131

Author(s):

Duhita Yassi ◽

Dini Widiarni ◽

Tri Juda Airlangga ◽

Lestaria Aryanti ◽

Muchtarudin Mansyur

Keyword(s):

Cleft Palate ◽

Otitis Media ◽

Cleft Lip ◽

Cleft Lip And Palate ◽

Otitis Media With Effusion ◽

Group Analysis ◽

Cross Sectional ◽

Purposive Sampling ◽

Significant Difference ◽

The Mean

Latar belakang: Celah bibir dan palatum merupakan kelainan proses pertumbuhan area orofasial yang menimbulkan permasalahan kompleks. Penelitian ini menitikberatkan permasalahanyang terkait dengan fungsi bicara. Tujuan: Penelitian ini melaporkan gambaran skor nasalance padacelah palatum, hubungan antara skor nasalance percontoh celah palatum dan tanpa celah palatum sertafaktor-faktor yang berhubungan dengan skor nasalance. Metode: Desain penelitian adalah comparativecross sectional. Pengambilan percontoh dilakukan dengan purposive sampling. Dilakukan wawancara,pengisian kuesioner, pemeriksaan THT, audiometri, timpanometri, nasoendoskopi, dan nasometri.Hasil: Didapatkan gambaran rerata skor nasalance percontoh celah palatum. Terdapat perbedaanbermakna antara skor nasalance percontoh celah palatum dan tanpa celah palatum pada Uji Gajah danUji Hantu (p<0,001). Pada analisis multivariat secara keseluruhan faktor-faktor yang berhubungandengan skor nasalance (adenoid, otitis media efusi, serta gangguan pendengaran) dan keberadaancelah palatum berpengaruh secara signifikan terhadap skor nasalance untuk semua uji nasalance(p<0,05) pada pengujian terhadap kedua kelompok percontoh. Bila dilihat secara parsial faktor adenoidberpengaruh secara signifikan terhadap skor semua uji nasalance baik pada analisis kedua kelompokpercontoh maupun pada percontoh celah palatum saja. Kesimpulan: Rerata skor nasalance kelompokcelah palatum lebih tinggi daripada kelompok tanpa celah palatum. Didapatkan peran faktor yangberpengaruh terhadap skor nasalance, khususnya adenoid. Diperlukan penelitian lebih lanjut terhadappercontoh sesudah operasi sehingga bisa dijadikan sebagai evaluasi terhadap keberhasilan tindakan. Kata kunci: celah palatum, skor nasalance, tonsil, adenoid, otitis media efusi, gangguan pendengaran ABSTRACTBackground: Cleft lip and palate is an orofacial malformation and associated with many problems. This study concerned in speech problem in cleft palate patients. Purpose: This study reportednasalance score in cleft palate patients, the correlation between nasalance score in cleft palate and noncleft palate groups and also some factors related with nasalance score in cleft palate patients. Methods:The design of this study was comparative cross sectional, with purposive sampling. Data was collectedwith interview, questioner apllication, ENT examination, audiometry, tympanometry, nasoendoscopy,and nasometry. Results: The result of this study reported the mean of nasalance score in cleft palatepatients. There was significant difference in nasalance score between cleft palate and non cleft palatepatients in Uji Gajah and Uji Hantu (p>0,05). In multivariate analysis, in general the factors relatedwith nasalance score (adenoid, otitis media with effusion, and hearing loss) and cleft palate itself weresignificantly correlated with nasalance score in all nasalance test (p<0,05) in both groups analysis butno signifficant correlation in cleft palate group analysis. Partially, adenoid was significantly correlated in both group analysis and cleft palate group analysis. Conclusion: The mean of nasalance score incleft palate group was higher than non cleft group. Some factors in this study, especially adenoid had corelations with nasalance score. It needs further study to evaluate the nasalance score patients withcleft palate after surgery to compare the results. Keywords: cleft palate, nasalance score, tonsil, adenoid, otitis media with effusion, hearing disturbance

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Occurrence of Cleft Lip and Palate in the Faroe Islands and Greenland from 1950 to 1999

The Cleft Palate-Craniofacial Journal ◽

10.1597/1545-1569_2003_040_0426_ooclap_2.0.co_2 ◽

2003 ◽

Vol 40 (4) ◽

pp. 426-430 ◽

Cited By ~ 4

Author(s):

Linda P. Jakobsen ◽

Kirsten Mølsted ◽

Kaare Christensen

Keyword(s):

Cleft Palate ◽

Cleft Lip ◽

Genetic Factors ◽

Cleft Lip And Palate ◽

Faroe Islands ◽

Hearing Disorders ◽

Live Births ◽

Time Period ◽

The Mean ◽

Isolated Cleft Palate

Objective To describe the occurrence of cleft lip with or without cleft palate (CL/P) and isolated cleft palate (CP) in the Faroe Islands and Greenland over a 50-year time period that has included substantial changes in lifestyle. Design A prevalence study based on patient records obtained from the Institute of Speech and Hearing Disorders in Copenhagen, Denmark, at which the treatment of patients with CP and CL/P from Greenland, the Faroe Islands, and Denmark is coordinated. Participants All live-born children in the Faroe Islands, Greenland, and Denmark with CL/P or CP born in the period 1950 to 1999 (Faroe Islands and Greenland) and 1950 to 1987 (Denmark). Results and Conclusion The mean prevalence of CL/P in the Faroe Islands and Greenland during the period 1950 to 1999 was 1.0 and 0.6 per 1000 live births, respectively. This is significantly lower than the mean prevalence of 1.4 (p < .05 and p < .001) per 1000 live births found in Denmark. The mean prevalence of CP in the Faroe Islands and Greenland was 1.5 and 1.1 per 1000 live births, respectively, which is significantly higher than the Danish prevalence of 0.5 per 1000 live births (p < .001 in both tests). There was no clear time trend in the prevalence, indicating that genetic factors or timetable environmental factors play a dominating role in the etiology of CL/P and CP in the Faroe Islands and Greenland.

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Prepubertal Midface Growth in Unilateral Cleft Lip and Palate following Alveolar Molding and Gingivoperiosteoplasty

The Cleft Palate-Craniofacial Journal ◽

10.1597/03-037.1 ◽

2004 ◽

Vol 41 (4) ◽

pp. 375-380 ◽

Cited By ~ 57

Author(s):

Catherine T. H. Lee ◽

Barry H. Grayson ◽

Court B. Cutting ◽

Lawrence E. Brecht ◽

Wen Yuan Lin

Keyword(s):

Cleft Lip ◽

Cleft Lip And Palate ◽

Permutation Test ◽

Long Term Effect ◽

Significant Difference ◽

History Of ◽

The Mean ◽

Late Start ◽

Nasoalveolar Molding

Objectives To examine the long-term effect of nasoalveolar molding and gingivoperiosteoplasty (modified Millard type) on midface growth at prepuberty. Procedures In this retrospective study, 20 consecutive patients with a history of complete unilateral cleft lip and palate were evaluated. Ten patients had nasoalveolar molding and gingivoperiosteoplasty performed at lip closure; 10 control patients had nasoalveolar molding but no gingivoperiosteoplasty because of late start in treatment or poor compliance. A single surgeon (C.B.C.) performed all surgical procedures. Standardized lateral cephalometric radiographs were evaluated at two time periods: T1 at pre–bone-grafting age and T2 at prepuberty age. Superimposition and cephalometric analysis were undertaken to investigate the two groups. Two cephalometric reference planes, sella-nasion and basion-nasion, were used to assess the vertical and sagittal relations of the midface (ANS-PNS). The reference landmarks were procrustes fitted. The mean location and variance of ANS and PNS landmarks were computed. All results were analyzed by permutation test. Results No significant difference in mean location or variance of ANS-PNS in both vertical and sagittal planes at both T1 and T2 periods were found between the two groups (p > .05). Conclusions The results suggested that midface growth in sagittal or vertical planes (up to the age of 9 to 13 years) were not affected by presurgical alveolar molding and gingivoperiosteoplasty (Millard type).

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PAX7, PAX9 and RYK Expression in Cleft Affected Tissue

Medicina ◽

10.3390/medicina57101075 ◽

2021 ◽

Vol 57 (10) ◽

pp. 1075

Author(s):

Mārtiņš Vaivads ◽

Ilze Akota ◽

Māra Pilmane

Keyword(s):

Cleft Palate ◽

Cleft Lip ◽

Cleft Lip And Palate ◽

Rank Correlation ◽

Control Group ◽

Orofacial Clefts ◽

Spearman’S Rank Correlation ◽

Morphological Studies ◽

Affected Tissue ◽

Isolated Cleft Palate

Background and Objectives: Cleft lip with or without cleft palate is one of the most common types of congenital malformations. Transcription factors paired box 7 and 9 (PAX7, PAX9) and receptor-like tyrosine kinase (RYK) have been previously associated with the formation of orofacial clefts but their exact possible involvement and interactions in the tissue of specific cleft types remains uncertain. There is a limited number of morphological studies analyzing these specific factors in cleft affected tissue due to ethical aspects and the limited amount of available tissue material. This study analyses the presence of PAX7, PAX9, and RYK immunopositive structures within different cleft affected tissue to assess their possible involvement in cleft morphopathogenesis. Materials and Methods: Cleft affected tissue was collected from non-syndromic orofacial cleft patients during cleft correcting surgery (36 patients with unilateral cleft lip, 13 patients with bilateral cleft lip, 26 patients with isolated cleft palate). Control group oral cavity tissue was obtained from 7 patients without cleft lip and palate. To evaluate the number of immunopositive structures in the cleft affected tissue and the control group, a semiquantitative counting method was used. Non-parametric statistical methods (Kruskal–Wallis H test, Mann–Whitney U test, and Spearman’s rank correlation) were used. Results: Statistically significant differences for the number of PAX7, PAX9, and RYK-positive cells were notified between the controls and the patient groups. Multiple statistically significant correlations between the factors were found in each cleft affected tissue group. Conclusions: PAX7, PAX9, and RYK have a variable involvement and interaction in postnatal morphopathogenesis of orofacial clefts. PAX7 is more associated with the formation of unilateral cleft lip, while PAX9 relates more towards the isolated cleft palate. The stable presence of RYK in all cleft types indicates its possible participation in different facial cleft formations.

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