scholarly journals Penatalaksanaan Repair Palatoplasty dengan Teknik Furlow Double Opposing Z Plasty

2015 ◽  
Vol 1 (1) ◽  
pp. 115
Author(s):  
Pingky Krisna Arindra ◽  
Prihartiningsih Prihartiningsih ◽  
Bambang Dwi Rahardjo
Keyword(s):  
Soft Palate ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Fibrous Tissue ◽  
Previous Surgery ◽  
Clinical Appearance ◽  
Post Surgery ◽  
Repair Procedure ◽  
Two Stages

Kasus bibir dan lelangit sumbing merupakan salah satu kelainan deformitas yang sering terjadi. Keadaan klinis bervariasi mulai dari kasus sumbing tidak komplit sampai dengan komplit. Keadaan klinis dengan lebar celah yang bervariasi membutuhkan teknik pembedahan yang tepat. Pasien-pasien dengan bibir dan atau lelangit sumbing mungkinsebelumnya telah menjalani beberapa intervensi pembedahan, sehingga sering memerlukan koreksi lebih lanjut untuk memperbaiki hasil operasi sebelumnya. Pasien anak laki-laki usia 4 tahun 7 bulan mengeluhkan masih terdapatnya celah di lelangit. Pasien didiagnosis dengan labiognatopalatoschisis bilateral. Sebelumnya pasein sudah menjalani 4 kali operasi penutupan celah bibir dan lelangit. Pasien menjalani 2 kali operasi bibir sumbing dengan metode lip adhesion dan metode Barsky, dan 2 kali operasi lelangit sumbing dengan metode pushback dilanjutkan dengan koreksi dengan z plasty, tetapi hasil akhir masih terdapat celah di palatum mole. Selanjutnya dilakukan operasi repair palatoplasi denganmetode Furlow double opposing z plasty dengan kombinasi insisi lateral, dan didapatkan hasil menutupnya celah di palatum mole sampai dengan uvula. Telah dilakukan operasi repair palatoplasi dengan metode Furlow double opposing z plasty. Teknik ini dilakukan untuk menghindari insisi yang terlalu luas dikarenakan terdapatnya jaringan fibrous yang tebal pada mukosa palatum pasca operasi sebelumnya. Tujuan studi kasus adalah untuk mengetahui kemampuan teknik Furlow Double Opposing Z Plasty sebagai prosedur repair palatoplasty. Repair Palatoplasty Management with Furlow Double Opposing Z Plasty Technique. Cases of cleft lip and palate are one of the deformity disorders that often occur. There are variety of clinical appearance ranging from incomplete to complete cases. Clinical appearance with different width requires proper surgical technique. Patients with cleft lip and palate had undergone surgical intervention, so that they needed surgical correction to repair the result or failure of the previous surgery. A Four year old boy complain there was cleft on the soft palate. The patient was diagnosed with labiognatopalatoscisis. The patient had undergone two stages of cleft lip surgery and twice of cleft palate surgery with pushback method and repair with z plasty, however the result was unsatisfactory. Further, the patient underwent repair palatoplasty surgery with Furlow double opposing z plasty method combined with lateral relaxing insicion. The result in the post surgery was the closure of cleft soft palate up to uvula. Repair palataplasty surgery has been done with Furlow double opposing z plasty method. This technique could avoid extended incision due to thick fibrous tissue on the palatum mucosa as the result of serial previous surgery. The aim of this case case study is to determine the technical capabilities of Furlow Double Opposing Z Plasty as palatoplasty repair procedure.

Influence of Infant Cleft Dimensions on Velopharyngeal Function in 5-Year-Old Danish Children Born With Unilateral Cleft Lip and Palate

2019 ◽  
Vol 57 (4) ◽  
pp. 420-429
Author(s):  
Susanna Botticelli ◽  
Annelise Küseler ◽  
Kirsten Mølsted ◽  
Helene Soegaard Andersen ◽  
Maria Boers ◽  
...  
Keyword(s):  
Soft Palate ◽  
Hard Palate ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Controlled Trial ◽  
Velopharyngeal Insufficiency ◽  
Primary Surgery ◽  
Multicenter Randomized Controlled Trial ◽  
Palate Repair ◽  
Velopharyngeal Function

Aim: To examine the association of cleft severity at infancy and velopharyngeal competence in preschool children with unilateral cleft lip and palate operated with early or delayed hard palate repair. Design: Subgroup analysis within a multicenter randomized controlled trial of primary surgery (Scandcleft). Setting: Tertiary health care. One surgical center. Patients and Methods: One hundred twenty-five infants received cheilo-rhinoplasty and soft palate repair at age 3 to 4 months and were randomized to hard palate closure at age 12 or 36 months. Cleft size and cleft morphology were measured 3 dimensionally on digital models, obtained by laser surface scanning of preoperative plaster models (mean age: 1.8 months). Main outcome measurements: Velopharyngeal competence (VPC) and hypernasality assessed from a naming test (VPC-Sum) and connected speech (VPC-Rate). In both scales, higher scores indicated a more severe velopharyngeal insufficiency. Results: No difference between surgical groups was shown. A low positive correlation was found between posterior cleft width and VPC-Rate (Spearman = .23; P = .025). The role of the covariate “cleft size at tuberosity level” was confirmed in an ordinal logistic regression model (odds ratio [OR] = 1.17; 95% confidence interval [CI]:1.01-1.35). A low negative correlation was shown between anteroposterior palatal length and VPC-Sum (Spearman = −.27; P = .004) and confirmed by the pooled scores VPC-Pooled (OR = 0.82; 95% CI: 0.69-0.98) and VPC-Dichotomic (OR = 0.82; 95% CI: 0.68-0.99). Conclusions: Posterior cleft dimensions can be a modest indicator for the prognosis of velopharyngeal function at age 5 years, when the soft palate is closed first, independently on the timing of hard palate repair. Antero-posterior palatal length seems to protect from velopharyngeal insufficiency and hypernasality. However, the association found was significant but low.

Attitude of the Canine in Secondary Bone-Grafted and Nongrafted Patients with Cleft Lip and Palate

2005 ◽  
Vol 42 (6) ◽  
pp. 679-686 ◽  
Author(s):  
Enkhtuvshin Gereltzul ◽  
Yoshiyuki Baba ◽  
Kimie Ohyama
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Panoramic Radiography ◽  
Control Groups ◽  
Significant Difference ◽  
Before And After ◽  
Group 2 ◽  
Two Stages ◽  
And Control ◽  
Group 1

Objective To investigate the eruption pattern of the cleft-side canine regarding its pre-eruption position relative to the cleft in bone-grafted (BG) and nongrafted (NonBG) patients with cleft lip and palate. Methods Fifty-three patients with cleft lip and palate (21 BG, 32 NonBG) were examined by panoramic radiography and posteroanterior cephalography taken before and after canine eruption. Subjects were categorized into BG, NonBG, and control groups. Canines at the pre-eruption stage were categorized as close to (group 1) or distant from (group 2) the cleft area. The canine angle and its change between the two stages were evaluated. Results No significant differences were noted between the initial canine angle of the BG and NonBG groups. Although canines in the BG group erupted without a significant change in angle, the canine angle increased significantly (p < .0001) in the NonBG and control groups. In group 1, a greater change in canine angle was noted in the NonBG (p < .05) and control (p < .01) groups than in the BG group. In group 2, no significant difference was noted among the three groups. Conclusions In BG patients, a canine located near the cleft appears to erupt at the same angle as it had before grafting. However, in NonBG patients, it erupts more vertically, guided by cortical bone. For canines distant from the cleft area, there is no significant difference in the change in angulation between NonBG and BG patients.

Decision Tree for Pre-Graft Orthodontic Treatment: A Case Study of Cleft Lip and Palate Patients in the West Coast of Sabah

2018 ◽  
Vol 24 (2) ◽  
pp. 1398-1401 ◽  
Author(s):  
Zaturrawiah Ali Omar ◽  
Chin Su Na ◽  
Albira Sentian ◽  
Kong Lan Yien
Keyword(s):  
Decision Tree ◽  
West Coast ◽  
Orthodontic Treatment ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
The West

scholarly journals Maxillary Growth Evaluation After Cleft Palate Repair Using Goslon Criteria: Preliminary Study

1970 ◽  
Vol 1 (3) ◽  
Author(s):  
Huntal Simamora ◽  
Evie Lamtiur ◽  
Nur A. ◽  
Siti Handayani ◽  
Kristaninta Bangun
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Alveolar Bone ◽  
Mean Value ◽  
Treatment Result ◽  
Maxillary Hypoplasia ◽  
Post Surgery ◽  
Cleft Lip Palate ◽  
Palate Repair ◽  
Maxillary Growth

Background: The goal of palatoplasty is to achieve normal maxillofacial growth, normal speech, and prevent hearing loss. Disturbance of maxillary growth may occur in cleft lip palate patients after palatoplasty. To determine how many patients later developed a disrupted maxillary growth following operations, a retrospective study was designed to evaluate patients with complete unilateral cleft lip and palate who have undergone two-flap palatoplasty.Methods:A retrospective analytic study evaluated the maxillary growth of 15 consecutive unilateral cleft lip and palate patient aged around 8-year-old treated in the Division of Plastic Surgery Cipto Mangunkusumo Hospital, Jakarta. Cephalogram and dental study models were used to assess growth. Cleft lip and palate repair were performed to all patients without alveolar bone graft or any orthodontic treatment. Result: The cephalogram shows that 53,3% of the patients developed maxillary hypoplasia post palatoplasty. Mean value of the Goslon Yardstick was 3,53 (intermediate category by Goslon criteria).No patient fell into the Goslon 1 or 5 categories. Discussion: Disturbed maxillary growth is postulated to be caused by the manipulation and suturing of the maxillary vomer, and scarring of the dentoalveoli post-surgery. Another contributing factor is the intrinsic tissue deficiency. Conclusion: Maxillary hypoplasia is a possible complication following two !ap palatopasty, affecting either anteroposterior, transversal and vertical maxillary growth. This finding needs to be proven especially after the process of growth ceased. It is highly probable that maxillary disruption is higher when the two flap palatoplasty technique leaves lateral areas of denuded bone on the maxillary tuberosity.

scholarly journals The correlation between the severity of anterior crossbite and skeletal deformities in post-surgery cleft lip and palate among children

2020 ◽  
Vol 32 (3) ◽  
pp. 227
Author(s):  
Prastiwi Setianingtyas ◽  
Risti Saptarini Primarti ◽  
Lucky Riawan ◽  
Fahmi Oscandar
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Rank Correlation ◽  
Primary Dentition ◽  
Congenital Deformity ◽  
P Value ◽  
Weak Correlation ◽  
Skeletal Deformities ◽  
Post Surgery ◽  
High Level

Introduction: Cleft lip and palate is the most common craniofacial malformations, which is a congenital deformity of lip and palate or both. Anterior crossbite is occlusal characteristics that are often found in patients with cleft lip and palate who had surgery, caused by dentoalveolar or skeletal abnormalities, can be distinguished based on the cephalometric analysis. This research was aimed to analyse the correlation between the severity of anterior crossbite and skeletal deformities in post-surgery cleft lip and palate among children. Methods: The research design was an analytic correlation with the sample selection based on purposive sampling. The research was conducted from 14 cleft lip and palate patients in the primary dentition (aged 4-6 years old) who had surgery (for 2-3 years) using analysis of study models and cephalometric digital. Statistical analysis was conducted by Spearman Rank Correlation Coefficient test to analyse the relationship between the severity of anterior crossbite with skeletal deformities. Results: Statistic test showed that 42.86% of the anterior crossbite in the cleft lip and palate post-surgery in primary dentition had a very high level of severity, thus leading to very poor occlusion. As many as 21.43% had a high level of severity, which leads to poor occlusion, and 35.71% had a moderate level of severity, which leads to fair occlusion. The Spearman Coefficient of Rank Correlation test results showed a weak correlation between the severity of anterior crossbite with skeletal deformities with coefficient relation of 0.13 and p-value of 0.48 (p<0.05). Conclusion: There is a weak correlation between the severity of anterior crossbite with skeletal deformities in post-surgery cleft lip and palate among children.

scholarly journals Novel GREM1 Variations in Sub-Saharan African Patients With Cleft Lip and/or Cleft Palate

2018 ◽  
Vol 55 (5) ◽  
pp. 736-742 ◽  
Author(s):  
Lord Jephthah Joojo Gowans ◽  
Ganiyu Oseni ◽  
Peter A. Mossey ◽  
Wasiu Lanre Adeyemo ◽  
Mekonen A. Eshete ◽  
...  
Keyword(s):  
Cleft Palate ◽  
Soft Palate ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Sequence Data ◽  
Regulatory Elements ◽  
The Face ◽  
Sub Saharan ◽  
African Patients ◽  
Coding Variants

Objective: Cleft lip and/or cleft palate (CL/P) are congenital anomalies of the face and have multifactorial etiology, with both environmental and genetic risk factors playing crucial roles. Though at least 40 loci have attained genomewide significant association with nonsyndromic CL/P, these loci largely reside in noncoding regions of the human genome, and subsequent resequencing studies of neighboring candidate genes have revealed only a limited number of etiologic coding variants. The present study was conducted to identify etiologic coding variants in GREM1, a locus that has been shown to be largely associated with cleft of both lip and soft palate. Patients and Method: We resequenced DNA from 397 sub-Saharan Africans with CL/P and 192 controls using Sanger sequencing. Following analyses of the sequence data, we observed 2 novel coding variants in GREM1. These variants were not found in the 192 African controls and have never been previously reported in any public genetic variant database that includes more than 5000 combined African and African American controls or from the CL/P literature. Results: The novel variants include p.Pro164Ser in an individual with soft palate cleft only and p.Gly61Asp in an individual with bilateral cleft lip and palate. The proband with the p.Gly61Asp GREM1 variant is a van der Woude (VWS) case who also has an etiologic variant in IRF6 gene. Conclusion: Our study demonstrated that there is low number of etiologic coding variants in GREM1, confirming earlier suggestions that variants in regulatory elements may largely account for the association between this locus and CL/P.

scholarly journals CLEFT LIP AND PALATE

2016 ◽  
Vol 23 (05) ◽  
pp. 516-521
Author(s):  
Tajammal Abbas Shah
Keyword(s):  
Family History ◽  
Soft Palate ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Study Results ◽  
History Of ◽  
Group A ◽  
Group B ◽  
Surgical Unit ◽  
Palatal Defect

A prospective study was conducted to look for prevalence of cleft lip and palate ina population presenting to a surgical unit in a teaching hospital. Objectives: To see prevalenceof cleft lip and palate alone, lip and palate combined, right or left sided, male to femaledistribution, and possible factors responsible for clefting. Study Design: A prospective study.Setting: Surgical Unit II at Allied Hospital Faisalabad. Period: March 2009 to March 2010 forone year. Materials and Methods: Total 55 patients were treated in year 2009 out of total17900 (0.3 %) patients admitted in all surgical wards and 6508 patients admitted in surgicalunit II (0.8%). Patients were divided into three groups, cleft lip alone (group A), cleft palatealone (group B) and combined cleft lip and palate (group C). Children up to the age of 5 yearswith congenital abnormality were included in study. Results: Out of 6508 patients admitted insurgical unit II 55 patients (0.8%) had cleft lip and palate defect. 55 patients were divided inthree groups. In group A, 32 patients presented with cleft lip alone ( 58.1 % ), 16 ( 29 % ) weremales and 16 ( 29 % ) were females, 21 patients have left sided ( 38 % ), 4 right sided (7.27% )and 7 patients have bilateral ( 12.72 % ) defects. 2 patients (3.63 %) had family history of cleft lipand both were males. In group B, 12 patients ( 21.8 %) had cleft palate alone, 7 patients ( 12.72% ) were males and 5 patients ( 9 % ) were females, 10 patients ( 1.18 % ) had soft palate onlywhile 2 patients ( 3.63 % ) had compete ( hard and soft ) palatal defect. In group C, 11 patients,had cleft lip and palate combined ( 20 % ), 6 patients were males ( 10.9 % ) and 5 patients ( 9% ) were females, 8 patients ( 14.54 % ) had only soft palate defect while 3 patients ( 5.45 % )had complete palatal defect associated with 8 patients ( 14.54 % ) left sided unilateral lip defectand 3 patients ( 5.45% ) had bilateral cleft lip. All patients were operated without any mortality.Ages of mothers at earliest were 16 and 18 years, 3 cousin marriages, ( 5.45 % ) all fathers weresmokers, belonged to poor socio economic families and no history of mother’s exposure toradiation, drug abuse during gestational life. Conclusion: As it is obvious from this study thatall patients belongs to poor socio economics group, and all fathers were smokers, 3 patientsborn in parents who had cousin marriages ( 5.45 % ) 2 patients ( 3.63 % ) with family history,cleft lip and palate are multifactorial congenital abnormalities, runs in families and is influencedby various environmental factors.

scholarly journals Case report on bilateral cleft palate with protuded premaxilla

2022 ◽  
Vol 4 (4) ◽  
pp. 154-157
Author(s):  
Priyanka Kosare ◽  
Pallavi Madanrao Bobade
Keyword(s):  
Case Report ◽  
Cleft Palate ◽  
Soft Palate ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Bilateral Cleft Lip ◽  
Icd 10

Cleft palate (ICD 10-Q 35.9) with Protruding of premaxilla is common feature in patient with bilateral cleft lip and palate it is due to the under trained growth at anterior nasal septal and vomero-premaxillary suture without lateral continuities. Hippocrates (400BC) AND Galen(150AD) mansion cleft lip, but not cleft palate in their writing, Cleft palate –Fanco.(1556), Repair of cleft lip –as early as 255-206 BC in CHINA. The first successful closure of a soft palate defect was reported in 1764 by LEMONNIERa French dentist.

Comparison of Velopharyngeal Growth Patterns between Cleft Lip and/or Palate Patients Requiring or Not Requiring Pharyngeal Flap Surgery

1994 ◽  
Vol 31 (6) ◽  
pp. 452-460 ◽  
Author(s):  
Mohammad Mazaheri ◽  
Athanasios E. Athanasiou ◽  
Ross E. Long
Keyword(s):  
Cleft Palate ◽  
Soft Palate ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Growth Curves ◽  
Growth Patterns ◽  
Flap Surgery ◽  
Velopharyngeal Incompetence ◽  
Lateral Cephalograms ◽  
Pharyngeal Flap

This investigation compares the patterns of velopharyngeal growth in cleft lip and/or palate patients. Those who had velopharyngeal competence and acceptable speech are compared with those who presented with velopharyngeal incompetence requiring pharyngeal flap surgery or prosthesis later. Lateral cephalograms of 30 cleft palate only (CPO), 35 unilateral cleft lip and palate (UCLP), and 20 bilateral cleft lip and palate (BCLP) children of the Lancaster Cleft Palate Clinic were studied. These records were taken at 6 month intervals during the first 2 postnatal years and annually thereafter up to 6 years of age. Soft tissue landmark points in the velopharyngeal region were digitized. Length and thickness of the soft palate and height and depth of the nasopharynx were measured. Evaluation of the growth curves of these four cephalometric variables indicated only two significant differences between children who later required pharyngeal flap surgery and those who did not. These differences were found in the growth in length of the soft palate of the CPO group and in the growth in depth of the nasopharynx of the BCLP group. Based on the present cephalometric data, it is Impossible to predict at an early age those cleft lip and/or palate patients who will later require pharyngeal flaps.

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