scholarly journals Prevalence of cleft lip: A retrospective hospital based study

2020 ◽  
Vol 11 (SPL3) ◽  
pp. 1911-1917
Author(s):  
Pranati T ◽  
Dhanraj Ganapathy ◽  
Adimulapu Hima Sandeep
Keyword(s):  
Cleft Palate ◽  
Cleft Lip ◽  
Single Centre ◽  
Multi Centre Study ◽  
Congenital Birth Defects ◽  
Repair Procedure ◽  
Cleft Lip Repair ◽  
And Gender ◽  
Gender Variations ◽  
Rotation Advancement

Amongst the most frequent congenital birth defects are facial malformations, including cleft lips associated with or without cleft palate (CL/P) and cleft palate (CP). Although the incidence of such malformations worldwide is around 1.5 per 1,000 live births, the rate for CL/P ranges six-fold and for CP three-fold. The study aims to determine the prevalence and gender variations of isolated cleft lip among patients who have visited Saveetha Dental College and have undergone primary cleft lip repair procedure. A retrospective study was conducted and data collection was done from dental archives pertaining from June 2019 to April 2020. Data consisted of patients with isolated cleft lip who underwent primary cleft lip repair procedure. Data was imported to IBM SPSS Version 20 for statistical analysis. Results were tabulated. From this study, it has been observed that prevalence of isolated cleft lip is more among males (55.6%) compared to females (44.4%) and belonging to the age group 0 to 6 years. Millard's technique (rotation advancement technique) is the most commonly employed technique for primary cleft lip repair. Male predilection observed (statistically not significant). This study was conducted in a single centre – Saveetha Dental College. Extensive multi centre study with increased sample size is to be done.

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.

scholarly journals Cleft Lip Repair: Technical Refinements for the Wide Cleft

2010 ◽  
Vol 3 (2) ◽  
pp. 81-86 ◽  
Author(s):  
Eric Meyer ◽  
Alan Seyfer
Keyword(s):  
Congenital Malformations ◽  
Cleft Lip ◽  
Common Type ◽  
Upper Lip ◽  
Vast Array ◽  
Triangular Flap ◽  
Aesthetic Results ◽  
Cleft Lip Repair ◽  
Rotation Advancement

Clefts of the lip and palate are among the most common congenital malformations. A unilateral deformity is the most common type of cleft, but even within this subgroup there is a great deal of variety due to the accompanying severe distortion of the upper lip, cheek, nose, and maxilla. To repair such a variety of clefts with good aesthetic results, several general incisional approaches should be mastered along with a variety of subtle techniques that improve the end product. The most common repair utilized in America is the Millard rotation-advancement technique. This is partly due to the perceived superiority in results compared with other repairs and the ease with which this repair can be taught to residents. This repair places the scar along an artificial philtral column and is often quite sufficient in small clefts. Unfortunately, adoption of this “one size fits all” approach can limit the arsenal of the surgeon facing the vast array of differing cleft lip deformities. For example, the modified triangular flap, or Tennison-Randall repair, can be of value when presented with the wider unilateral cleft lip. In an effort to not only demonstrate that excellent results can be achieved when incisional patterns (Millard and Tennison) are used appropriately (small versus large clefts), we compared the results of two types of repairs, performed by a single surgeon over a period of 30 years. In addition, a variety of subtle techniques are reviewed to assist in obtaining excellent aesthetic results for any size repair.

scholarly journals Antropometric Evaluation Of Gentur's Cheiloplasty Method In Unilateral Cleft Lip

2017 ◽  
Vol 3 (2) ◽  
pp. 52-60
Author(s):  
Rani Septrina ◽  
Gentur Sudjatmiko
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Anthropometric Data ◽  
Cross Sectional ◽  
Before And After ◽  
Cleft Lip Repair ◽  
Unilateral Cleft Lip Repair ◽  
Palate Patient ◽  
Vertical Height ◽  
Rotation Advancement

Background: Cheiloplasty, the earliest surgical procedure in cleft lip and palate patient, has impact on functional and aesthetical appearance1. The Gentur’s technique is a method of cleft lip surgery that has been developed by him and has been used in RSUPN Cipto Mangunkusumo/Faculty of Medicine Universitas Indonesia2. It uses the rotation-advancement, small triangular, preventing notching concepts with some other details to overcome the wide cleft. This study was conducted to answer whether the Gentur’s technique gives symmetrical result in anthropometric measurements. Methods: Cross sectional analytic study will be taken from medical record in 14 unilateral cleft lip patients underwent cheiloplasty procedure. Direct anthropometric data before and after procedure were analyzed using SPSS17. Anthropometric data such as cupid’s bow, vertical height, horizontal height, vermillion and nostril were noted. Results: From 14 patients, we found 9 patients who underwent surgery in 3 months of age (64.3%) are mostly female (n=9, 64.3%), have complete defect (n=12, 85.8%) and left sided defect (n=8, 57.1%). Gentur’s technique is able to produce significant lip and nose symmetry (CI 95%, pvalue <0.005) in cupid’s bow, vertical height, horizontal height, thickness of vermillion and nose. By doing this technique, the author is able to create good lip and nose symmetry (78.57%) even in wide defect (64.3%) and palatal collapse (57.1%). Conclusion: Gentur’s technique is able to utilize tissue deficiency to create ideal lip and nose in unilateral cleft lip repair even in patients with wide gap.

Improved Early Cleft Lip and Palate Complications at a Surgery Specialty Center in the Developing World

2018 ◽  
Vol 55 (8) ◽  
pp. 1145-1152 ◽  
Author(s):  
Eugene Park ◽  
Gaurav Deshpande ◽  
Bjorn Schonmeyr ◽  
Carolina Restrepo ◽  
Alex Campbell
Keyword(s):  
Cleft Palate ◽  
Cleft Lip ◽  
Developing World ◽  
Cleft Lip And Palate ◽  
Care Delivery ◽  
Complication Rates ◽  
Surgical Mission ◽  
Cleft Palate Repair ◽  
Cleft Lip Repair ◽  
Palate Repair

Objective: To evaluate complication rates following cleft lip and cleft palate repairs during the transition from mission-based care to center-based care in a developing region. Patients and Design: We performed a retrospective review of 3419 patients who underwent cleft lip repair and 1728 patients who underwent cleft palate repair in Guwahati, India between December 2010 and February 2014. Of those who underwent cleft lip repair, 654 were treated during a surgical mission and 2765 were treated at a permanent center. Of those who underwent cleft palate repair, 236 were treated during a surgical mission and 1491 were treated at a permanent center. Setting: Two large surgical missions to Guwahati, India, and the Guwahati Comprehensive Cleft Care Center (GCCCC) in Assam, India. Main Outcome Measure: Overall complication rates following cleft lip and cleft palate repair. Results: Overall complication rates following cleft lip repair were 13.2% for the first mission, 6.7% for the second mission, and 4.0% at GCCCC. Overall complication rates following cleft palate repair were 28.0% for the first mission, 30.0% for the second mission, and 15.8% at GCCCC. Complication rates following cleft palate repair by the subset of surgeons permanently based at GCCCC (7.2%) were lower than visiting surgeons ( P < .05). Conclusions: Our findings support the notion that transitioning from a mission-based model to a permanent facility-based model of cleft care delivery in the developing world can lead to decreased complication rates.

scholarly journals Dexamethasone Suppresses Palatal Cell Proliferation through miR-130a-3p

2021 ◽  
Vol 22 (22) ◽  
pp. 12453
Author(s):  
Hiroki Yoshioka ◽  
Goo Jun ◽  
Akiko Suzuki ◽  
Junichi Iwata
Keyword(s):  
Cell Proliferation ◽  
Cleft Palate ◽  
Birth Defects ◽  
Cleft Lip ◽  
Neural Crest Cell ◽  
Congenital Birth Defects ◽  
Cranial Neural Crest Cell ◽  
Primary Mouse ◽  
Mirna Sequencing ◽  
Crest Cell

Cleft lip with or without cleft palate (CL/P) is one of the most common congenital birth defects. This study aims to identify novel pathogenic microRNAs associated with cleft palate (CP). Through data analyses of miRNA-sequencing for developing palatal shelves of C57BL/6J mice, we found that miR-449a-3p, miR-449a-5p, miR-449b, miR-449c-3p, and miR-449c-5p were significantly upregulated, and that miR-19a-3p, miR-130a-3p, miR-301a-3p, and miR-486b-5p were significantly downregulated, at embryonic day E14.5 compared to E13.5. Among them, overexpression of the miR-449 family (miR-449a-3p, miR-449a-5p, miR-449b, miR-449c-3p, and miR-449c-5p) and miR-486b-5p resulted in reduced cell proliferation in primary mouse embryonic palatal mesenchymal (MEPM) cells and mouse cranial neural crest cell line O9-1. On the other hand, inhibitors of miR-130a-3p and miR-301a-3p significantly reduced cell proliferation in MEPM and O9-1 cells. Notably, we found that treatment with dexamethasone, a glucocorticoid known to induce CP in mice, suppressed miR-130a-3p expression in both MEPM and O9-1 cells. Moreover, a miR-130a-3p mimic could ameliorate the cell proliferation defect induced by dexamethasone through normalization of Slc24a2 expression. Taken together, our results suggest that miR-130-3p plays a crucial role in dexamethasone-induced CP in mice.

A Surgical and Educational Video of the Inferior Turbinate Mucosal Flap for the Nasal Floor and Intraoral Reconstruction in Unilateral Complete Cleft Lip Repair

2020 ◽  
Vol 57 (8) ◽  
pp. 1045-1050
Author(s):  
Rafael Denadai ◽  
Pang-Yun Chou ◽  
Soyeon Jung ◽  
Nobuhiro Sato ◽  
Dax Carlo G. Pascasio ◽  
...  
Keyword(s):  
Cleft Lip ◽  
Inferior Turbinate ◽  
Original Description ◽  
Educational Video ◽  
Mucosal Flap ◽  
Intraoral Reconstruction ◽  
Nasal Floor ◽  
Cleft Lip Repair ◽  
Key Steps ◽  
Rotation Advancement

Since the original description of Millard rotation advancement principle for cleft lip repair, many important contributions have subsequently been described by other surgeons worldwide. However, the reconstruction of the nasal floor and intraoral lining has received less attention over time. This article demonstrates a modified unilateral complete cleft lip repair using the rotation advancement principle plus multipurpose inferior turbinate mucosal flap. The accompanying videos display the 10 key steps for rationale, design, and proper execution of the inferior turbinate mucosal flap for the nasal floor and intraoral reconstruction.

Cleft Lip Repair

2019 ◽  
pp. 503-518
Author(s):  
Samuel Lance ◽  
Catherine Tsai ◽  
Amanda Gosman
Keyword(s):  
Surgical Technique ◽  
Plastic Surgery ◽  
Clinical Evaluation ◽  
Postoperative Care ◽  
Cleft Lip ◽  
Surgical Techniques ◽  
Bilateral Cleft Lip ◽  
Cleft Lip Repair ◽  
Rotation Advancement

Understanding the anatomy and surgical technique for repair of the unilateral and bilateral cleft lip remain essential to the practice of plastic surgery. This chapter summarizes the relevant anatomy, clinical evaluation, surgical technique, and postoperative care of the cleft lip patient. Step-by-step surgical descriptions and illustrations are provided along with commentary regarding common pitfalls encountered with these techniques. The surgical techniques described are a modified Millard rotation advancement technique for repair of the unilateral cleft lip and a modified Byrd repair for correction of the bilateral cleft lip.

Alveolar Bone Grafting

2019 ◽  
pp. 95-98
Author(s):  
Raj M. Vyas ◽  
Gennaya L. Mattison
Keyword(s):  
Cleft Palate ◽  
Bone Graft ◽  
Bone Grafting ◽  
Crucial Role ◽  
Cleft Lip ◽  
Alveolar Bone ◽  
Mixed Dentition ◽  
Maxillary Expansion ◽  
Alveolar Bone Grafting ◽  
Cleft Lip Repair

Alveolar bone grafting plays a crucial role in cleft reconstruction. When neonatal presurgical orthodontia is successful in aligning the cleft segments, alveolar reconstruction can be initiated as a gingivoperiosteoplasty during primary cleft lip repair. In children with cleft palate, alveolar bone grafting is usually done after transverse maxillary expansion with a palatal expander. Exact timing of bone grafting is controversial; most centers initiate orthodontic evaluation/expansion between ages 7 and 8 years (beginning of mixed dentition) with an aim to bone graft before age 10 in order to allow osteogenic incorporation prior to eruption of the permanent canine teeth.

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