scholarly journals Knowledge and practice of feeding plate obturators among medical doctors in Kanti children’s hospital

2021 ◽  
Vol 4 (1) ◽  
pp. 20-28
Author(s):  
B Pathak ◽  
KR Joshi ◽  
S Bhattarai ◽  
H Joshi
Keyword(s):  
Cleft Palate ◽  
Cleft Lip ◽  
Treatment Protocol ◽  
Medical Doctors ◽  
Feeding Difficulties ◽  
Children's Hospital ◽  
Children’S Hospital ◽  
Knowledge And Practice ◽  
Feeding Plate ◽  
Study Participants

Introduction: Cleft lip and cleft palate (CLCP) affects several systems and functions of the child and result in social and psychological problems.Therefore early repair of CLCP is imperative. Every cleft center follows its own surgical treatment protocol. Before closure of palatal defects, babies with cleft palate have great difficulty in feeding. To overcome this feeding difficulties, use of special bottles, nipples, initial palatal obturator therapy are used. The first exposure of those children are primarily the medical doctors including pediatricians from where they are generally referred to the concerned speciality for repair of CLCP. The aim of this study was to assess the knowledge and practice of orofacial clefts and feeding plate obturator among medical doctors working in Kanti Children’s Hospital (KCH). Method: This was a questionnaire based survey among medical doctors working in KCH. The pretested questionnaire with 7 questions each on the knowledge and practice of feeding plate obturator was distributed among the medical doctors and data was collected. The data collected were subjected to statistical analysis using frequency of responses and percentages. Results: Of the total 57 study participants, 32 (56.1%) were males and 25 (43.9%) were females. Majority i.e. 61.4% belonged to 31-40 years age group. 91.2% study participants faced the cleft lip/ palate related feeding difficulties 0-5 times/month while 5 (8.8%) faced this condition 6-10 times/ month. Majority of the infants who were less than 28 days (43.9%) attended the OPD due to difficultyin feeding/ swallowing (57.9%) followed by regurgitation/ aspiration (22.8%). 49.1% of the participants thought feeding plate oburator as the best way to feed a cleft patient on discharge from hospital. In their clinical practice, three fourth of paticipants (70.2%) had never seen a patient with feeding plate obturator, half of the participants (50.9%) didn’t advise for feeding plate obturator for patients withcleft palate and 89.5% were not aware of the replacement of feeding plate obturator. Conclusion: There is low exposure regarding the feeding plate obturator among medical doctors in KCH which needs to be reinforced through meaningful continuing education and training programs.

scholarly journals The efficacy of transnasal palatal transillumination for the diagnosis of submucous cleft palate

2021 ◽  
Vol 17 (1) ◽  
Author(s):  
Yasir S. Jamal ◽  
Sabah S. Moshref ◽  
Abeer M. Baamir ◽  
Mazin O. Kurdi ◽  
Doaa Y. Jamal
Keyword(s):  
Cleft Palate ◽  
Cleft Lip ◽  
Diagnostic Techniques ◽  
Lateral Release ◽  
Feeding Difficulties ◽  
Presenting Symptoms ◽  
Submucous Cleft Palate ◽  
Cheap Method ◽  
Operative Findings ◽  
Simple Repair

Abstract Background Submucous cleft palate (SMCP) is a congenital abnormality with various clinical and anatomical features. Submucous cleft pathologies may be unrecognized during routine examinations. Current diagnostic techniques are constrained and unrevealing in presurgical patients. This prospective study aimed to evaluate transnasal palatal transillumination technique in diagnosis of SMCP at our institute hospital, during period from 2005-2020. Patients and methods Twenty-one cases with SMCP were recruited with age range from 2-60 months. Transnasal palatal transillumination with controllable light intensity endoscope used to evaluate SMCP and cases were photo and video recorded. Results In this study, 21 cases (13 males and 8 females) with SMCP were detected or confirmed by intranasal transnasal palatal transillumination. Frequency of SMCP patients at our institute was 3.39%. All patients presented with symptomatic complaints at diagnosis time, apart from 5 patients (23.8%) were diagnosed during cleft lip repair operations. Presenting symptoms were hypernasality (23.8%), delayed speech (23.8%), perforated palate with nasal escape of milk and food (14.3%), feeding difficulties (14.3%), and otitis media (4.8%). During intra-oral examination, all cases had a bifid uvula accompanied SMCP. Submucous cleft palate appeared as thin palate with central lucency. According to operative findings, operations done for repair were mostly two long palatal flaps (n = 13, 61.9%), von Langenbeck (n = 5, 23.8%), simple repair with lateral release incisions (n = 2, 9.6%), and simple repair without lateral release incision (n = 1, 4.8%). Conclusions Intraoperative assessment of submucous cleft palate with transnasal palatal transillumination is easy and cheap method to avoid missing cases of SMCP.

scholarly journals Successful Management of Feeding Difficulties in Patient with Severe Bilateral Cleft Lip and Palate

2014 ◽  
Vol 4 (2) ◽  
pp. 124-126
Author(s):  
Dimple Padawe ◽  
Vilas Takate ◽  
Tanay Gunjikar
Keyword(s):  
Cleft Lip ◽  
Developmental Disorder ◽  
Cleft Lip And Palate ◽  
Failure To Thrive ◽  
Later Life ◽  
Successful Management ◽  
Feeding Difficulties ◽  
Psychological Maladjustment ◽  
Bilateral Cleft Lip ◽  
Feeding Plate

ABSTRACT Cleft lip and palate is one of the most common developmental disorder found in humans. A child born with cleft lip and palate has plethora of complex problems, such as feeding difficulties, middle ear diseases, dentofacial abnormalities, slow weight gain, and even failure to thrive. Feeding difficulties are the main cause of distress for both the child and mother, and may also lead to psychological maladjustment of child in later life. Various methods have been described to overcome feeding difficulties faced child and mother. This case report describes a case of severe bilateral cleft lip and palate (Veau's class IV cleft) successfully managed by fabrication of simple feeding plate and counseling of mother. How to cite this article Padawe D, Takate V, Gunjikar T. Successful Management of Feeding Difficulties in Patient with Severe Bilateral Cleft Lip and Palate. J Contemp Dent 2014; 4(2):124-126.

A Systematic Review of Feeding Interventions for Infants with Cleft Palate

2021 ◽  
pp. 105566562110512
Author(s):  
Cameron Penny ◽  
Connor McGuire ◽  
Michael Bezuhly
Keyword(s):  
Systematic Review ◽  
Cleft Palate ◽  
Systematic Reviews ◽  
Cleft Lip ◽  
Positive Impact ◽  
Delivery Systems ◽  
Measurement Tool ◽  
Education Programs ◽  
Feeding Difficulties ◽  
Feeding Interventions

Objective Various devices and techniques have been proposed to reduce feeding difficulties experienced by infants with cleft palate. The aim of this review is to identify and assess the scope and quality of evidence for these interventions. Methods A systematic review of published literature evaluating feeding interventions for infants with cleft palate (with or without cleft lip) from database inception to 2021 was conducted using Preferred Reporting Items for Systematic Reviews guidelines. Quality appraisal of included studies was conducted using a methodological index for nonrandomized studies, Cochrane, or a measurement tool to assess systematic reviews 2 instruments, according to study type. Results Fourteen studies met inclusion criteria, with the majority (71%) of studies consisting of second-level evidence. Included interventions were specialty bottles (21%), alternative feeding delivery systems (14%), obturators (14%), and educational programs (14%). Specialty bottles and palatal obturators did not appear to offer any substantial growth advantages compared to traditional bottles or no intervention, respectively. Designated education programs for the mothers of infants with clefts had a positive impact on infant growth. Conclusions Overall evidence evaluating feeding interventions for infants with cleft palate was moderate to low. While it does not appear that specialized feeding delivery systems or palatal obturators significantly improve growth in infants with clefts compared to children without cleft conditions, education programs do appear to be beneficial.

scholarly journals A Cross-Sectional Analysis of the BC Children’s Hospital Cleft Palate Program Waitlist

2019 ◽  
Vol 27 (4) ◽  
pp. 311-318 ◽  
Author(s):  
Leslie Tze Fung Leung ◽  
Christine A. Loock ◽  
Rebecca Courtemanche ◽  
Douglas J. Courtemanche
Keyword(s):  
Cleft Palate ◽  
Plastic Surgery ◽  
Wait Time ◽  
Wait Times ◽  
Service Needs ◽  
Cross Sectional ◽  
Clinical Assessments ◽  
Children's Hospital ◽  
Children’S Hospital ◽  
Sectional Analysis

Objective: A 2016 review of the BC Children’s Hospital Cleft Palate - Craniofacial Program (CPP) revealed that one-third of patients met the program’s care recommendations and half met the American Cleft Palate-Craniofacial Association guidelines. This study reviews patients on the CPP waitlist and determines median wait times and missed clinical assessments as well as identifies how wait times are influenced by medical complexity, specialized speech service needs, vulnerability, and distance from clinic. Design: Cross-sectional. Setting: BC Children’s Hospital Cleft Palate—Craniofacial Program. Patients: Five hundred seventy-six waitlisted patients. Main Outcome Measures: Additional wait time after recommended appointment date. Correlation of additional wait time with diagnosis, number of specialists required, speech services needed, vulnerability, and distance from the clinic. Missed plastic surgery, speech, and orthodontic assessments according to CPP team recommendations and ACPA guidelines. Results: Patients had a median additional wait time of 11 months (interquartile range: 5-27). Longer additional wait times were associated with a craniofacial diagnosis ( P = .019), a need for formal speech assessments or evaluations ( P < .001), or a requirement to see multiple specialists ( P < .001). Vulnerability and distance from clinic did not affect wait times. Plastic surgery assessments were not available at the preschool and preteen time points for 45 (8%) patients, 355 (62%) patients were unable to access speech assessments, and 120 (21%) were unable to complete an orthodontic assessment. Conclusion: Patients wait up to an additional year to be seen by the CPP and miss speech, orthodontic, and surgical assessments at key developmental milestones. Additional resources are required to address these concerns.

A clinical case of hamartoma (teratoma) of the tongue in combination with a cleft palate in a newborn

2020 ◽  
pp. 42-45
Author(s):  
Yu.O. Volkov ◽  
Ad.A. Mamedov ◽  
L.M. Makarova ◽  
E.A. Ryzhov ◽  
B.A. Tkachenko
Keyword(s):  
Cleft Palate ◽  
Congenital Malformation ◽  
Clinical Case ◽  
Interdisciplinary Approach ◽  
Successful Implementation ◽  
Maxillofacial Region ◽  
Children's Hospital ◽  
Children’S Hospital ◽  
Newborn Child ◽  
Subsequent Rehabilitation

The article presents a rare clinical case of hamartoma of the tongue in combination with a cleft palate, diagnosed in a newborn child, as a manifestation of a severe congenital malformation of the maxillofacial region. The preparation and successful implementation of the first stage of treatment of this combined pathology and subsequent rehabilitation in a multidisciplinary children's hospital are described in detail on the basis of continuity in the work of specialists and an interdisciplinary approach.

Time Trends and Determinants of Fistula in Cleft Patients at BC Children's Hospital, Canada

2018 ◽  
Vol 55 (7) ◽  
pp. 1013-1019
Author(s):  
Negar Salimi ◽  
Jolanta Aleksejüunienė ◽  
Edwin Yen ◽  
Angelina Loo
Keyword(s):  
Time Trends ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Palatal Fistula ◽  
Children's Hospital ◽  
Time Period ◽  
Treatment Type ◽  
Children’S Hospital ◽  
Total Observation ◽  
Type Of Surgery

Objective: To examine the time trends and determinants of palatal fistula in children with different types of cleft at British Columbia's Children's Hospital between 1995 and 2012. Methods: A total of 558 medical charts of nonsyndromic patients with cleft lip and palate were eligible for the chart review. The occurrence of primary palatal fistula was assessed at any time throughout the patient's total observation period. Three types of clefts were recorded: unilateral cleft lip and palate (ULCLP), bilateral cleft lip and palate (BLCLP), and isolated cleft palate (ICP). Cleft severity, time period of treatment, type of surgery and surgeon's experience were tested as determinants. Results: Of all 558 patients, 228 had ULCLP, 226 had ICP, and 104 had BLCLP. The combined postoperative palatal fistula rate was 28%. The significant differences in fistula rates related to type of cleft (patients with BLCLP had the highest fistula rates), time period (rates were higher in earlier years than in later years), type of surgery (highest rates were for two-flap palatoplasty), and surgeons with less experience. Conclusions: Almost one quarter of the patients, developed fistula, and fistula incidence declined after 2009. The higher fistula rates were determined by cleft severity, time period of treatment, type of surgery, and surgeon's experience.

Factors Associated With Delay in Cleft Surgery at a Tertiary Children’s Hospital in a Major US Metropolitan City

2021 ◽  
pp. 105566562198950
Author(s):  
Jacqueline Stoneburner ◽  
Naikhoba C. O. Munabi ◽  
Eric S. Nagengast ◽  
Madeleine S. Williams ◽  
Pedram Goel ◽  
...  
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Female Gender ◽  
Hispanic Ethnicity ◽  
Delayed Surgery ◽  
Factors Associated ◽  
Children's Hospital ◽  
Children’S Hospital ◽  
Syndromic Diagnosis ◽  
Cleft Surgery

Objective: To identify factors associated with late cleft repair at a US tertiary children’s hospital. Design: Retrospective study of children with CL/P using Children’s Hospital Los Angeles (CHLA) records. Setting: US tertiary children’s hospital. Patients/Participants: Patients undergoing primary CL or CP repair at CHLA from 2009 to 2018. Main Outcome Measures: Proportion of children who had delayed primary CL repair or CP repair using CHLA and American Cleft Palate-Craniofacial Association (ACPA) guidelines and factors associated with late surgery. Results: In total, 805 patients—503 (62.5%) who had CL repair, 302 (37.5%) CP repair—were included. Using CHLA protocol, 14.3% of patients seeking CL repair had delayed surgery. Delay was significantly associated with female gender, non-Hispanic ethnicity, Spanish primary language, government insurance, bilateral cleft, cleft lip and palate (CLP), and syndromic diagnosis. Using ACPA guidelines, 5.4% had delayed surgery. Female gender and syndromic diagnosis were significantly associated with delay and remained significant after adjustment for confounders in multivariate models. For CP repair, 60.3% of patients had delayed surgery using CHLA protocol. Cleft lip and palate diagnosis, complete cleft, syndromic diagnosis, and longer travel distance were significantly associated with delay. Using ACPA guidelines, 28.5% had delayed surgery; however, significant association with patient variables was not consistently observed. Conclusions: Delay in cleft surgery occurs most often for patients seeking CP repair and is associated with female gender, non-Hispanic ethnicity, Spanish language, government insurance, and bilateral CL, CLP, or syndromic diagnoses. Initiatives should aim to optimize cleft surgery delivery for these subpopulations.

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