Single-visit Feeding Obturator Fabrication in Infants with Cleft Lip and Palate: A Case Series and Narrative Review of Literature

Presurgical infant orthopedics (PSIO) is done to reduce the size of the cleft defect along with improving the arch alignment and nasolabial aesthetics in patients with cleft lip and palate, leading to an improvement of nasolabial aesthetics allowing for a tidier and more aesthetic reparative procedure and postsurgical scar. Since the 2000s, clear aligners have slowly and steadily treaded their way as an acceptable orthodontic modality, with their usage and acceptability increasing considerably over the past decade. Thus, from the knowledge gathered in its 10 years working with 3-dimensional (3-D) diagnosis, treatment planning, and 3-D Printing services, Compass 3D (Belo Horizonte, Brazil) developed the OrthoAligner NAM system. This case series highlights one of the world’s first documented cases of PSIO treated with a series of clear aligners.

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Hard Palate Repair Timing and Facial Growth in Cleft Lip and Palate: A Systematic Review

The Cleft Palate-Craniofacial Journal ◽

10.1597/05-058 ◽

2006 ◽

Vol 43 (5) ◽

pp. 563-570 ◽

Cited By ~ 48

Author(s):

Yu-Fang Liao ◽

Michael Mars

Keyword(s):

Systematic Review ◽

Hard Palate ◽

Cleft Lip ◽

Cleft Lip And Palate ◽

Case Reports ◽

Case Series ◽

Long Term Results ◽

Facial Growth ◽

Cleft Lip Palate ◽

Palate Repair

Objective: To evaluate the effect of timing of hard palate repair on facial growth in patients with cleft lip and palate, with special reference to cranial base, maxilla, mandible, jaw relation, and incisor relation. Design: A systematic review. Methods: The search strategy was based on the key words “facial growth,” “cleft lip palate,” and “timing of (hard) palate repair.” Case reports, case-series, and studies with no control or comparison group in the sample were excluded. Results: Fifteen studies met the selection criteria. All the studies were retrospective and nonrandomized. Five studies used cephalometry and casts, seven used cephalometry, and three used casts. Methodological deficiencies and heterogeneity of the studies prevented major conclusions. Conclusion: The review highlights the importance of further research. Prospective well-designed, controlled studies, especially targeting long-term results, are required to elucidate the effect of timing of hard palate repair on facial growth in patients with cleft lip and palate.

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Long-Term Otologic and Audiometric Outcomes in Patients with Cleft Palate

Otolaryngology ◽

10.1177/0194599817707514 ◽

2017 ◽

Vol 157 (4) ◽

pp. 676-682 ◽

Cited By ~ 10

Author(s):

Terence E. Imbery ◽

Lindsay B. Sobin ◽

Emily Commesso ◽

Lindsey Koester ◽

Sherard A. Tatum ◽

...

Keyword(s):

Cleft Palate ◽

Cleft Lip ◽

Cleft Lip And Palate ◽

Medical Center ◽

Academic Medical Center ◽

Case Series ◽

Closure Rate ◽

Pressure Equalization

Objective Describe longitudinal audiometric and otologic outcomes in patients with cleft palates. Study Design Case series with chart review. Setting Single academic medical center. Methods Charts of 564 patients with a diagnosis of cleft palate (59% syndromic etiology, 41% nonsyndromic) from 1998 to 2014 were reviewed. Patients without at least 1 audiometric follow-up were excluded from analysis. Patient demographics, surgeries, audiometric tests, and otologic data were recorded for 352 patients. Results Forty-five percent had isolated cleft palates, 34% had unilateral cleft lip and palate, and 21% had bilateral cleft lip and palate. Patients were followed for a mean of 50.3 months with a mean of 3.2 separate audiograms performed. Patients received a mean of 2.93 pressure equalization tubes. Increased number of pressure equalization tubes was not associated with incidence of cholesteatoma, which was identified in only 4 patients. Nine patients underwent eventual tympanoplasty with an 89% closure rate. Analysis of mean air-bone gap by cleft type did not reveal significant differences ( P = .08), but conductive losses and abnormal tympanometry persisted into teenage years. Conclusions Patients with cleft palates have eustachian tube dysfunction, which, in our cohort, resulted in persistent conductive hearing loss, highlighting the importance of long-term follow-up. Cholesteatoma incidence was low and not associated with number of tubes, which at our institution were placed prophylactically. Tympanoplasty was successful in those with persistent perforations.

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A clinical and demographic profile of the cleft lip and palate in Sub-Himalayan India: A hospital-based study

Indian Journal of Plastic Surgery ◽

10.4103/0970-0358.96602 ◽

2012 ◽

Vol 45 (01) ◽

pp. 115-120 ◽

Cited By ~ 12

Author(s):

Jyoti Dvivedi ◽

Sanjay Dvivedi

Keyword(s):

Cleft Lip ◽

Cleft Lip And Palate ◽

Health Workers ◽

Tertiary Care ◽

Case Series ◽

Care Hospital ◽

Low Socioeconomic ◽

The Status ◽

Baseline Information ◽

History Of

ABSTRACT Objectives: To study the cleft lip and cleft palate in the poverty stricken Sub-Himalayan Garhwal region of India, being a commonly seen congenital abnormality and scarcity of studies about the demography of cleft in this region. Design: A prospective cohort observational case series was performed on 4657 cleft patients at a Tertiary care Hospital in Dehradun, India, over a period of 5 years. Outcome measures: The authors investigated the differences between age and sex with cleft status and family history of clefts, birth order, religion, socioeconomic status, parent literacy, source of information for treatment, haematological investigations showing the status of infection and coagulation in such children and satisfaction after treatment. Results: Seventy-two percent parents of cleft lip patients were illiterate, and only 8% were graduates, the majority of patients were from the low socioeconomic class. The siblings of 1.1% of the cleft patients had similar deformity. Anemia was seen in 83.16% cases which was commonly microcytic hypochromic type and eosinophilia was seen in 25.50% of cases. In the coagulation profile, International Nationalized Ratio was found to be raised in 52.12%. Almost 95% of the families were fully satisfied by the treatment and results. Conclusion: This study will provide baseline information on the status of these less privileged cleft patients in this mountainous region for future reference to health workers.

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Three-Dimensional Soft Tissue Nasal Changes After Nasoalveolar Molding and Primary Cheilorhinoplasty in Infants With Unilateral Cleft Lip and Palate

The Cleft Palate-Craniofacial Journal ◽

10.1177/1055665618771427 ◽

2018 ◽

Vol 56 (1) ◽

pp. 31-38 ◽

Cited By ~ 3

Author(s):

Laura Mancini ◽

Travis L. Gibson ◽

Barry H. Grayson ◽

Roberto L. Flores ◽

David Staffenberg ◽

...

Keyword(s):

Cleft Lip ◽

Cleft Lip And Palate ◽

Three Dimensional ◽

Case Series ◽

Midsagittal Plane ◽

Retrospective Case ◽

Anthropometric Measures ◽

Nasal Tip ◽

Nasoalveolar Molding ◽

Nasal Changes

Objective: To quantify 3-dimensional (3D) nasal changes in infants with unilateral cleft lip with or without cleft palate (UCL±P) treated by nasoalveolar molding (NAM) and cheilorhinoplasty and compare to noncleft controls. Design: Retrospective case series of infants treated with NAM and primary cheilorhinoplasty between September, 2012 and July, 2016. Infants were included if they had digital stereophotogrammetric records at initial presentation (T1), completion of NAM (T2), and following primary cheilorhinoplasty (T3). Images were oriented in 3dMD Vultus software, and 16 nasolabial points identified. Patients: Twenty consecutively treated infants with UCL±P. Interventions: Nasoalveolar molding and primary cheilorhinoplasty. Main Outcome Measures: Anthropometric measures of nasal symmetry and morphology were compared in the treatment group between time points using paired Student t tests. Postsurgical nasal morphology was compared to noncleft controls. Results: Nasal tip protrusion increased, and at T3 was 2.64 mm greater than noncleft controls. Nasal base width decreased on the cleft side by 4.01 mm after NAM and by 6.73 mm after cheilorhinoplasty. Columellar length of the noncleft to cleft side decreased from 2:1 to 1:1 following NAM. Significant improvements in subnasale, columella, and nasal tip deviations from midsagittal plane were observed. Treatment improved symmetry of the alar morphology angle and the nasal base–columella angle between cleft and noncleft sides. Conclusions: Three-dimensional analysis of UCL±P patients demonstrated significant improvements in nasal projection, columella length, nasal symmetry, and nasal width. Compared to noncleft controls, nasal form was generally corrected, with overcorrection of nasal tip projection, columella angle, and outer nasal widths.

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Transporte óseo alveolar intraoral en pacientes con hendiduras alveolares: serie de casos Intraoral alveolar bone transportation in alveolar cleft patients: case series

ACTA DE OTORRINOLARINGOLOGÍA & CIRUGÍA DE CABEZA Y CUELLO ◽

10.37076/acorl.v45i4.121 ◽

2018 ◽

Vol 45 (4) ◽

pp. 255-260

Author(s):

Luis Gonzalez ◽

Alberto Pedraza

Keyword(s):

Cleft Lip ◽

Cleft Lip And Palate ◽

Alveolar Bone ◽

Average Distance ◽

Case Series ◽

Retrospective Case ◽

Alveolar Cleft ◽

Fixed Dental Prosthesis ◽

Case Series Study ◽

Bone Transportation

Introducción: El tratamiento de la hendidura alveolar, del paciente fisurado, permite un adecuado crecimiento facial. Los injertos óseos han sido el tratamiento ideal. Sin embargo la técnica de distracción osteogénica mediante transporte óseo alveolar intraoral ha demostrado ser muy predecible. Objetivo: Describir los resultados del cierre de la Hendidura alveolar, con la técnica de transporte óseo alveolar intraoral bifocal y trifocal en pacientes labio fisurados. Diseño: Estudio retrospectivo de serie de casos. Materiales y métodos: Fueron tratados 4 pacientes con hendidura alveolar unilateral, manejados con la técnica de transporte óseo alveolar intraoral bifocal y trifocal en el año 2008 al 2009, con un seguimiento hasta el año 2014. Todos los pacientes fueron tratados con un aparato Hyrax® (Dentaurum, Alemania) modificado. Resultados: El promedio de distancia del transporte óseo requerido fue de 9,75mm (rango de 15 mm a 9 mm). Se colocaron 5 implantes dentales rehabilitados con prótesis dental fija. Conclusión: El estudio de los casos clínicos demuestra una predictibilidadelevada así como un rango de éxito alto, en los individuos tratados conesta técnica. Por tal motivo el transporte óseo alveolar intraoral es una alternativa eficaz para el tratamiento de hendiduras alveolares extensas.Introduction: The management of alveolar cleft patients, allows an adequate facial growth in cleft lip and palate patients. Bone grafts have been the gold standard treatment. However, the technique of osteogenic distraction by intraoral alveolar bone transportation has proven to be highly predictable. Objective: To describe the results of alveolar cleft management with the intraoral bifocal and trifocal alveolar bone transportation technique in cleft palate patients. Design of study: Retrospective case series study. Materials and methods: 4 patients with unilateral alveolar cleft were treated with the bifocal and trifocal intraoral alveolar bone transportation technique from 2008 to 2009. The cases were followed up until 2014. All patients were treated with a modified Hyrax® (Dentaurum, Germany) device. Results: The average distance of bone transportation required was 9.75mm (range from 15mm to 9mm). 5 dental implants with fixed dental prosthesis were placed. Conclusion: Clinical cases study demonstrated a high predictability, as well as a high success ratein individuals treated with this technique. Therefore, intraoral alveolar bone transportation is an effective alternative for the management of extensive alveolar clefts.

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Cosmetic Outcome Following Cleft Lip and Palate Repair: A Case Series

10.36648/2254-6758.7.1.107 ◽

2019 ◽

Vol 07 (01) ◽

Author(s):

Yallanasa NI ◽

Amrut HB

Keyword(s):

Cleft Lip ◽

Cleft Lip And Palate ◽

Case Series ◽

Cosmetic Outcome ◽

Palate Repair

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Patients With Cleft Lip and Palate Associated With Intraoral Fibrous Bands: A Report of 3 Cases and Review of Literature

The Cleft Palate-Craniofacial Journal ◽

10.1177/1055665619867233 ◽

2019 ◽

Vol 57 (3) ◽

pp. 389-394

Author(s):

Natthacha Vamvanij ◽

Zung-Chung Chen ◽

Lun-Jou Lo

Keyword(s):

Cleft Lip ◽

Cleft Lip And Palate ◽

Mouth Opening ◽

Main Concern ◽

Review Of Literature ◽

Feeding Problems ◽

Review Of The Literature ◽

Early Management ◽

Clinical Presentations ◽

Maxilla And Mandible

In rare instances, cleft lip and palate occur in association with synechia, intraoral fibrous bands connecting the maxilla and mandible. The main concern in synechia is a restricted mouth opening that leads to airway and feeding problems. This study reports our experience in the treatment of 3 cases and includes a review of the literature. Three patients with intraoral fibrous bands received treatment and follow-ups in our center. Division of the bands and reconstruction of the lip and palate were successfully performed. All reported cases in the literature were collected for a summary of clinical presentations and as references for management. Early management of the synechia improves the mouth opening and facilitates the treatment of associated anomalies.

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