Peer Review #2 of "Three-dimensional facial development of children with unilateral cleft lip and palate during the first year of life in comparison with normative average faces (v0.1)"

Objective Because of significant differences in pathomorphology at birth, it may be that a better treatment outcome prognosis exists for patients with incomplete versus complete cleft forms. Can reaction patterns be extracted from changes in maxillary dimensions of different cleft forms within the first year of life to support this hypothesis? Subjects Chronologically consecutive casts of the maxilla (1 week and 3, 6, and 12 months of life) of 15 patients with complete unilateral cleft lip and palate (cUCLP) and 13 patients with incomplete unilateral cleft lip and palate (iUCLP). All patients were treated with passive palatal plates. Cheiloplasty was performed at 6 months of age. No primary osteoplastic surgery was carried out. Interventions Following digitizing with a three-dimensional laser scanner, all cast surfaces were computer reconstructed, aligned, and superimposed. Distances between the surfaces were determined and expressed graphically. Computer-aided determination of defined maxillary dimensions was performed. The volumes of segmented surfaces were determined and compared. Results Within the first year of life, decreased sagittal but increased transverse alveolar growth for patients with iUCLP was found. The increase in alveolar crest length in patients with iUCLP was 50% less within the first year of life than in patients with cUCLP. In the same patients, the volumes of the molar segments were, on average, larger at each registration stage and the increase in these volumes larger within the first year of life. Conclusion Conclusions regarding the direction and extent of growth cannot be drawn from the visible level of severity of the malformation.

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Hospitalization, Breast-Milk Feeding, and Growth in Infants with Cleft Palate and Cleft Lip and Palate Born in Denmark

The Cleft Palate-Craniofacial Journal ◽

10.1597/07-007.1 ◽

2008 ◽

Vol 45 (6) ◽

pp. 628-632 ◽

Cited By ~ 22

Author(s):

Lisa H. V. Smedegaard ◽

Dorthe R. N. Marxen ◽

Jette H. V. Moes ◽

Eva N. Glassou ◽

Cand Scientsan

Keyword(s):

Breast Milk ◽

Cleft Palate ◽

Cleft Lip ◽

Cleft Lip And Palate ◽

First Year ◽

Health Visitors ◽

Facial Clefts ◽

Growth References ◽

First Year Of Life ◽

Milk Feeding

Objective: To evaluate if the duration of postpartum hospitalization, duration of breast-milk feeding, and growth during the first year of life in infants with cleft lip and palate (CLP) and cleft palate (CP) are comparable to infants without facial clefts. Design: Prospective data collection using a registration chart developed by the authors. Setting: Special health care of infants with CLP/CP born in Denmark. Participants: All mature infants with CLP/CP born in 2003 and 2004 were included. Of 165 infants, 115 participated in the study. Intervention: In Denmark, parents of children with CLP/CP receive counseling. This counseling is managed by specially trained health visitors/nurses and is initiated at birth. The counseling seeks to support parents’ confidence in having an infant with CLP/CP and to initiate a relationship between the infant and the parents. Main Outcome Measures: Duration of postpartum hospitalization, duration of breast-milk feeding, and weight and length at birth, 5 months of age, and 12 months of age. Results: Hospitalization was 4 days and comparable to that of infants without CLP/CP. The infants with CLP/CP received breast milk but for a shorter period compared with infants without CLP/CP. Weights at birth, 5 months of age, and 12 months of age were identical with Danish growth references. Conclusion: The authors find the results satisfactory and believe that the counseling provided by the health visitors/nurses plays a part in the results.

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Presurgical Orthopedics and Satisfaction in Motherhood: A Randomized Clinical Trial (dutchcleft)

The Cleft Palate-Craniofacial Journal ◽

10.1597/07-045.1 ◽

2008 ◽

Vol 45 (3) ◽

pp. 284-288 ◽

Cited By ~ 21

Author(s):

Charlotte Prahl ◽

Birte Prahl-Andersen ◽

Martin A. Van't Hof ◽

Anne M. Kuijpers-Jagtman

Keyword(s):

Cleft Palate ◽

Cleft Lip ◽

Cleft Lip And Palate ◽

Controlled Trial ◽

First Year ◽

Balanced Allocation ◽

The Individual ◽

First Year Of Life ◽

Presurgical Orthopedics ◽

Infant Orthopedics

Objective: To study the effect of infant orthopedics on satisfaction in motherhood. Design: Prospective two-arm randomized controlled trial in parallel with three participating academic cleft palate centers. Treatment allocation was concealed and was performed by means of a computerized balanced allocation method. Setting: Cleft palate centers of Amsterdam, Nijmegen, and Rotterdam, the Netherlands. Patients: Two groups of infants with complete unilateral cleft lip and palate and no other malformations. Interventions: Group IO+ (n = 27) wore passive maxillary plates during the first year of life, group IO− (n = 27) did not. Main Outcome Measure(s): Mean satisfaction scores were obtained from completed questionnaires at 6, 24, and 58 weeks of age. A 4-point scale was used (1 = very satisfactory to 4 = very unsatisfactory). Results: The range of the mean scores for the individual items on the questionnaires for both groups ranged between 1.1 and 2.4. No differences were found between groups. Mothers appear to be satisfied in motherhood, least satisfied with the available time for themselves, and very satisfied with hugging and walking their babies. No differences were found between groups. Conclusions: Results from the present study show that infant orthopedics, with a passive plate during the first year of life, in children with a unilateral cleft lip and palate has no influence on the mothers’ satisfaction in motherhood.

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Treatment Outcome after One-Stage Repair in Children with Complete Unilateral Cleft Lip and Palate Assessed with the Goslon Yardstick

The Cleft Palate-Craniofacial Journal ◽

10.1597/07-242.1 ◽

2009 ◽

Vol 46 (4) ◽

pp. 374-380 ◽

Cited By ~ 15

Author(s):

Piotr Fudalej ◽

Maria Hortis-Dzierzbicka ◽

Barbara Obloj ◽

Dorota Miller-Drabikowska ◽

Zofia Dudkiewicz ◽

...

Keyword(s):

Cleft Lip ◽

Cleft Lip And Palate ◽

Pearson Correlation ◽

Interrater Agreement ◽

Dental Arch ◽

First Year ◽

Kappa Statistics ◽

One Stage ◽

First Year Of Life ◽

Plaster Models

Objective: To compare results of Golson Yardstick measurement of dental arch relationships in a sample of 10-year-old Polish children with results of the Golson measurement in published reports. Materials and Methods: Plaster models of 28 consecutively treated subjects with unilateral cleft lip and palate (UCLP) that was repaired with a one-stage simultaneous closure performed in the first year of life. All individuals were born between 1994 and 1995. The Goslon score (categories 1 to 5) was allocated. Intra- and interrater agreement was assessed with kappa statistics and Pearson correlation coefficient. Independent t tests were employed to detect difference between the score in the present and other published samples. Results: Mean Goslon score equaled 2.44; 57% of the patients were allocated Goslon category 1 or 2, 32% were rated Goslon 3, and 11% of the patients were assigned category 4 or 5. Intrarater agreement was between 0.75 and 0.77. Interrater agreement was 0.79. Conclusions: Dental arch relationship following one-stage repair was comparable with the results of the centers with the best outcome.

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Language Skills of Young Children with Unilateral Cleft Lip and Palate following Infant Orthopedics: A Randomized Clinical Trial

The Cleft Palate-Craniofacial Journal ◽

10.1597/1545-1569_2003_040_0356_lsoycw_2.0.co_2 ◽

2003 ◽

Vol 40 (4) ◽

pp. 356-362 ◽

Cited By ~ 9

Author(s):

Emmy M. Konst ◽

Toni Rietveld ◽

Herman F. M. Peters ◽

Anne Marie Kuijpers-Jagtman

Keyword(s):

Clinical Trial ◽

Language Development ◽

Cleft Lip ◽

Cleft Lip And Palate ◽

Language Skills ◽

Expressive Language ◽

Receptive Language ◽

First Year ◽

First Year Of Life ◽

Infant Orthopedics

Objective To investigate the effects of infant orthopedics (IO) on the language skills of children with complete unilateral cleft lip and palate (UCLP). Design In a prospective randomized clinical trial (Dutchcleft), two groups of children with complete UCLP were followed up longitudinally: one group was treated with IO based on a modified Zurich approach in the first year of life (IO group); the other group did not receive this treatment (non-IO group). At the ages of 2, 2½, 3, and 6 years, language development was evaluated in 12 children (six IO and six non-IO). Receptive language skills were assessed using the Reynell test. Expressive language skills of the toddlers were evaluated by calculating mean length of utterance (MLU) and mean length of longest utterances (MLLU); in the 6-year-olds, the expressive language skills were measured using standardized Dutch language tests. Patients The participants had complete UCLP without soft tissue bands or other malformations. Results IO did not affect the receptive language skills. However, the expressive language measures MLU and MLLU were influenced by IO. At age 2½ and 3 years, the IO group produced longer utterances than the non-IO group. In the follow-up, the difference in expressive language between the two groups was no longer significant. Conclusions Children treated with IO during their first year of life produced longer sentences than non-IO children at the ages of 2½ and 3 years. At 6 years of age, both groups presented similar expressive language skills. Hence, IO treatment did not have long-lasting effects on language development.

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Weight Gain in Children with Cleft Lip and Palate without Use of Palatal Plates

Plastic Surgery International ◽

10.1155/2012/973240 ◽

2012 ◽

Vol 2012 ◽

pp. 1-4 ◽

Cited By ~ 1

Author(s):

Renato da Silva Freitas ◽

Andrey Bernardo Lopes-Grego ◽

Helena Luiza Douat Dietrich ◽

Natacha Regina de Moraes Cerchiari ◽

Tabatha Nakakogue ◽

...

Keyword(s):

Weight Gain ◽

Cleft Palate ◽

Cleft Lip ◽

Cleft Lip And Palate ◽

World Health ◽

First Year ◽

Average Weight ◽

Syndromic Diagnosis ◽

Health Organization ◽

First Year Of Life

Goals/Background. To evaluate children’s growth in the first year of life, who have cleft palate and lip, without the use of palatal plates. Materials/Method. Chart review was conducted, retrospectively, in the Center for Integral Assistance of Cleft Lip and Palate (CAIF), in Brazil, between 2008 and 2009. Results for both genders were compared to the data published by the World Health Organization (WHO) regarding average weight gain in children during their first year of life. Results. Patients with syndromic diagnosis and with cleft classified as preforamen were excluded, resulting in a final number of 112 patients: 56 male and 56 female. Similar patterns were seen comparing the two genders. Although it was observed weight gain below the average until the 11th month in male patients and until 9 months in female patients, both genders remained at the 50th percentile (p50) and improved after the 4th month of age for boys and the 9th month of age for girls. Conclusion. Children with cleft palate weigh less than regular children during their first months of life. At the end of the first year, weight gain is similar comparing normal and affected children. However, factors that optimized weight gain included choosing the best treatment for each case, proper guidance, and multiprofessional integrated care.

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