scholarly journals The effect of lip closure on palatal growth in patients with unilateral clefts

PeerJ ◽  
2020 ◽  
Vol 8 ◽  
pp. e9631
Author(s):  
Robin Bruggink ◽  
Frank Baan ◽  
Gem Kramer ◽  
Colet Claessens ◽  
Anne Marie Kuijpers-Jagtman ◽  
...  
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Surgical Intervention ◽  
Automatic Segmentation ◽  
Control Group ◽  
First Year ◽  
Observer Variability ◽  
Before And After ◽  
Healthy Control ◽  
Two Populations

Objectives The objective of this study was to compare maxillary dimensions and growth in newborns with Complete Unilateral Cleft Lip and Palate (UCLP) to healthy newborns before and after cheiloplasty. Additionally, a palatal growth curve is constructed to give more information about the natural growth before surgical intervention. Methods Twenty-eight newborns with complete UCLP were enrolled in this study. Multiple plaster-casts of each child during their first year were collected and grouped in before and after cheiloplasty. A previous developed semi-automatic segmentation tool was used to assess the maxillary dimensions and were compared to a healthy control group. Z-scores were calculated to indicate differences between the two populations and if cheiloplasty had influence on maxillary growth. Furthermore, the prediction model created in a previous study was used to indicate differences between predictions and the outcome in UCLP measurements. The analysis was tested for inter- and intra-observer variability. Results Results show differences in alveolar and palatal shape in UCLP patients in comparison with healthy controls. Prior to cheiloplasty an increased width and alveolar length was observed while the palatal depth was decreased. After cheiloplasty the widths moved towards normal but were still significantly larger. Conclusion Infants with unilateral cleft lip and palate show a wider maxillary arch in comparison with the control population. Initial treatment has most influence on the width of the arch, which decreased towards normal.

scholarly journals Study of the stress of parents of patients with cleft lip and palate in a surgical process

2013 ◽  
Vol 30 (4) ◽  
pp. 517-524 ◽  
Author(s):  
Maria de Lourdes Merighi Tabaquim ◽  
Matilde Aparecida Motta Marquesini
Keyword(s):  
Intervention Program ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Surgical Intervention ◽  
Sao Paulo ◽  
São Paulo ◽  
The People ◽  
Stress Levels ◽  
Before And After ◽  
The City

Family with children affected by genetic factors or teratogenics involving functional, aesthetic and psychological sequels such as cleft lip and palate are vulnerable to several stress levels and need corrective and rehabilitation interventions. This study aimed to investigate the stress levels of fathers and mothers before and after surgical intervention in children with cleft lip and palate. The participants were 14 parents of children diagnosed with Cleft Incisive Transforamen Unilateral and Bilateral Incisive Transforamen of both genders, 21-53 participants of the surgical intervention program at the Hospital de Reabilitação de Anomalias Craniofaciais, Universidade de São Paulo in the city of Bauru, State of São Paulo. The results have allowed us to conclude that the people responsible for patients, patients and parents of the patients with cleft palatal lip, in surgical situation, present higher levels of stress in the period of pre-surgery, with modified quality in the autonomic aspects of the organism, besides bodily significantly unsatisfactory reactions.

Study of Viridans Streptococci and Staphylococcus Species in Cleft Lip and Palate Patients before and after Surgery

2005 ◽  
Vol 42 (3) ◽  
pp. 277-279 ◽  
Author(s):  
Erry Mochamad Arief ◽  
Zeehaida Mohamed ◽  
Fauziah Mohamad Idris
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Colony Count ◽  
Control Group ◽  
Viridans Streptococci ◽  
Cotton Swab ◽  
Normal Children ◽  
Streptococcus Oralis ◽  
Before And After ◽  
Sterile Cotton Swab

Objective To determine the effect of surgery on types and colony count of Streptococcus and Staphylococcus species in cleft lip and palate (CLP) patients. Design Saliva samples were collected after the morning meal by placing a sterile cotton swab in the vestibule of the oral cavity from cleft lip and palate patients immediately preoperative and 12 weeks postoperative. Normal children were examined as a control group. Samples were cultured; Staphylococcus and Streptococcus isolates were identified and quantified. Patients Fifteen cleft lip and palate patients and 22 normal children, aged 3 to 39 months were examined. Results Streptococcus mitis biovar 1, Streptococcus salivarius and Streptococcus oralis of the viridans group of streptococci were the most commonly found in normal children, as well as in cleft lip and palate children. In the cleft lip and palate group, mean streptococcal count was 32.41 (29.80) and 46.46 (42.80) in the pre- and postoperative periods, respectively; in the normal group, the count was 20.93 (27.93) and 49.92 (34.72) at 0 week and 12 weeks, respectively. Staphylococcus aureus was the most common Staphylococcus species found in CLP patients, representing 47.4% postoperatively. In the cleft lip and palate children, mean staphylococcal count was 5.34 (8.13) and 0.56 (0.92) in the pre- and postoperative periods, respectively; in normal children, the count was 0.82 (1.98) and 0.60 (2.55) at 0 and 12 weeks, respectively. The differences were statistically significant only for the staphylococcal count between pre- and postoperative periods in children with cleft lip and palate as tested by analysis of variance (p < .05). Conclusions Cleft lip and palate patients had more colonization by S. aureus compared with normal children, and the colony count decreased significantly following surgical repair of the cleft lip and palate.

Effect of Fibrinogen Substitution in Afibrinogenemia on Hemorheology and Platelet Function

1995 ◽  
Vol 74 (03) ◽  
pp. 853-858 ◽  
Author(s):  
Armin J Reininger ◽  
Cornelia B Reininger ◽  
Michael Spannagl ◽  
Achim Mellinghoff ◽  
Astrid Porr ◽  
...  
Keyword(s):  
Kinematic Viscosity ◽  
Platelet Adhesion ◽  
Normal Values ◽  
Receptor Expression ◽  
Control Group ◽  
Thrombin Time ◽  
Before And After ◽  
Healthy Control ◽  
Dynamic And Kinematic Viscosity ◽  
Two Populations

SummaryFibrinogen substitution can correct bleeding in afibrinogenemia. We assessed the effect of fibrinogen substitution in a patient lacking immunoreactive fibrinogen. Fibrinogen and thrombin time were not measurable before, but became detectable within 30 min after substitution, parallelled by an increase in ADP-induced platelet aggregation from <10% to 32%. Platelet adhesion, measured by Stagnation Point Flow Adhesio- Aggregometry, was notdetectable prior to substitution but attained normal values thereafter. Scanning electron microscopy of adhering platelets revealed pseudopodia protrusion and spreading. Morphometry revealed two populations of spread platelets one of which demonstrated inhibited spreading as compared to healthy controls. Immunoelectron microscopy revealed normal GPIIb/IIIa receptor expression, both before and after substitution. Dynamic and kinematic viscosity of plasma and whole blood remained below the 99.9% confidence border of a healthy control group. In afibrinogenemia fibrinogen levels as low as 10% of normal concentration sufficed to normalize coagulation, platelet adhesion, and, partially, spreading.

Treating Velopharyngeal Inadequacy Using Bilateral Buccal Flap Revision Palatoplasty

2019 ◽  
Vol 4 (5) ◽  
pp. 878-892
Author(s):  
Joseph A. Napoli ◽  
Linda D. Vallino
Keyword(s):  
Systematic Review ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
A Priori ◽  
Sufficient Evidence ◽  
Obstructive Sleep ◽  
Before And After ◽  
Buccal Flap

Purpose The 2 most commonly used operations to treat velopharyngeal inadequacy (VPI) are superiorly based pharyngeal flap and sphincter pharyngoplasty, both of which may result in hyponasal speech and airway obstruction. The purpose of this article is to (a) describe the bilateral buccal flap revision palatoplasty (BBFRP) as an alternative technique to manage VPI while minimizing these risks and (b) conduct a systematic review of the evidence of BBFRP on speech and other clinical outcomes. A report comparing the speech of a child with hypernasality before and after BBFRP is presented. Method A review of databases was conducted for studies of buccal flaps to treat VPI. Using the principles of a systematic review, the articles were read, and data were abstracted for study characteristics that were developed a priori. With respect to the case report, speech and instrumental data from a child with repaired cleft lip and palate and hypernasal speech were collected and analyzed before and after surgery. Results Eight articles were included in the analysis. The results were positive, and the evidence is in favor of BBFRP in improving velopharyngeal function, while minimizing the risk of hyponasal speech and obstructive sleep apnea. Before surgery, the child's speech was characterized by moderate hypernasality, and after surgery, it was judged to be within normal limits. Conclusion Based on clinical experience and results from the systematic review, there is sufficient evidence that the buccal flap is effective in improving resonance and minimizing obstructive sleep apnea. We recommend BBFRP as another approach in selected patients to manage VPI. Supplemental Material https://doi.org/10.23641/asha.9919352

Sri Lankan Cleft Lip and Palate Study Model Analysis: Clefts of the Secondary Palate

1993 ◽  
Vol 30 (2) ◽  
pp. 227-230 ◽  
Author(s):  
Andrew Mccance ◽  
David Roberts-Harry ◽  
Martyn Sherriff ◽  
Michael Mars ◽  
William J.B. Houston
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Model Analysis ◽  
Control Group ◽  
Tooth Size ◽  
Sri Lankan ◽  
Control Groups ◽  
Secondary Palate ◽  
Comparable Control ◽  
And Control

The study models of a group of adult Sri Lankan patients with clefts of the secondary palate were investigated. Tooth-size and arch-dimension comparisons were made with a comparable control group. Significant differences were found between the cleft and control groups in tooth sizes, chord lengths, and arch widths. The cleft group dimensions were generally smaller than those of the control group. Overjets were larger in the cleft group.

Oral Health-Related Quality of Life Among Sudanese Children Treated for Cleft Lip and Palate

2021 ◽  
pp. 105566562098769
Author(s):  
Mecheala Abbas Ali ◽  
Alwaleed Fadul Nasir ◽  
Shaza K. Abass
Keyword(s):  
Quality Of Life ◽  
Oral Health ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Control Group ◽  
Arabic Version ◽  
Health Related Quality ◽  
Related Quality ◽  
Health Related

Objective: This study compared the oral health-related quality of life (OHRQoL) among children with a cleft lip with or without a cleft palate (CL±P) and a group of their peers. The reliability of the Arabic version of the Child Oral Health Impact Profile Questionnaire (COHIP) was also assessed. Design: A cross-sectional study. Settings: Cleft clinic in a private dental college in Omdurman City, Sudan. Patients: In all, 75 children (mean age 11.3 ± 2.5 years) with a history of CL±P and a group of 150 school children without CL±P (mean age 11.4 ± 2.6 years). Main Outcome Measures: Overall and subscale scores on the Arabic version of the COHIP. Results: Test–retest reliability of COHIP in Arabic was high with an interclass correlation coefficient >0.8. Cronbach α value internal consistency was 0.8 for the total scale and between 0.7 and 0.8 for the subscales. The COHIP score was 89.41 ± 19.97 in children with CL±P and 122.82 ± 9.45 for the control group. Children with CL±P had significantly lower scores on the overall and all subscales when compared to children without CL±P ( P ≤ .001). Among the children with CL±P, there were no statistically significant differences on the COHIP based on age and/or gender ( P ≥ .05). Conclusions: Children with CL±P had a relatively high OHRQoL, which was lower than that of their peers without CL±P in both the overall scale and all subscales. Gender and age differences had no significant impact on the OHRQoL. The COHIP Arabic version showed appropriate reliability.

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.

Comparison of Dental Caries Prevalence in Patients with Cleft Lip and/or Palate and Their Sibling Controls

2009 ◽  
Vol 46 (5) ◽  
pp. 529-531 ◽  
Author(s):  
Mahmoud Al-Dajani
Keyword(s):  
Dental Caries ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Maxillofacial Surgery ◽  
Permanent Teeth ◽  
Control Group ◽  
Oral And Maxillofacial Surgery ◽  
Caries Prevalence ◽  
Dmft Index ◽  
And Control

Objective: To evaluate the prevalence of dental caries in patients with cleft lip and/or palate and their cleft-free sibling controls. Methods: The two subject groups (patient and control) comprised 106 participants. The former group consisted of 53 patients with cleft lip and/or palate, aged 12 to 29 years, who visited the Oral and Maxillofacial Surgery Hospital at Damascus University of Syria. The control group consisted of the patients’ siblings who had no clefts, and they were sex matched to the patient group. Dental caries were examined clinically and were reported using the decayed, missing, and filled permanent teeth (DMFT) index. The DMFT scores were compared between the two groups. Results: The author found an overall association of dental caries with the presence of cleft lip and/or palate (odds ratio  =  2.52; 95% confidence interval  =  1.389–4.574; p < .05). The DMFT index scores were proportionally higher in patients with cleft lip and/or palate compared with the control group (p < .001). Conclusion: Subjects with cleft lip and palate are susceptible to dental caries independently of socioeconomic status.

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