Speech outcomes in 10-year-old children with complete unilateral cleft lip and palate after one-stage lip and palate repair in the first year of life

2012 ◽  
Vol 65 (2) ◽  
pp. 175-181 ◽  
Author(s):  
Maria Hortis-Dzierzbicka ◽  
Elzbieta Radkowska ◽  
Piotr S. Fudalej
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
First Year ◽  
One Stage ◽  
Palate Repair ◽  
First Year Of Life

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

2009 ◽  
Vol 46 (4) ◽  
pp. 374-380 ◽  
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.

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

2008 ◽  
Vol 45 (6) ◽  
pp. 628-632 ◽  
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.

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

2008 ◽  
Vol 45 (3) ◽  
pp. 284-288 ◽  
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.

One-Stage Cleft Lip and Palate Repair in an Older Population

2015 ◽  
Vol 26 (5) ◽  
pp. e426-e430 ◽  
Author(s):  
Ethem Guneren ◽  
Halil Ibrahim Canter ◽  
Kemalettin Yildiz ◽  
Resit Burak Kayan ◽  
Mustafa Aykut Ozpur ◽  
...  
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Older Population ◽  
One Stage ◽  
Palate Repair

Speech and Hearing Outcomes of the Patients with Cleft Lip and Palate: Comparison between One-Stage Simultaneous and Two-Stage Surgical Repairs

2020 ◽  
Vol 103 (11) ◽  
pp. 1171-1177
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Common Belief ◽  
Two Stage ◽  
Treatment Protocols ◽  
Palatal Fistula ◽  
One Stage ◽  
Significant Difference ◽  
Cleft Lip Palate ◽  
Palate Repair

Background: Conventional treatment for cleft lip and palate patients is lip repair at three to four months and then palatal repair at nine to 12 months of age. However, for the patients who delay seeing a doctor especially in a developing area such as Northern Thailand, simultaneous lip and palate repair is performed at 12 to 18 months of age or later, depending on the age at the first visit. It is a common belief that patients with cleft lip and palate will be behind non-cleft patients in early development phonemes because of the open palate. This delay persists until the palate is repaired and on into the postoperative period. This proposition has not been proven with long-term clinical outcomes in one-stage repairs. Objective: To investigate the effects of one-stage repair on speech assessment, hearing, and incidence of palatal fistula. The results were compared with conventional two-stage surgical repairs. Materials and Methods: The present study was designed two groups. Group 1 consisted of 25 children (mean age 11.28±1.93 years) treated with a one-stage repair. Cleft lip, palate, and alveolus were repaired at a single surgical session in the first 18 months of life (mean age at the time of surgery 13.52±4.51 months). Group 2 consisted of 17 children (mean age 11.02±2.23 years) treated in two-stage surgical repairs. Lip repair was performed at a median age of 4.01 months (IQR 3.62 to 5.46), and palate repair was performed at a mean age of 13.54±4.14 months. Both groups underwent cleft lip and palate repairs at the Division of Plastic Surgery, Department of Surgery, Faculty of Medicine, Chiang Mai University between January 1, 2004 and December 31, 2010. Speech and hearing for all patients were evaluated by experienced ENT doctors. The palatal fistula was evaluated by the same plastic surgeons. Results: One-stage repair showed significant normal articulation and less articulation disorder when compared with two-stage surgical repairs. However, no significant difference was determined for other speech assessments, hearing, and incidence of palatal fistula. Conclusion: Because one-stage repair seems to have a more positive influence on articulation, and both surgical treatment protocols give similar results on speech assessments, hearing, and incidence of palatal fistula, regardless of the timing of the surgery, the one-stage repair is not inferior to conventional two-stage surgical repairs for patients in developing areas. This is due to several important advantages, such as less hospitalization, lower cost, and less chance of nosocomial infection. Keywords: One-stage repair, Speech, Hearing, Palatal fistula, Cleft lip, Palate

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

2003 ◽  
Vol 40 (4) ◽  
pp. 356-362 ◽  
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.

scholarly journals Incidence of Palatal Fistula after One-Stage Palatoplasty and Factors Influencing the Fistula Occurrence

1970 ◽  
Vol 2 (4) ◽  
Author(s):  
Nurardhilah Vityadewi ◽  
Kristaninta Bangun
Keyword(s):  
Body Weight ◽  
Cleft Palate ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Fistula Formation ◽  
Bivariate Analysis ◽  
One Stage ◽  
Cleft Palate Repair ◽  
Hypernasal Speech ◽  
Palate Repair

Background: Cleft palate repair may be compromised by a number of complications, most commonly the development of a fistula. Fistulas are related to an increased rate of hypernasal speech, articulation problems, and food or liquid regurgitation from the nose. Fistulas also tend to recur after a secondary repair to address the fistulas. This study reviews the rate of fistula in our craniofacial center after a onestage cleft palate repair; and to determine whether, cleft type, age at repair, type of cleft repair, hemoglobin level presurgery, and patients nutritional state influence the risk of fistula occurence. Patient and Method: A retrospective analysis was performed on medical records of 93 patients who underwent palate repair between January 2012 to October 2013. All consecutive cleft (lip and) palate patients are included. Bivariate analysis was performed to identify the predictors of fistula formation. Result: Ninety-three patients (50 male and 43 female) underwent one-stage palatoplasty. Cleft palate fistulas occured in 19 of 93 patients (20,4%). The age of the patients at the time of repair ranged from 9 to 144 months (mode 18 months). All palate repairs were done in one stage, using either the two flap (N=66), Wardill-Kilner (N=24), Furlow (N=2), and Langenback (N=1) techniques. No significant influence was found related between age at the time of repair (p 0.789), body weight (p 0.725), Hemoglobin value (p 0.295), and type of cleft (p 0.249) to the rate of fistula occurrence. Summary: This study found no association between , body weight, preoperative hemoglobin value, and the type of cleft to the rate of fistula following cleft palate surgery.

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

2012 ◽  
Vol 2012 ◽  
pp. 1-4 ◽  
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.

Patterns of Maxillary Alveolar Arch Growth Changes of Infants with Unilateral Cleft Lip and Palate: Preliminary Findings

2003 ◽  
Vol 40 (4) ◽  
pp. 363-372 ◽  
Author(s):  
Bert Braumann ◽  
Ludger Keilig ◽  
Angelika Stellzig-Eisenhauer ◽  
Christoph Bourauel ◽  
Stefaan Bergé ◽  
...  
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Three Dimensional ◽  
Laser Scanner ◽  
First Year ◽  
Osteoplastic Surgery ◽  
Growth Changes ◽  
Crest Length ◽  
First Year Of Life

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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