The Effect of Presurgical Treatment on Palatal Tissue Area in Unilateral Cleft Lip and Palate Subjects

1977 ◽  
Vol 4 (4) ◽  
pp. 181-185 ◽  
Author(s):  
A. G. Huddart ◽  
J. J. Crabb
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
The Other ◽  
Normal Children ◽  
Orthopaedic Treatment ◽  
Tissue Area

The investigation measures the area of palatal tissue at birth and at four months in three groups of subjects: (1) 30 complete unilateral cleft lip and palate cases who received presurgical maxillary orthopaedic treatment; (2) 15 similar cases who did not receive such treatment and were used as controls; (3) 30 normal children with intact palates. The changes occurring in the three groups of cases over the four month period are compared. In particular it was noted that presurgical treatment retarded the growth of palatal tissue. The significance of this in relation to the other findings and presurgical treatment generally is discussed.

Photometric Evaluation of Bilateral Cleft Lip and Palate Patients after Primary Columella Lengthening

2010 ◽  
Vol 47 (1) ◽  
pp. 58-65 ◽  
Author(s):  
Maria Costanza Meazzini ◽  
Giulia Rossetti ◽  
Alberto Morabito ◽  
Giovanna Garattini ◽  
Roberto Brusati
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Traditional Approach ◽  
The Other ◽  
Normal Children ◽  
Regional Center ◽  
Long Term Study ◽  
Other Hand ◽  
Nasolabial Angle ◽  
Bilateral Cleft Lip

Objective To evaluate the results in terms of nasal esthetics of children with bilateral cleft lip and palate, operated with the Cutting primary columella lengthening technique, associated with Grayson orthopedic nasoalveolar molding, and to compare them with the nasal aspects of children with bilateral cleft lip and palate operated with a traditional approach and to an age-matched sample of normal Caucasian children. Design Normalized photogrammetry. Setting Regional Center for CLP, Department of Maxillo-Facial Surgery, San Paolo Hospital, Milan. Patients Three groups of patients 5 years of age. Cutting group: 18 patients treated with the Grayson-Cutting technique. Delaire group: 18 patients treated with the traditional Delaire technique. Normal children: 40 normal preschool children. Results With the Cutting-Grayson technique, the columella length, nasal tip angle, and protrusion are greatly improved compared with the previous protocol and are close to normal. On the other hand, the nasolabial angle and interalar distances are still excessively wide in both samples. Conclusions Although this is not a long-term study, at this time none of the patients operated with this technique have needed secondary columella lengthening. On the other hand, although certainly improved, the nasal anatomy obtained is far from normal.

Early Orthopaedic Treatment of Unilateral Cleft Lip and Palate

1978 ◽  
Vol 5 (3) ◽  
pp. 119-132 ◽  
Author(s):  
W. C. Shaw
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Alveolar Cleft ◽  
Orthopaedic Treatment ◽  
Partial Data ◽  
Alveolar Tissue ◽  
Maxillary Arch

Serial frontal and lateral cephalometric radiographs with implants and study models of 31 infants' who received orthopaedic treatment for unilateral cleft lip and palate, were analysed with an electronic XY reader. Partial data for 50 normal infants and 10 isolated palatal cleft patients were included to allow certain comparisons. The records at birth indicate that the size of the alveolar cleft in unilateral cleft cases is governed mainly by the degree of transverse segmental separation which is present and only to a lesser extent by deficiency of alveolar tissue, except in a minority of cases. It is clear that in the early months of life, the divided maxillary arch can be made to assume near normal dimensions by inward rotation of the anterior ends of the segments, at the alveolar and basal level, around axes in the tuberosity regions. Appositional growth of the cleft margins makes little contribution to the reduction in cleft size. The significance of the findings is discussed.

Problems of Accuracy and Reliability in Cephalometric Studies with Implants in Infants with Cleft Lip and Palate

1977 ◽  
Vol 4 (2) ◽  
pp. 93-100 ◽  
Author(s):  
W. C. Shaw
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Simulated Trial ◽  
Orthopaedic Treatment ◽  
Head Positioning ◽  
The Stability

A simulated trial was carried out to assess the accuracy of cephalometric radiography with the aid of implants in infants receiving cleft lip and palate orthopaedic treatment. The stability of the implants is also discussed. It was concluded that the technique is of limited value since the implants may be disturbed by the developing teeth and because slight inaccuracy in head positioning may lead to substantial errors of interpretation.

Intraoral Photographs for Rating Dental Arch Relationships in Unilateral Cleft Lip and Palate

2009 ◽  
Vol 46 (4) ◽  
pp. 415-419 ◽  
Author(s):  
Yu-Fang Liao ◽  
Chiung-Shing Huang ◽  
I-Feng Lin
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
The Other ◽  
Viable Alternative ◽  
Dental Arch ◽  
Significant Difference ◽  
Intraexaminer Reliability ◽  
Experienced Examiner ◽  
Dental Casts

Background and Purpose: The Goslon Yardstick is one of the most commonly used methods to assess dental arch relationships of patients with unilateral cleft lip and palate. This system was originally applied to dental casts. For reasons of economy and convenience, we aimed to determine whether intraoral photographs could substitute for dental casts for rating dental arch relationships. Methods: Records of 58 patients with nonsyndromic complete unilateral cleft lip and palate from the Chang Gung Craniofacial Center, Taipei, Taiwan, were used in this study. A set of dental casts and digital intraoral photographs taken at around 9 years of age were available for all patients. An experienced examiner rated the dental casts using the Goslon Yardstick to provide the reference scores. The other three examiners rated the intraoral photographs and repeated the rating 1 week later to calculate inter- and intraexaminer reliability. The photographic scores for each examiner were then compared with the reference scores to determine the validity of the photographs. Results: The results showed no significant difference between the rating of dental casts and photographs using the Goslon Yardstick. Reliability was also high for rating on photographs. Conclusions: Intraoral photographs appear to be a viable alternative to the application of the Goslon Yardstick on dental casts.

scholarly journals Treatment Outcome in Cleft Lip and Palate: Issues and Perspectives

1999 ◽  
Vol 10 (2) ◽  
pp. 225-239 ◽  
Author(s):  
K. Molsted
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Single Gene ◽  
Fetal Surgery ◽  
Scar Formation ◽  
Late Gestation ◽  
The Other ◽  
Craniofacial Morphology ◽  
Response To Treatment ◽  
Contributory Factor

In the last 40 years, great progress has been made toward a better understanding of many aspects of the cleft lip and palate defect, but there is still a long way to go before there is agreement on the optimal treatment procedures. With regard to the primary operations, it can be stated, in a somewhat simplified form, that there are two main schools of thought in cleft treatment. One advocates early closure of the lip and palate, a procedure which imparts a high priority to early speech function. The other recommends delayed closure of the hard palate, thereby according a high priority to the growth of the maxilla A number of intercenter and multicenter studies have been carried out recently in an effort to elucidate which procedures give the best result, both esthetically and functionally. The results are ambiguous, and this has led a number of researchers to suggest that the randomized clinical trial is the only way to resolve the ambiguity. The fact that it has proved difficult to identify the optimal procedures in the field of cleft lip and palate treatment need not only be due to a less than optimal research design: a contributory factor might also be the great variability in craniofacial morphology and in the response to treatment in patients who have exactly the same cleft lip and palate diagnosis. Intensive research has made it possible to state categorically that clefts occur due to many different factors in an interplay between genetics and environment. Therefore, it is not likely that a single gene can be responsible for clefting. Since scar tissue presents many problems-for instance, impairment of growth-the reduction or prevention of scar formation has long been a desirable goal. The discovery that a fetus can heal without scar formation has led to many animal experiments. The timing of the surgical intervention on fetuses is critical, since late-gestation fetuses heal with adult-like scarring. There are still many unsolved problems connected with fetal surgery, and at present prenatal surgery for repair of cleft lip and palate is not ethically defensible in humans. On the other hand, it appears that there are considerable possibilities for the reduction of human scarring after surgery with the introduction of various wound-healing medications.

Do Orofacial Clefts Impair Breastfeeding and Increase the Prevalence of Anemia?

2021 ◽  
pp. 105566562110543
Author(s):  
Aluísio Eustáquio de Freitas Miranda-Filho ◽  
Heloisa de Sousa Gomes ◽  
Roberta Bessa Veloso Silva ◽  
Nelson Pereira Marques ◽  
Hercílio Martelli ◽  
...  
Keyword(s):  
Statistical Analysis ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
The Other ◽  
Deficiency Anemia ◽  
Control Group ◽  
Orofacial Cleft ◽  
Orofacial Clefts ◽  
History Of ◽  
Prevalence Of Anemia

Objective This study aimed to correlate the prevalence of iron deficiency anemia and breastfeeding with orofacial clefts in children. Design Data on the participant profile, presence and type of the cleft lip and/or palate (CL/P), and records on anemia and breastfeeding were collected from patients’ charts, and submitted to statistical analysis by χ2 test ( p < .05; software SPSS 23.0). Results Two-hundred and ten files were divided according to: CL/P presence (cleft group;    n = 132) or absence (control group;    n = 78). Group CL/P was subdivided according to the type of cleft: CL/P-I (cleft lip;    n = 35); CL/P-II (cleft lip and palate;    n = 45); CL/P-III (cleft palate;    n = 43); and CL/P-IV (rare orofacial clefts;    n = 9). Group CL/P had significantly more records on anemia ( p = .016) and fewer records on breastfeeding (P<.01) than controls. More records on anemia occurred in CL/P-II ( p = .004) and CL/P-IV ( p = .006) than the control group. The comparison among the orofacial cleft types regarding the anemia records showed no statistically significant differences ( p = .123). Group CL/P-I had more records on breastfeeding than the other cleft types ( p < .01). Conclusions Thus, it is suggested that the breastfeeding process is more complex, and the history of anemia is more frequent, in children with cleft lip and palate or rare orofacial clefts than in children without clefts.

Early Palatal Changes after Initial Palatal Surgery in Children with Cleft Lip and Palate

1996 ◽  
Vol 33 (2) ◽  
pp. 104-111 ◽  
Author(s):  
Gem J.C. Kramer ◽  
Jan B. Hoeksma ◽  
Birte Prahl-Andersen
Keyword(s):  
Soft Palate ◽  
Growth And Development ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Timing Of Surgery ◽  
Normal Children ◽  
Anterior Arch ◽  
Arch Width ◽  
Different Types ◽  
Palatal Surgery

Early palatal growth and development after primary palatal closure was studied in children with different types of cleft lip and palate (CLP). Palatal dimensions were measured on dental casts taken at fixed ages, from 9 months to 4 years of age. The results showed that soft and hard palatal closure in one stage had a significant impeding influence on posterior sagittal palatal growth compared to closure of the soft palate only. Timing of surgery possibly had a small temporary restrictive effect on posterior transverse palatal growth and development. Type and severity of the oral cleft had a significant effect on transverse palatal development and anterior sagittal dimensions. Anterior arch width was reduced in children with a complete unilateral (U) CLP or bilateral (B) CLP. The palates of the latter children had consistently larger anterior arch depths. Compared to normal children, palates of cleft children changed anteriorly from wider at 9 months of age to narrower at 4 years of age. Arch depths were smaller in cleft children except for anterior arch depths in children with complete BCLP.

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