Early Postnatal Development of the Mandible in Children with Isolated Cleft Palate and Children with Nonsyndromic Robin Sequence

2006 ◽  
Vol 43 (2) ◽  
pp. 160-167 ◽  
Author(s):  
J. Eriksen ◽  
N. V. Hermann ◽  
T. A. Darvann ◽  
S. Kreiborg
Keyword(s):  
Cleft Palate ◽  
Growth Velocity ◽  
Cleft Lip ◽  
Growth Potential ◽  
Control Group ◽  
X Rays ◽  
Mandibular Growth ◽  
Robin Sequence ◽  
Significant Difference ◽  
Isolated Cleft Palate

Objective Analysis of early postnatal mandibular size and growth velocity in children with untreated isolated cleft palate (ICP), nonsyndromic Robin sequence (RS), and a control group of children with unilateral incomplete cleft lip (UICL). Material 114 children (66 isolated cleft palate, 7 Robin sequence, 41 unilateral incomplete cleft lip) drawn from a group representing all Danish cleft children born from 1976 through 1981. All children were examined at both 2 and 22 months of age. Methods Cephalometric x-rays and maxillary plaster casts. Mandibular length and height were measured and mandibular growth velocity (mm/year) was calculated. Cleft width was measured on the casts at 2 months of age. Results Mean mandibular length and posterior height were significantly smaller in isolated cleft palate and Robin sequence, compared with unilateral incomplete cleft lip. Mandibular length in Robin sequence was also significantly shorter, compared with isolated cleft palate. No significant difference was found between mean mandibular growth velocities in the three groups. No significant correlation was found between mandibular length and cleft width in either isolated cleft palate or Robin sequence at 2 months of age. Conclusion The children with isolated cleft palate and Robin sequence had small mandibles shortly after birth, but with a relatively normal growth potential. No true mandibular catch-up growth was found up to 22 months of age in either group. No significant correlation was found between mandibular size and cleft width in either group at 2 months of age. However, there was a significant trend toward the shorter the mandible, the more severe the sagittal extension of the cleft.

scholarly journals Evaluation of Eustachian tube function in patients of cleft palate and effects of palatoplasty on these findings

2021 ◽  
Vol 7 (9) ◽  
pp. 1473
Author(s):  
Lalit Kochar ◽  
Deepak V. Chauhan ◽  
S. P. Bajaj ◽  
Akash Juneja
Keyword(s):  
Cleft Palate ◽  
Eustachian Tube ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Care Hospital ◽  
Eustachian Tube Function ◽  
Significant Difference ◽  
Tube Function ◽  
Isolated Cleft Palate ◽  
Palatal Surgery

<p class="abstract"><strong>Background:</strong> Isolated cleft palate and cleft palate and cleft lip patients have poor Eustachian tube function which results in hearing impairment that too in the speech formative years. Aim of study was to evaluate tympanometric findings in patient of cleft palate and effect of palatoplasty on both short term and long term postoperatively.</p><p class="abstract"><strong>Methods:</strong> The subjects consisted of patients attending the cleft lip and palate clinic. This was a combined clinic consisting of department of plastic surgery, department of ENT and department of dental surgery held every month at a tertiary care hospital in Delhi. Study consisted of three groups of patients namely preoperative group, postoperative group and pre-postoperative group.</p><p class="abstract"><strong>Results:</strong> No significant difference was observed in tympanometric abnormalities in cases of combined cleft lip and palate as compared to isolated cleft palate. After age of 5 months once changes of OME has set in there was no significant change in middle ear findings irrespective of palatal repair.</p><p class="abstract"><strong>Conclusions:</strong> There is a very high prevalence of otitis media with effusion in these patients. The changes do resolve spontaneously after age of seven, this perhaps is due to combined effect, growth, development and l maturity of Eustachian tube and palatal surgery rather than palatal surgery alone.</p><p> </p>

scholarly journals Non routine use of alveolar incision in Von Langenbeck technique palatoplasty in children; a safe and viable technique in our centre

2019 ◽  
Vol 6 (7) ◽  
pp. 2239
Author(s):  
Philemon E. Okoro ◽  
Benjamin M. Kejeh
Keyword(s):  
Blood Loss ◽  
Cleft Palate ◽  
Statistical Significance ◽  
Test Group ◽  
Control Group ◽  
Significant Difference ◽  
Duration Of Surgery ◽  
Prospective Comparative Study ◽  
And Gender ◽  
Isolated Cleft Palate

Background: Repair of the palate is among the challenging reconstructive surgeries in children. No single technique has achieved completely satisfactory results. The von Langenbeck technique (VLT) is one of the techniques in common use. We have sort to find out if the lateral alveolar incision in VLT can be safely avoided in selected cases.Methods: This is a prospective comparative study of cases of isolated unilateral cleft palate in children 18 years and below which were repaired using the VLT with and without lateral alveolar incision in our centre between January 2013 and December 2018. Outcome parameters obtained included duration of surgery, blood loss, complication and fistula rates. Data was analyzed using SPSS 21. Statistical significance was set at p<0.05.Results: Eighty four patients were included in the study; 36 were in the test group and 48 were in the control group. There was no significant difference in the age, weight and gender of the two groups. The duration of surgery was significantly shorter in the test group and fistula and complication rate was less.Conclusions:This study has demonstrated that comparable, if not better results can be achieved in well selected patients with unilateral isolated cleft palate using only dissection along the margin of the cleft. This new technique reduces the duration of surgery and anaesthesia and may reduce blood loss and complications. 

Length of the Cervical Spine as a Factor in the Etiology of Cleft Palate

1993 ◽  
Vol 30 (3) ◽  
pp. 274-278 ◽  
Author(s):  
Zbyněk Šmahel ◽  
Božena Škvařilová
Keyword(s):  
Cervical Spine ◽  
Cleft Palate ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Growth Potential ◽  
Adult Males ◽  
Simultaneous Exposure ◽  
Isolated Cleft Palate ◽  
Short Spine ◽  
Normal Controls

The length of the cervical spine in a series of 206 adult males with cleft lip and/or palate and 50 normal controls was measured. The patients were divided into five subgroups according to the type and extent of the cleft. The shortening of the spine was most marked in bilateral cleft lip and palate patients (complete), less marked in unilateral cleft lip and palate patients, and was slight in isolated cleft palate patients. Complete isolated cleft palate and cleft lip was not associated with a shortening of the spine. A shortening of the cervical spine in less extensive types of isolated cleft palate was suggestive of the participation of the spine in their development, while in cleft lip and palate a simultaneous exposure to a teratogenic agent or any other developmental error during early stages of embryogenesis could explain the concomitant occurrence of spine anomalies. Patients with cleft lip and palate associated with a short spine also had a shorter mandibular ramus, which could be suggestive of simultaneous damage to both structures during morphogenesis. This relationship was not demonstrated in isolated cleft palate that developed in later stages of embryogenesis. In these cases a short spine itself could not have impaired the growth potential of the mandible, yet it could have mechanically induced the development of cleft palate. These observations are in agreement with the present state of knowledge on the development of orofacial clefts as shown in experimental animals.

How Does Hypodontia Compare in Nonsyndromic Pierre Robin Sequence Versus Isolated Cleft Palate and Isolated Cleft Lip?

2021 ◽  
pp. 105566562110177
Author(s):  
Maria Dillon ◽  
Madhavi Seshu ◽  
Norah Flanigan ◽  
Susana Dominguez-Gonzalez
Keyword(s):  
Cleft Palate ◽  
Cleft Lip ◽  
Pierre Robin Sequence ◽  
Robin Sequence ◽  
Sequence Versus ◽  
Group 2 ◽  
Alder Hey ◽  
Isolated Cleft Palate ◽  
Pierre Robin ◽  
Group 1

Objective: To assess the prevalence and patterns of hypodontia in nonsyndromic Pierre Robin sequence (PRS) and compare it with hypodontia in nonsyndromic isolated cleft palates and isolated cleft lips. Design: Retrospective cohort study. Setting: Alder Hey Children’s Hospital, United Kingdom. Patients: Patients with nonsyndromic PRS (group 1), isolated cleft palate (group 2), and isolated cleft lip (group 3). Main Outcome Measures: Hypodontia in the permanent dentition assessed from orthopantomographs. Results: A total of 154 patients were included. Group 1 had the highest incidence of hypodontia with 47% having at least one tooth congenitally absent. Groups 2 and 3 had reduced rates of hypodontia with 27% and 19% of the groups missing teeth, respectively; 93% of cases of hypodontia in group 1 involved the absence of at least one second premolar. Of these patients, there was found to be bilateral agenesis of second premolars in 50% of cases. Conclusions: Patients with PRS and cleft palates are more likely to have hypodontia than those with isolated cleft palates or unilateral cleft lips. Patients with PRS have more severe hypodontia than those with isolated cleft palates or unilateral cleft lips. Bilateral agenesis of lower second premolars is a commonly seen pattern among patients with PRS. In this large UK study, a similar prevalence and pattern of hypodontia to other nonsyndromic PRS populations worldwide has been demonstrated.

scholarly journals PAX7, PAX9 and RYK Expression in Cleft Affected Tissue

Medicina ◽  
2021 ◽  
Vol 57 (10) ◽  
pp. 1075
Author(s):  
Mārtiņš Vaivads ◽  
Ilze Akota ◽  
Māra Pilmane
Keyword(s):  
Cleft Palate ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Rank Correlation ◽  
Control Group ◽  
Orofacial Clefts ◽  
Spearman’S Rank Correlation ◽  
Morphological Studies ◽  
Affected Tissue ◽  
Isolated Cleft Palate

Background and Objectives: Cleft lip with or without cleft palate is one of the most common types of congenital malformations. Transcription factors paired box 7 and 9 (PAX7, PAX9) and receptor-like tyrosine kinase (RYK) have been previously associated with the formation of orofacial clefts but their exact possible involvement and interactions in the tissue of specific cleft types remains uncertain. There is a limited number of morphological studies analyzing these specific factors in cleft affected tissue due to ethical aspects and the limited amount of available tissue material. This study analyses the presence of PAX7, PAX9, and RYK immunopositive structures within different cleft affected tissue to assess their possible involvement in cleft morphopathogenesis. Materials and Methods: Cleft affected tissue was collected from non-syndromic orofacial cleft patients during cleft correcting surgery (36 patients with unilateral cleft lip, 13 patients with bilateral cleft lip, 26 patients with isolated cleft palate). Control group oral cavity tissue was obtained from 7 patients without cleft lip and palate. To evaluate the number of immunopositive structures in the cleft affected tissue and the control group, a semiquantitative counting method was used. Non-parametric statistical methods (Kruskal–Wallis H test, Mann–Whitney U test, and Spearman’s rank correlation) were used. Results: Statistically significant differences for the number of PAX7, PAX9, and RYK-positive cells were notified between the controls and the patient groups. Multiple statistically significant correlations between the factors were found in each cleft affected tissue group. Conclusions: PAX7, PAX9, and RYK have a variable involvement and interaction in postnatal morphopathogenesis of orofacial clefts. PAX7 is more associated with the formation of unilateral cleft lip, while PAX9 relates more towards the isolated cleft palate. The stable presence of RYK in all cleft types indicates its possible participation in different facial cleft formations.

Analysis of the candidate genes responsible for non-syndromic cleft lip and palate in Japanese people

2000 ◽  
Vol 99 (2) ◽  
pp. 105-111 ◽  
Author(s):  
Atsuko TANABE ◽  
Shigeru TAKETANI ◽  
Yoko ENDO-ICHIKAWA ◽  
Rikio TOKUNAGA ◽  
Yutaka OGAWA ◽  
...  
Keyword(s):  
Cleft Palate ◽  
Candidate Genes ◽  
Cleft Lip ◽  
Transforming Growth Factor ◽  
Cleft Lip And Palate ◽  
Control Group ◽  
Case Group ◽  
Coding Region ◽  
Transforming Growth Factor Α ◽  
Significant Difference

In order to assess the association of alleles for candidate genes with non-syndromic cleft lip and palate, DNA samples from 43 Japanese patients were compared with those from 73 control subjects with respect to the genes encoding transforming growth factor α (TGFα), TGFβ and γ-aminobutyric acid type A receptor β3 (GABRB3). The restriction fragment length polymorphisms of the 3′-non-coding region of the TGFα gene K-primer region were observed after digestion with NcoI and HinfI. Allele 4 was the most common among cases of cleft lip with or without cleft palate, whereas allele 2 was the most common among controls. A significant difference was found in this region between groups with cleft lip (with or without cleft palate) and controls (χ2 = 10.190; P = 0.017). Three alleles of the TGFβ2 gene were tested, and allele 2 was the most common in both cases and controls. The proportion of allele 2 in the case group was greater than that in the control group, showing a significant difference between cases of cleft lip (with or without cleft palate) and controls (χ2 = 19.208; P < 0.0001). No significant differences in variants of TGFβ3 or GABRB3 between case and control populations were observed. Thus it is concluded that TGF genes play a role in craniofacial development, and that alleles of TGFα or/and TGFβ2 are associated with cleft lip and cleft palate in Japanese populations.

Early Craniofacial Morphology and Growth in Children with Unoperated Isolated Cleft Palate

2002 ◽  
Vol 39 (6) ◽  
pp. 604-622 ◽  
Author(s):  
N.V. Hermann ◽  
S. Kreiborg ◽  
T.A. Darvann ◽  
B.L. Jensen ◽  
E. Dahl ◽  
...  
Keyword(s):  
Cleft Palate ◽  
Growth Pattern ◽  
Cleft Lip ◽  
Growth Direction ◽  
Craniofacial Morphology ◽  
Control Group ◽  
Facial Morphology ◽  
Facial Growth ◽  
Vertical Growth ◽  
Isolated Cleft Palate

Objective Analysis of craniofacial morphology and growth in children with untreated isolated cleft palate (ICP) (cleft of the secondary palate only) at 2 and 22 months of age and comparison of the morphology and growth to that of a control group with unilateral incomplete cleft lip (UICL). Material and Methods A total of 98 cleft children (53 with ICP and 45 with UICL) drawn from a larger group representing all Danish children with cleft born in the period 1976 to 1981 were included in the study. Craniofacial morphology and growth were analyzed using three-projection infant cephalometry. Results The ICP group differed significantly from the UICL group. The most striking findings in the ICP group were: short maxilla; reduced posterior maxillary height; increased posterior maxillary width (in the 2-month-old); short mandible; reduced posterior height of the mandible; bimaxillary retrognathia; and reduced pharyngeal depth, height, and area. The facial growth pattern was fairly similar in the two groups except for a somewhat more vertical growth direction in the ICP group. Conclusion The facial morphology in ICP children differs significantly from that of children with UICL of the same age. The differences in facial morphology can be ascribed to the difference in the primary anomaly in the ICP group. The facial growth pattern was fairly similar in the ICP and UICL group; however, a somewhat more vertical growth direction was observed in the ICP group.

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.

Dental anomalies frequency in submucous cleft palate versus complete cleft palate

2021 ◽  
Author(s):  
João Paulo Schwartz ◽  
Daniela Gamba Garib
Keyword(s):  
Cleft Palate ◽  
Permanent Teeth ◽  
Tooth Agenesis ◽  
Dental Anomalies ◽  
Supernumerary Teeth ◽  
Chi Square ◽  
Intergroup Comparison ◽  
Significant Difference ◽  
Submucous Cleft Palate ◽  
Isolated Cleft Palate

Summary Background/Objectives This retrospective study evaluated the prevalence of dental anomalies of number in different subphenotypes of isolated cleft palate. Materials/Methods The sample comprised 26 individuals with submucous cleft palate (group S) and 68 individuals with complete cleft palate (group C) aged between 9 and 12 years from a single centre. Panoramic radiographs were evaluated regarding the presence of dental anomalies of number in permanent teeth. Intergroup comparison was performed using chi-square tests (P &lt; 0.05). Results Tooth agenesis was found in 34.61 and 36.76 per cent of group S and group C, respectively. The most commonly missing teeth were the maxillary second premolar, maxillary lateral incisor, and mandibular second premolar. Supernumerary teeth were found in none and 1.47 per cent of the individuals with submucous and complete cleft palate, respectively. No statistically significant difference was found between groups for the frequency of tooth agenesis and supernumerary teeth. Limitations Only dental anomalies of number were evaluated. Conclusions/Implications Individuals with submucous and complete cleft palate showed similar prevalence for tooth agenesis and supernumerary teeth. Dental anomalies frequency seems not to be a discriminator for subphenotypes of cleft palate.

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