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Cleft Lip

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41. Pre-surgical NAM (nasoalveolar molding): an evaluation of a rational treatment and systematic review. Part I: bilateral cleft lip and palate

Pre-surgical NAM (nasoalveolar molding): an evaluation of a rational treatment and systematic review. Part I: bilateral cleft lip and palate Print | PDF PROSPERO This information has been provided by the named contact for this review. CRD has accepted this information in good faith and registered the review in PROSPERO. The registrant confirms that the information supplied for this submission is accurate and complete. CRD bears no responsibility or liability for the content of this registration

2019 PROSPERO

42. How does bone-anchored maxillary protraction affect the temporomandibular joints of patients with nonsyndromic cleft lip and palate compared to conventional maxillary protraction?

How does bone-anchored maxillary protraction affect the temporomandibular joints of patients with nonsyndromic cleft lip and palate compared to conventional maxillary protraction? Print | PDF PROSPERO This information has been provided by the named contact for this review. CRD has accepted this information in good faith and registered the review in PROSPERO. The registrant confirms that the information supplied for this submission is accurate and complete. CRD bears no responsibility

2019 PROSPERO

44. Non-Syndromic Patients With Cleft Lip And/Or Palate (CLP) Tend To Have Higher Caries Prevalence Than Non-CLP Patients

Non-Syndromic Patients With Cleft Lip And/Or Palate (CLP) Tend To Have Higher Caries Prevalence Than Non-CLP Patients UTCAT2989, Found CAT view, CRITICALLY APPRAISED TOPICs University: | | ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM View the CAT / Title Non-Syndromic Patients With Cleft Lip And/Or Palate (CLP) Tend To Have Higher Caries Prevalence Than Non-CLP Patients Clinical Question In patients with non-syndromic cleft lip/cleft palate, is there greater predisposition to caries than in non (...) -CL/P patients? Clinical Bottom Line Non-syndromic patients with cleft lip and/or palate tend to have higher caries prevalence than non-CLP patients. This is supported by a meta-analysis of several cross-sectional trials in which the decayed, missing, and filled (DMF) index was significantly higher for CLP patients than non-CLP patients. This would suggest that dentists should factor in CLP while determining caries risk status for patients. Best Evidence (you may view more info by clicking

2016 UTHSCSA Dental School CAT Library

45. No Significant Difference in Velopharyngeal Function Between Conventional Orthognathic Surgery and Maxillary distraction for advancement of the maxilla in cleft lip and palate patients.

No Significant Difference in Velopharyngeal Function Between Conventional Orthognathic Surgery and Maxillary distraction for advancement of the maxilla in cleft lip and palate patients. UTCAT2625, Found CAT view, CRITICALLY APPRAISED TOPICs University: | | ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM View the CAT / Title No Significant Difference in Velopharyngeal Function Between Conventional Orthognathic Surgery and Maxillary Distraction for Advancement of the Maxilla in Cleft Lip and Palate (...) Patients Clinical Question Is there a difference in the development of velopharyngeal insufficiency when maxillary advancement in the cleft patient is performed with conventional orthognathic surgery or distraction osteogenesis? Clinical Bottom Line For repaired cleft lip and palate patients, there is no significant difference in development of velopharyngeal insufficiency after maxillary advancement due to conventional orthognathic (CO) surgery or distraction osteogenesis (DO). This is supported

2014 UTHSCSA Dental School CAT Library

46. Delivering effective genetic services for patients and families affected by cleft lip and/or palate. (PubMed)

Delivering effective genetic services for patients and families affected by cleft lip and/or palate. Genetic services for individuals affected by cleft lip and/or palate (CL/P) and their families are an important aspect of clinical care; yet debate exists as to how this service should be offered. This study explored the utility, acceptability, and delivery of genetic services from the perspectives of cleft-specialist clinicians, genetic counsellors, and affected families. Analysis of data (...) collected from three focus groups and eleven individual interviews identified two overarching themes "Referring patients and families to genetic services" and "The role of a genetic specialist in the context of CL/P". The first examines the common reasons for referral to the genetics service, how best to judge the timing of a referral, and the optimal approach to the delivery of sensitive genetic information. The second theme discusses the role of the genetic specialist in the context of cleft care

2019 European Journal of Human Genetics

47. Symmetrical Philtral Column Repair for Unilateral Cleft Lip. (PubMed)

Symmetrical Philtral Column Repair for Unilateral Cleft Lip. When treating a patient with a unilateral cleft lip, the goal is to try and achieve a result that is the least perceivable at conversational distance.The end result should be a balanced and symmetrical lip with scars that are hidden or are placed in natural anatomical lines.Several methods have been described to repair the lip . The most popular repairs at present are the rotation-advancement or its modifications and the various (...) versions of the straight line repair.In our unit we have evolved a method that we title the Symmetrical Philtral Column (SPC) repair.In this method we attempt to achieve a philtral column that mirrors the philtral column on the normal side and to producing a balanced appearing lip.This method has been used for the last 14 years in over 500 patients.The results have been satisfying with a lip revision rate of 6%.The SPC repair of a unilateral cleft lip is an effective and safe repair.The repair is easy

2019 Plastic and reconstructive surgery

48. Accurate diagnosis of fetal cleft lip/palate by typical signs of magnetic resonance imaging. (PubMed)

Accurate diagnosis of fetal cleft lip/palate by typical signs of magnetic resonance imaging. This study aims to evaluate the accuracy of magnetic resonance imaging (MRI) in diagnosing orofacial clefts and proposes specific signs for determining the type of cleft.Pregnant women in whom fetal facial malformations are suspected by ultrasonography (US) underwent 1.5T Magnetic Resonance Imaging (MRI). The accuracy of the prenatal US and MRI diagnosis was compared with the postnatal findings.A total (...) 71 fetuses were included in the final analysis, which comprised of 35 cases of isolated cleft lip, six cases of cleft lip and alveolus, 21 cases of cleft lip and palate, four cases of isolated cleft palate, and five normal fetuses. MRI was more sensitive than US (MRI 100%, US 77.5%; Fisher exact test: MRI vs. US 0.000). The accuracy of MRI for all types was 100%. Specific signs (Inverted T, L/anti-L, U, and 'Notch' signs) were proposed, indicating the normal hard, unilateral cleft, bilateral

2019 Prenatal diagnosis

49. "Comparison of the Fisher Anatomic Subunit and Modified Millard Rotation-Advancement cleft lip repairs." (PubMed)

"Comparison of the Fisher Anatomic Subunit and Modified Millard Rotation-Advancement cleft lip repairs." When analyzing cleft lip repair techniques, the modified rotation-advancement repair (RA) is most widely utilized; however, the anatomic subunit approach (AS) is gaining popularity. The purpose of this study was to compare the outcomes of these two surgical techniques by the same surgeon.Anthropometric measurements were performed on post-operative photos of cleft lip repairs performed (...) by a single surgeon As described by Rossell-Perry et al., four parameters were measured: lip height, lip width, vermilion height, and alar base width. An aesthetic ratio of cleft to non-cleft side for each measurement was used as a quantitative measure of outcome. Qualitative analysis of cleft lip repair was evaluated using the Steffensen's criteria.12 modified rotation-advancement repairs and 10 anatomic subunit repairs were analyzed. A one sample t-test assessed the difference of each aesthetic ratio

2019 Plastic and reconstructive surgery

50. Comparative Evaluation of Esthetic Outcomes in Unilateral Cleft Lip Repair Between the Mohler and Fisher Repair Techniques: A Prospective, Randomized, Observer-Blind Study. (PubMed)

Comparative Evaluation of Esthetic Outcomes in Unilateral Cleft Lip Repair Between the Mohler and Fisher Repair Techniques: A Prospective, Randomized, Observer-Blind Study. The Mohler and Fisher techniques are 2 of the most widely used surgical techniques of cleft lip repair showing satisfactory esthetic results. Their random use and preference by some surgeons irrespective of cleft severity have invited considerable doubt regarding whether one technique performs better than the other. The aim (...) of this study was to measure and compare the esthetic outcomes between these 2 techniques of unilateral cleft lip repair.This prospective, randomized, observer-blind study included 50 patients with unilateral cleft lip with or without cleft palate. Preoperative cleft severity was evaluated based on the Unilateral Cleft Lip Severity Index. All patients then underwent 1 of the 2 techniques of lip repair, assigned by randomization, performed by a single blinded surgeon. The postsurgical esthetic outcome

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2019 Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons Controlled trial quality: uncertain

51. Impact of nasalis muscle repair in unilateral cleft lip patients. (PubMed)

Impact of nasalis muscle repair in unilateral cleft lip patients. Although the role of nasalis muscle in the establishment of nasal deformity is well recognized; its abnormal anatomy and role in the correction of alar deformity in cleft lip patients have not been adequately studied. This work aimed to study the effect of nasalis muscle repair on the postoperative nasal symmetry.A controlled prospective randomized study was conducted on 45 cases of unilateral complete pre-alveolar cleft (...) . Patients were divided into two groups; Group 1 (repair of the Orbicularis muscle only), Group 2 was further divided into 2 subgroups: Subgroup A (repair of the orbicularis oris muscle and dissection and repair the origin of the nasalis muscle). Subgroup B (repair of the orbicularis oris muscle and dissection of both origin and abnormal insertion of the nasalis and repair of the origin). Evaluation was conducted both subjectively and objectively through cleft lip evaluation profile and nostril angles

2019 Journal of cranio-maxillo-facial surgery : official publication of the European Association for Cranio-Maxillo-Facial Surgery Controlled trial quality: uncertain

52. The effect of a small triangular skin flap on vermillion height after cleft lip repair: a photogrammetry study. (PubMed)

The effect of a small triangular skin flap on vermillion height after cleft lip repair: a photogrammetry study. During primary cleft lip repair, a small triangular flap of about 2mm is sometimes required to achieve better symmetry of Cupid's bow. The aim of this study was to evaluate the symmetry of Cupid's bow, with and without the use of a small triangular skin flap (STSF). Forty-five children who underwent the repair of unilateral cleft lip between January 1999 and December 2000 were (...) the patients in the two groups. Thus, there is no difference in vermillion height ratio with or without a STSF in cleft lip repair. The use of a small triangular skin flap needs to be assessed carefully, as it will create an unsightly scar over the philtrum area.Copyright © 2019 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

2019 International Journal of Oral and Maxillofacial Surgery

53. Influence of timing of delayed hard palate closure on articulation skills in 3-year-old Danish children with unilateral cleft lip and palate. (PubMed)

Influence of timing of delayed hard palate closure on articulation skills in 3-year-old Danish children with unilateral cleft lip and palate. Differing results regarding articulation skills in young children with cleft palate (CP) have been reported and often interpreted as a consequence of different surgical protocols.To assess the influence of different timing of hard palate closure in a two-stage procedure on articulation skills in 3-year-olds born with unilateral cleft lip and palate (UCLP (...) participants had the lip and soft palate closed around 4 months of age. Audio and video recordings of a naming test were available from 113 children (32 girls and 81 boys) and were transcribed phonetically. Recordings were obtained prior to hard palate closure in the LHPC group. The main outcome measures were percentage consonants correct adjusted (PCC-A) and consonant errors from blinded assessments. Results from 36 Danish-speaking children without CP obtained previously by Willadsen in 2012 were used

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2019 International Journal of Language & Communication Disorders Controlled trial quality: uncertain

54. The Smile Index: Part 2. A Simple, Prognostic Severity Scale for Unilateral Cleft Lip. (PubMed)

The Smile Index: Part 2. A Simple, Prognostic Severity Scale for Unilateral Cleft Lip. There is no universally accepted classification system for unilateral cleft lip that objectively quantifies the spectrum of disease, making it difficult to evaluate postoperative outcomes in the context of preoperative severity.Anthropometric measurements and photographs were prospectively collected from unilateral cleft lip patients in Morocco, Bolivia, Vietnam, and Madagascar. Columellar angle, cleft width (...) , nostril widths, vertical lip heights, and horizontal vermillion lengths were measured preoperatively and postoperatively. "Unacceptable" postoperative outcomes were defined as those with a cleft-side/non-cleft-side vertical lip height discrepancy greater than 3 mm, based on previous sociologic and cleft outcome studies.Of the 147 patients studied, 22 had unacceptable outcomes. Univariate logistic and multivariate logistic stepwise models showed that among preoperative characteristics, cleft width

2019 Plastic and reconstructive surgery

55. Beware the Alar Base Optical Illusion in Assessment of Unilateral Cleft Lip Nasal Deformity. (PubMed)

Beware the Alar Base Optical Illusion in Assessment of Unilateral Cleft Lip Nasal Deformity. After repair of unilateral cleft lip, lateral drift of the alar base is expected and may require revision. Although the alar base appears wider than on the noncleft side, by measurement it could be symmetric or narrow. Is this an optical illusion?This is a retrospective photographic evaluation of children who underwent repair of unilateral complete cleft lip and palate. On submental standardized (...) photographs, raters judged whether the alar base position was wider, equal to, or narrower than on the noncleft side. The true alar base position was measured by photogrammetry and the frequency of alar base misjudgment was assessed. On control photographs, the cleft side alar base was wider than the noncleft side. On test photographs, the cleft side alar base was narrower than the noncleft side. Possible association between misjudgment and nasal features was also evaluated. Data were analyzed using

2019 Plastic and reconstructive surgery

56. "The influence of four different treatment protocols on maxillofacial growth in patients with unilateral complete cleft lip, palate, and alveolus". (PubMed)

"The influence of four different treatment protocols on maxillofacial growth in patients with unilateral complete cleft lip, palate, and alveolus". To evaluate the effect of four different treatment protocols on maxillofacial growth in patients aged 7-8 years with UCCLPA.61 patients with non-syndromic unilateral complete cleft lip, palate and alveolus were selected into this study. Patients with UCCLPA who had a repaired lip and unrepaired palate were placed in group 1. Patients with UCCLPA who (...) received one-stage palatoplasty were placed in group 2. Patients with UCCLPA who received two-stage palatoplasty were placed in group 3. Patients with UCCLPA who received lip adhesion and two-stage palatoplasty were placed in group 4. The control group was composed of 16 patients with unilateral incomplete cleft lip. Kolmogorov-Smirnov test was used to test the nature of data distribution. Bonferroni test and Kruskal-Wallis H test were used for multiple comparisons.Group 5 showed more protruding

2019 Plastic and reconstructive surgery

57. Orthodontic burden of care for patients with a cleft lip and/or palate. (PubMed)

Orthodontic burden of care for patients with a cleft lip and/or palate. Patients with a cleft lip and/or palate may require multiple episodes of orthodontic treatment, e.g. before alveolar bone grafting, upper arch alignment, orthodontic camouflage and in combination with orthognathic surgery. There is little published regarding the overall orthodontic burden of care for these patients.To assess the orthodontic burden of care for patients with a cleft lip and/or palate.Data were collected (...) retrospectively from all consecutive cleft patients who had completed orthodontic treatment between January 2014 and December 2015 at Great Ormond Street Hospital, London, United Kingdom.Forty-two patients were included in the study: Twenty-three patients with a cleft lip and palate; nine with an isolated cleft palate; eight with cleft lip and alveolus; and two with cleft lip. The mean age of orthodontic treatment commencement was 13.4 years (range = 8.9-18.2 years) with a mean duration of 3.4 years (range

2019 Journal of Orthodontics

58. Prognostic Factors for Hearing Outcomes in Children with Cleft Lip and Palate. (PubMed)

Prognostic Factors for Hearing Outcomes in Children with Cleft Lip and Palate. This study was performed to investigate the prognostic factors that influence hearing outcomes of children with cleft lip and palate after ventilation tube insertion.The authors retrospectively reviewed the hearing thresholds of 90 children with cleft lip and palate and performed univariate and multivariate analyses of five prognostic factors for hearing outcomes: age at palatoplasty, age at first ventilation tube (...) insertion, timing of ventilation tube insertion, frequency of ventilation tube insertion, and type of cleft palate.On univariate analysis, the authors found that older age at palatoplasty (p = 0.002), older age at first ventilation tube insertion (p = 0.025), and increased frequency of ventilation tube insertion (p = 0.048) were significant prognostic factors for poorer hearing outcomes in children with cleft lip and palate. Multiple logistic regression analysis showed that late palatoplasty (age older

2019 Plastic and reconstructive surgery

59. Three-Dimensional Outcome Assessments of Cleft Lip and Palate Patients Undergoing Maxillary Advancement. (PubMed)

Three-Dimensional Outcome Assessments of Cleft Lip and Palate Patients Undergoing Maxillary Advancement. The aim of this retrospective case series study was to compare three-dimensional postsurgical outcomes of patients with cleft lip and palate following maxillary advancement.Fifty consecutive cleft lip and palate patients who underwent whole-pieced Le Fort I advancements were assigned to the major (advancement ≥ 5 mm) or minor (advancement < 5 mm) groups. Three-dimensional surgical simulation (...) revealed that the outcome discrepancy measurements were affected by different combinations of independent variables. The reliability test showed high consistency of the authors' method for three-dimensional measurements.The actual surgical outcomes of cleft lip and palate patients differed from the virtual simulations. The outcome discrepancies are impacted by multiple factors. The outcome discrepancies of all rotational surgical corrections (roll, yaw, and pitch) were positively correlated

2019 Plastic and reconstructive surgery

60. Usefulness of Airway Scope for intubation of infants with cleft lip and palate-comparison with Macintosh laryngoscope: a randomized controlled trial. (PubMed)

Usefulness of Airway Scope for intubation of infants with cleft lip and palate-comparison with Macintosh laryngoscope: a randomized controlled trial. Airway Scope (AWS) with its plastic blade does not require a head-tilt or separate laryngoscopy to guide intubations. Therefore, we hypothesized that its use would reduce the intubation time (IT) and the frequency of airway complication events when compared with the use of Macintosh Laryngoscope (ML) for infants with cleft lip and palate (CLP (...) complications were considered secondary outcomes. Moreover, we looked for associations between IT and the patient's characteristics: extensive clefts, age, height, and weight. We used the Mann-Whitney test and Fisher's exact probability test for statistical analysis; p < 0.05 was considered as statistically significant.The mean IT was 31.5 ± 8.3 s in AWS group and 26.4 ± 8.9 s in ML group. Statistical significant difference was not found in IT between the two groups. The IT of AWS group was statistically

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2019 BMC Anesthesiology Controlled trial quality: uncertain

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