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Cleft Lip

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41. Surgical correction of upper lip deficit in patients with cleft lip using dermis fat graft (PubMed)

Surgical correction of upper lip deficit in patients with cleft lip using dermis fat graft This study aimed to assess dermis fat graft (DFG) as a choice to correct the tissue deficit in the free border of the upper lip in cleft lip repair surgery.Thirty-five individuals who referred to Alzahra Hospital at 2013-2014, with lip deformity following the primary repair surgery of cleft lip underwent surgery by DFG technique. Outcomes were assessed 4 months after the surgery based on comparison (...) of preoperative and postoperative photographs.The results in 18 (51.42%) patients were excellent, 10 (28.57%) good, and 7 (20%) intermediate according to the satisfaction of patients and investigators in terms of filling of lip deficit and motion of the upper lip. Moreover, complications and pain were minimal after 4-month follow-up.This method introduces an admissible method with 80% good to excellent results based on satisfactory of patients and surgeon.

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2017 Journal of research in medical sciences : the official journal of Isfahan University of Medical Sciences

42. 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

43. 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

44. 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

45. 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

46. 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

47. Mechanical analyses of critical surgical maneuvers in the correction of cleft lip nasal deformity. (PubMed)

Mechanical analyses of critical surgical maneuvers in the correction of cleft lip nasal deformity. The relapse of nasal deformity is a challenge for modern correction of cleft lip. A comprehensive understanding in the biomechanical perspective of both the formation and correction of the cleft lip nasal deformity would lead to improved stability of the corrective outcome. In this study, a finite element model of secondary cleft lip nasal deformity was constructed, on which two critical

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2018 PLoS ONE

48. 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

49. 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

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

50. Child development skills and language in toddlers with cleft lip and palate. (PubMed)

Child development skills and language in toddlers with cleft lip and palate. Children born with cleft lip and palate (CLP) are exposed to several risk factors for developmental delay.This cross-sectional and descriptive study compared the performance of gross motor, adaptive fine motor, social-personal and language skills in children with non-syndromic cleft lip and palate (age = 36-47 months, n = 30) matched as to chronological age and gender. The evaluation instruments were Denver

2019 International Journal of Pediatric Otorhinolaryngology

51. 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

52. "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

53. 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

54. 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

55. 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

56. Intensive speech therapy in Ugandan patients with cleft (lip and) palate: a pilot-study assessing long-term effectiveness. (PubMed)

Intensive speech therapy in Ugandan patients with cleft (lip and) palate: a pilot-study assessing long-term effectiveness. In resource-limited countries, traditional models for speech therapy delivery are not adequate to reach all patients in need. In those countries, intensive speech therapy might be a solution. Preliminary results of previous research demonstrated that intensive speech therapy can be effective in the short term for patients living in countries with limited access to speech (...) therapy. Questions might arise whether or not intensive treatment results in long-term benefits for these patients. Hence, the present study investigated long-term effectiveness of intensive speech therapy provided to Ugandan patients born with a cleft palate with or without cleft lip (CP ± L) in terms of different speech characteristics.Five Ugandan patients with CP ± L, who received intensive speech therapy in the past, were contacted to participate in this follow-up study. All patients agreed

2019 International Journal of Pediatric Otorhinolaryngology

57. Symmetric Philtral Column Repair for Unilateral Cleft Lip. (PubMed)

Symmetric 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 result should be a balanced and symmetric 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 the author's unit, a method has evolved entitled the symmetric philtral column repair. In this method, the author attempts to achieve a philtral column that mirrors the philtral column on the normal side, producing a balanced appearing lip. This method has been used for the past 14 years in over 500 patients.The results have been satisfying, with a lip revision rate of 6 percent.The symmetric philtral column repair of a unilateral cleft lip is an effective and safe repair

2019 Plastic and reconstructive surgery

58. 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. The purpose of this study was to evaluate the effect of four different treatment protocols on maxillofacial growth in patients aged 7 to 8 years with unilateral complete cleft lip, palate, and alveolus.Sixty-one patients with nonsyndromic unilateral complete cleft lip, palate, and alveolus were entered into this study and grouped as follows: group 1 (...) patients had a repaired lip and an unrepaired palate; group 2 patients underwent one-stage palatoplasty; group 3 patients underwent two-stage palatoplasty; and group 4 patients underwent lip adhesion and two-stage palatoplasty. The control group was composed of 16 patients with unilateral incomplete cleft lip. The Kolmogorov-Smirnov test was used to test the nature of data distribution. The Bonferroni test and the Kruskal-Wallis H test were used for multiple comparisons.Group 5 showed a more protruding

2019 Plastic and reconstructive surgery

59. "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

60. 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

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