Cleft Lip

Geospatial Analysis of Risk Factors Contributing to Loss to Follow-up in Cleft Lip/Palate Care Multidisciplinary cleft care depends on follow-up at specified time points to monitor and address functional or aesthetic concerns that may arise during a child's development. However, loss to follow-up (LTFU) is common and can lead to missed opportunities for therapeutic and surgical intervention. This study explores clinical, demographic, and geographic determinants of LTFU in cleft care.Medical (...) records were retrospectively evaluated for 558 pediatric patients of a single mid-volume cleft team. The primary outcome was LTFU. Spatial dependency was evaluated using variograms. The probability of LTFU was assessed using a generalized linear geostatistical model within a Bayesian framework. Risk maps were plotted to identify vulnerable communities within our state at higher risk of LTFU.Younger age at last encounter was a strong predictor of LTFU (P < 0.0001), even when ignoring spatial dependency

A Comparison between Piezoelectric Devices and Conventional Rotary Instruments in Bone Harvesting in Patients with Lip and Palate Cleft: A Retrospective Study with Clinical, Radiographical, and Histological Evaluation Orofacial clefts are congenital malformations characterized by an incomplete shaping of structures that separate the nasal from the oral cavity and can affect the right, left, or both sides. The aim of the present study is to assess, with clinical, radiographical, and histological (...) evaluations, the efficacy of piezoelectric devices compared to traditional rotating instruments in the bone harvesting in patients with history of cleft.We have conducted a retrospective analysis on 20 patients with a history of orofacial clefts that were operated on from February 2014 to June 2017. The patients were divided into two groups: Group R in which bone graft was harvested using a burr and Group P in which the bone graft was obtained by a piezoelectric device. After a healing period of 8 months

Genome-Wide Screening of Aberrant Methylation Loci for Nonsyndromic Cleft Lip The pathogenicity of cleft lip (CL) is pretty complicated since it is influenced by the interaction of environment and genetic factors. The purpose of this study was to conduct a genome-wide screening of aberrant methylation loci in partial lesion tissues of patients with nonsyndromic CL (NSCL) and preliminarily validate candidate dysmethylated genes associated with NSCL.Fifteen healthy and sixteen NSCL fetal lip (...) tissue samples were collected. The Infinium HumanMethylation450 BeadChip was used to screen aberrant methylation loci in three NSCL and three healthy lip tissues. The differential methylation sites and functions of the annotated genes between NSCL and healthy lip tissues were analyzed using minfi package of R software, cluster analysis, Gene Ontology (GO) annotation, and metabolic pathway annotation. Gene expression was assessed in nine differentially methylated genes by real-time polymerase chain

A High Fidelity Cleft Lip Simulator Cleft lip surgery is technically difficult requiring precise planning and understanding of 3-dimensional structures to obtain an optimal outcome. A physical cleft lip simulator was developed that allows trainees to gain experience in cleft lip repair and primary rhinoplasty before operating on real patients.A cleft lip simulator that comprises multilayered soft tissues, bone, and realistic dissection planes was developed using 3D printing, adhesive (...) is a valuable tool for training in cleft lip surgery.A cleft lip simulator that allows performance of a cleft lip repair and primary rhinoplasty from start to finish was developed and pilot tested. The simulator provides a training platform to gain experience in cleft lip repair before operating on real patients.

A comparative study of immediate wound healing complications following cleft lip repair using either absorbable or non-absorbable skin sutures The aim of the study was to compare wound healing complications following the use of either absorbable or non-absorbable sutures for skin closure in cleft lip repair.This was a randomized controlled trial conducted at the Department of Oral and Maxillofacial Surgery, Lagos University Teaching Hospital, Idi Araba, Lagos State, Nigeria. Sixty subjects who (...) required either primary or secondary cleft lip repair and satisfied all the inclusion criteria were recruited and randomized into two groups (Vicryl group or Nylon group). The surgical wounds in all subjects were examined on 3rd, 7th, and 14th postoperative days (POD) for presence or absence of tissue reactivity, wound dehiscence, and local wound infection.Hemorrhage, tissue reactivity, wound dehiscence, and local wound infection were identified as wound healing complications following cleft lip repair

Volumetric reconstruction and determination of minimum crosssectional area of the pharynx in patients with cleft lip and palate: comparison between two different softwares The aim of this study was to assess the accuracy of volumetric reconstruction of the pharynx by comparing the volume and minimum crosssectional area (mCSA) determined with open-source applications (ITK-Snap, www.itksnap.org ; SlicerCMF) and commercial software (Dolphin3D, 11.8, Dolphin Imaging & Management Solutions (...) , Chatsworth, CA, USA) previously validated in the literature.The sample comprised of 35 cone-beam computed tomography (CBCT) scans of patients with unilateral cleft lip and palate, with mean age of 29±15. Three-dimensional volumetric models of the pharynx were reconstructed using semi-automatic segmentation using the applications ITK-Snap (G1) and Dolphin3D (G2). Volumes and minimum cross-sectional areas were determined. Inter- and intra-observer error were calculated using ICC test. Comparison between

Evaluation of the Effects of LUNII on Pre-operative Anxiety and on the Post-operative Period in Children With Cleft Lip and Palate Admitted for Alveolar Bone Graft: Pilot Study Evaluation of the Effects of LUNII on Pre-operative Anxiety and on the Post-operative Period in Children With Cleft Lip and Palate Admitted for Alveolar Bone Graft: Pilot Study - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results (...) information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove one or more studies before adding more. Evaluation of the Effects of LUNII on Pre-operative Anxiety and on the Post-operative Period in Children With Cleft Lip and Palate Admitted for Alveolar Bone Graft: Pilot Study (LUNII) The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing

Evolution of Acquired Middle Ear Cholesteatoma in Patients With Ectrodactyly, Ectodermal Dysplasia, Cleft Lip/Palate (EEC) Syndrome. To review an institutional experience with the surgical and clinical management of acquired middle ear cholesteatoma in patients with ectrodactyly, ectodermal dysplasia, cleft lip/palate (EEC) syndrome.Retrospective chart review.Tertiary referral center.Eight patients with medical history significant for EEC syndrome who underwent surgery for acquired middle ear

Nasoalveolar Molding Therapy may Offer Positive Effects on Unilateral Clefts of Lip and/or Palate. Correlation between nasoalveolar molding and surgical, aesthetic, functional and socioeconomic outcomes following primary repair surgery: A systematic review. Maillard S, Retrouvey JM, Ahmed MK, Taub PJ. J Oral Maxillofac Res. 2017;8(3):e2.No financial support was reported.Systematic review.Copyright © 2018 Elsevier Inc. All rights reserved.

Extreme maxillomandibular discrepancy in unilateral cleft lip and palate: Longitudinal follow-up in a patient with mandibular prognathism. Growth deficiency of the maxilla is a frequent finding in patients with complete unilateral cleft lip and palate. When the sagittal discrepancy is severe, orthodontic treatment combined with orthognathic surgery is required. This article reports the treatment of a girl born with unilateral cleft lip and palate who had lip and palate repair at 3 and 12 months

Therapeutic effect of a cleft lip teat on infants with respiratory and feeding disorders: Two case reports. Existing research into the effects of teat application has mainly focused on its negative and positive influence on the development of the oral cavity. Our work demonstrates that apart from changing the setting of the articulatory organs, the teat can also affect the quality of breathing, eating and sleeping.We described the cases of 2 children: a 19-month-old girl and a 2.5-month-old boy (...) , who had breathing disorders due to withdrawal of the tongue and impaired food intake.The babies were bottled fed with a special teat for cleft lip patients to observe the influence of the teat on the setting of the articulatory organs and breathing.We suspected that the specific construction of the teat-the wide outer part and the short internal part-would affect children's reflexes and articulatory organs so as to force the frontal position of the tongue, which was meant to facilitate breathing

Influence of Repaired Cleft Lip and Palate on Layperson Perception following Orthognathic Surgery. Facial scarring and disharmony caused by clefting are associated with psychosocial stress, which may be improved by orthognathic surgery. The authors examine how clefting influences change in layperson perception of a patient following orthognathic surgery.One thousand laypersons were recruited through Mechanical Turk to evaluate patient photographs before and after orthognathic surgery. Nineteen (...) patients-five with unilateral and five with bilateral clefting-were included. Respondents assessed six personality traits, six emotional expressions, and likelihood of seven interpersonal experiences on a scale from 1 to 7.Changes in all aspects of social perception after the procedure differed significantly between cleft versus noncleft cohorts (p < 0.01 for all). Respondents evaluated the change for the cleft cohort compared with the noncleft cohort as more trustworthy, friendly, sad, and afraid

The use of throat packs in pediatric cleft lip/palate surgery: a retrospective study Throat packs are commonly used to prevent ingestion or aspiration of blood and other debris during cleft lip/palate surgery. However, dislodgement or (partial) retainment after extubation could have serious consequences. The aim of the present study was to investigate the effect of omitting pharyngeal packing during cleft lip/palate surgery on the incidence of early postoperative complications in children.A (...) retrospective study was performed on all children who underwent cleft lip/palate surgery at the Wilhelmina Children's Hospital. This study compared the period January 2010 through December 2012 when pharyngeal packing was applied according to local protocol (group A) with the period January 2013 till December 2015 when pharyngeal packing was no longer applied after removal from the protocol (group B). Data were collected for sex, age at operation, cleft lip/palate type, type of repair, lateral incisions

Unilateral cleft lip repair: a comparison of treatment outcome with two surgical techniques using quantitative (anthropometry) assessment The unilateral cleft lip (UCL) repair technique has evolved extensively over the past century into its modern form and has been identified as an important determinant of treatment outcome. The aim of this study was to evaluate and compare treatment outcomes following repair of UCL using either the Tennison-Randall (triangular) technique or the Millard (...) rotation-advancement technique.This was a prospective randomized controlled study conducted at the Lagos University Teaching Hospital between January 2013 and July 2014. A total of 48 subjects with UCL presenting for primary surgery and who satisfied the inclusion criteria were recruited for the study. The subjects were randomly allocated into two surgical groups through balloting. Group A underwent cleft repair with the Tennison-Randall technique, while group B underwent cleft repair with the Millard

Anatomical Nasal Lining Flaps for Closure of the Nasal Floor in Unilateral and Bilateral Cleft Lip Repairs Reduce Fistulas at the Alveolus. Techniques vary for addressing the nasal floor during cleft lip repair in patients with a cleft lip and palate. Sometimes, no closure is performed, leaving a symptomatic alveolar fistula until the time of alveolar bone grafting. Often, medial and lateral skin flaps are used, but these are often thin and unreliable. Anatomical nasal lining flaps are used (...) to improve closure with robust, well-vascularized flaps that anatomically close the nasal floor.A retrospective chart review was performed to identify patients with a unilateral or bilateral cleft lip and palate who underwent primary cleft lip repair with nasal lining flaps or with medial and lateral flaps. The primary outcome was presence of a symptomatic and/or visible oronasal fistula.Sixty-four patients were included. Thirty-seven underwent closure with nasal lining flaps, whereas 27 underwent

Caregiver-Reported Outcomes and Barriers to Care among Patients with Cleft Lip and Palate. For children with cleft lip and/or palate, access to care is vital for optimizing speech, appearance, and psychosocial outcomes. The authors posited that inadequate access to care negatively impacts outcomes in this population.Sixty caregivers of children with cleft lip and palate were surveyed to assess perceived barriers using the validated Barriers to Care questionnaire. The questionnaire includes 39 (...) items divided into five subscales, with higher scores indicating fewer barriers. Caregiver-reported outcomes were assessed using the Cleft Evaluation Profile, which captures cleft-specific appearance- and speech-related outcomes. Higher scores correspond to less satisfactory outcomes. Desire for revision surgery was assessed as a binary outcome among caregivers. Multivariable regression was used to evaluate the relationship of barriers to care, caregiver-reported outcomes, and desire for revision

A New Paradigm in Cleft Lip Procedural Excellence: Creation and Preliminary Digital Validation of a Lifelike Simulator. Simulation is becoming an increasingly important tool for hands-on surgical education in a no-risk environment. Cleft lip repair is a common procedure where precise technique is needed to achieve optimal outcome, making it an ideal candidate for simulation. A digital simulated patient with a typical unilateral complete cleft lip and alveolus was constructed using existing (...) three-dimensional imaging studies. Key surface and internal anatomical elements were characterized in detail. A prototype high-fidelity simulator was constructed with silicone and synthetic polymers over a supportive scaffold, piloted by three surgeons using multiple techniques, and digitally compared to real patients. All surgeons completed key steps of a cleft lip repair on the simulator and found it approximated the haptics and anatomy of a cleft lip. Surface change and anthropometric movements

Quantifying Soft Tissue Shape and Symmetry: Patients with Cleft Lip/Palate and Facial Paralysis The objective of this study was to demonstrate simple three-dimensional analyses of facial soft tissue shape and asymmetry.There were 2 study samples: one retrospective comprised patients with repaired cleft lip and palate (CL/P) and control subjects; and the other prospective comprised patients with unilateral facial paralysis (FP) and control subjects. The data collected were digitized three

Influence of infancy care strategy on hearing in children and adolescents: A longitudinal study of children with unilateral lip and /or cleft palate. To evaluate the relation between ventilation tube insertion, otitis media with effusion duration and otologic outcomes in unilateral cleft lip and/or cleft palate children from infancy to teenage age.Retrospective longitudinal charts review of patients from the multidisciplinary cleft team of the University Hospital of Lausanne over a 30-year (...) period. 146 charts from consecutive patients with non-syndromic unilateral cleft lip and/or cleft palate who were born between January 1986 and January 2003 were included.The earlier in life a cleft child experience his first otitis media with effusion (OME), the worse his long-term hearing will be. Along with the age of onset of OME, we disclosed an influence of the duration of OME without ventilation tube (VT) insertion on short and long-term hearing outcomes. Different patterns were observed

Gene-Gene Interactions among SPRYs for Nonsyndromic Cleft Lip/Palate. Nonsyndromic cleft lip with or without cleft palate (NSCL/P) is a common birth defect with a complex genetic architecture. Gene-gene interactions have been increasingly regarded as contributing to the etiology of NSCL/P. A recent genome-wide association study revealed that a novel single-nucleotide polymorphism at SPRY1 in 4q28.1 showed a significant association with NSCL/P. In the current study, we explored the role of 3 (...) SPRY genes in the etiology of NSCL/P by detecting gene-gene interactions: SPRY1, SPRY2, and SPRY4-with SPRY3 excluded due to its special location on the X chromosome. We selected markers in 3 SPRY genes to test for gene-gene interactions using 1,908 case-parent trios recruited from an international consortium established for a genome-wide association study of nonsyndromic oral clefts. As the trios came from populations with different ancestries, subgroup analyses were conducted among Europeans