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Cleft Lip

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141. Bilateral suprazygomatic maxillary nerve blocks vs. infraorbital and palatine nerve blocks in cleft lip and palate repair: A double-blind prospective, randomised study. (PubMed)

Bilateral suprazygomatic maxillary nerve blocks vs. infraorbital and palatine nerve blocks in cleft lip and palate repair: A double-blind prospective, randomised study. Cleft defects are common craniofacial malformations which require early surgical repair. These patients are at high risk of postoperative airway obstruction and respiratory failure. Cleft surgery may require high doses of opioids which may contribute to these complications.To compare the effectiveness of proximal and distal (...) approaches to blocking the maxillary nerve in patients undergoing cleft lip or cleft palate surgery.Randomised, controlled and double-blind study.The current study was carried out in Guwahati (Assam, India) between April 2014 and June 2014.A total of 114 patients older than 6 months who underwent cleft lip or cleft palate surgery were included. Exclusion criteria included coagulation disorders, peripheral neuropathy or chronic pain syndrome, infection in the puncture site, allergy to local anaesthetics

2018 European Journal of Anaesthesiology

142. Three-dimensional development of the upper dental arch in unilateral cleft lip and palate patients after early neonatal cheiloplasty. (PubMed)

Three-dimensional development of the upper dental arch in unilateral cleft lip and palate patients after early neonatal cheiloplasty. This prospective morphometric study evaluated the growth of the upper dental arch in UCLP patients after early neonatal cheiloplasty and compared the selected dimensions with published data on non-cleft controls and on later operation protocol patients.The sample comprised 36 Czech children with nonsyndromic complete UCLP (cUCLP) and 20 Czech children (...) patients. Both the width and length dimensions increased after surgery. Important growth concerned the anterior ends of both segments. The width and length dimensions illustrated similar growth trends with non-cleft controls and UCLP patients who underwent later cheiloplasty.Early neonatal cheiloplasty caused no reduction in the length or width dimensions during the first year of life. Our data suggest a reconstructed lip has a natural formative effect on the actively growing anterior parts of upper

2018 International Journal of Pediatric Otorhinolaryngology

143. Outpatient versus Inpatient Primary Cleft Lip and Palate Surgery: Analysis of Early Complications. (PubMed)

Outpatient versus Inpatient Primary Cleft Lip and Palate Surgery: Analysis of Early Complications. Fiscal constraints are driving shorter hospital lengths of stay. Outpatient primary cleft lip surgery has been shown to be safe, but outpatient primary cleft palate surgery remains controversial. This study evaluates outcomes following outpatient versus inpatient primary cleft lip and palate surgery.The American College of Surgeons National Surgical Quality Improvement Program Pediatric database (...) was used to identify patients undergoing primary cleft lip and palate surgery between 2012 and 2015. Patient clinical factors and 30-day complications were compared for outpatient versus inpatient primary cleft lip and palate surgery. Univariate and multivariate analyses were performed.Three thousand one hundred forty-two patients were included in the primary cleft lip surgery group and 4191 in the primary cleft palate surgery group. Patients in the cleft lip surgery group with structural pulmonary

2018 Plastic and reconstructive surgery

144. Outcome of Patients with Complete Unilateral Cleft Lip and Palate: 20-Years Follow-up of Treatment Protocol. (PubMed)

Outcome of Patients with Complete Unilateral Cleft Lip and Palate: 20-Years Follow-up of Treatment Protocol. The treatment plan for cleft lip and palate varies among centers and requires long-term evaluation of its final outcome.A consecutive series of patients born from 1994 to 1996 were reviewed. Inclusion criteria were complete unilateral cleft lip and palate, undergoing all treatment procedures performed by the team, and continuous follow-ups until 20 years of age. Exclusion criteria were (...) incomplete data, having microform cleft lip on the contralateral side, presence of the Simonart band, and other abnormalities.A total of 72 patients were included. Average age at final evaluation was 21.3 years; 83.3 percent of patients underwent one-stage rotation-advancement lip repair and 16.7 percent underwent two-stage repair with an initial adhesion cheiloplasty. All patients underwent palate repair using the two-flap method at an average age of 12.3 months. Velopharyngeal insufficiency occurred

2018 Plastic and reconstructive surgery

145. Hearing status and behavioural patterns among school aged children with cleft lip and/or palate. (PubMed)

Hearing status and behavioural patterns among school aged children with cleft lip and/or palate. There is a dearth of studies on long term hearing status and behavioural patterns among cleft lip and/or palate children after their primary lip and palate closure in Malaysia. This study describes the audiology status and behavioural patterns in a group of school aged children with cleft lip and/or palate.A cross sectional study was carried out where caretakers of cleft lip and/or palate were asked (...) to complete the translated Malay language version of Strength Difficulties Questionnaire. The hearing status of the children was analyzed based on recent pure tone audiometric and tympanogram results. The patients' age, gender, type of cleft pathology, age of palatal surgery and behavioural patterns were examined for their potential relationship with hearing status.A total of 74 children (148 ears) aged between 7 and 17 years with cleft lip and/or palate were recruited. The result showed 37 ears (25.0

2018 International Journal of Pediatric Otorhinolaryngology

146. Pre-Surgical Infant Orthopedics (PSIO) And Naso-Alveolar Molding (NAM) Show Promise For Obtaining Normal Anatomy Of The Nose And Lip In Patients With Cleft Lip And Palate

Pre-Surgical Infant Orthopedics (PSIO) And Naso-Alveolar Molding (NAM) Show Promise For Obtaining Normal Anatomy Of The Nose And Lip In Patients With Cleft Lip And Palate UTCAT2163, Found CAT view, CRITICALLY APPRAISED TOPICs University: | | ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM View the CAT / Title Pre-Surgical Infant Orthopedics (PSIO) And Naso-Alveolar Molding (NAM) Show Promise For Obtaining Normal Anatomy Of The Nose And Lip In Patients With Cleft Lip And Palate Clinical Question (...) In a child with cleft lip and palate, is there long-term benefit to pre-surgical naso-alveolar molding versus traditional surgical treatment alone? Clinical Bottom Line Long-term anthropologic studies comparing NAM to traditional treatment show equivocal results; however, pre-surgical infant orthopedics (PSIO) is gaining a body of literature to support it’s use. Best Evidence (you may view more info by clicking on the PubMed ID link) PubMed ID Author / Year Patient Group Study type (level of evidence) #1

2011 UTHSCSA Dental School CAT Library

147. Patients With Cleft Lip, Alveolus And Palate May Be Predisposed To Periodontal Disease, Especially In Teeth Adjacent To The Cleft

Patients With Cleft Lip, Alveolus And Palate May Be Predisposed To Periodontal Disease, Especially In Teeth Adjacent To The Cleft UTCAT2160, Found CAT view, CRITICALLY APPRAISED TOPICs University: | | ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM View the CAT / Title Patients With Cleft Lip, Alveolus And Palate May Be Predisposed To Periodontal Disease, Especially In Teeth Adjacent To The Cleft Clinical Question Do patients with repaired cleft lip, alveolus, and palate have increased risk (...) of periodontal disease compared to normal subjects? Clinical Bottom Line While studies suggest that patient with cleft lip, palate and alveolus are predisposed to periodontal disease, especially in teeth near the cleft, further studies are required given lack of definitive evidence. Oral hygiene was also found to be poor in a majority of patients with cleft lip, alveolus, or palate, emphasizing the importance of good oral hygiene and close followup with these patients. Best Evidence (you may view more info

2011 UTHSCSA Dental School CAT Library

148. Rescue of lip switch flap at risk of necrosis due to venous congestion for cleft lip deformity (PubMed)

Rescue of lip switch flap at risk of necrosis due to venous congestion for cleft lip deformity In a 21-year-old male with bilateral cleft lip who developed marked venous congestion of a lip switch flap, we returned the grafted flap to the donor site to improve blood circulation of the flap and then re-transplanted it, which prevented flap necrosis. Here, we report the procedure and case.

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2016 Case Reports in Plastic Surgery & Hand Surgery

149. Vermilion Only Cross-lip Flap for Treating Whistle Deformity in Secondary Bilateral Cleft Lip Repair (PubMed)

Vermilion Only Cross-lip Flap for Treating Whistle Deformity in Secondary Bilateral Cleft Lip Repair Bilateral cleft lip repairs can result in various secondary deformities. One more commonly seen deformity, the whistle deformity, is characterized by a reduced or absent tubercle, orbicularis muscle diastasis, and abnormalities of the philtrum with notched appearance of cupid's bow. Various techniques have been described to address these problems. One common procedure is the lip-switch flap (...) originally described by Abbe in 1898, which has been modified by various surgeons. In these procedures, lower lip vermilion, mucosa, orbicularis, and lip skin are transposed to the upper lip on a pedicle that is later divided. In all these variations of the lip-switch procedure, the transposed tissue involves the entire lower lip skin-leaving large, unsightly, and unnecessary scars. It also brings abnormal tissue into the philtrum further distorting the upper lip. A modified cross-lip flap

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2016 Plastic and Reconstructive Surgery Global Open

150. Nonsyndromic cleft lip with or without cleft palate and cancer: Evaluation of a possible common genetic background through the analysis of GWAS data (PubMed)

Nonsyndromic cleft lip with or without cleft palate and cancer: Evaluation of a possible common genetic background through the analysis of GWAS data Previous research suggests a genetic overlap between nonsyndromic cleft lip with or without cleft palate (NSCL/P) and cancer. The aim of the present study was to identify common genetic risk loci for NSCL/P and cancer entities that have been reported to co-occur with orofacial clefting. This was achieved through the investigation of large genome

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2016 Genomics data

151. Cleft sidedness and congenitally missing teeth in patients with cleft lip and palate patients (PubMed)

Cleft sidedness and congenitally missing teeth in patients with cleft lip and palate patients The aim of this study was to investigate the prevalence of cleft sidedness, and the number of congenitally missing teeth in regard to cleft type and gender.The charts, models, radiographs, and intraoral photographs of 201 cleft patients including 131 males with the mean age of 12.3 ± 4 years and 70 females with the mean age of 12.6 ± 3.9 years were used for the study. T test, Chi-square, and binomial (...) tests were used for assessment of the data.One hundred forty-eight of the subjects suffered from cleft lip and palate followed by 41 subjects who suffered from cleft lip and alveolus. Chi-square test did not show any significant difference between the genders. Binomial test showed that left-sided cleft was more predominant in unilateral cleft lip and palate patients (P < 0.001). This study also showed that the upper lateral incisors were the most commonly missing teeth in the cleft area.

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2016 Progress in orthodontics

152. Genetic polymorphism of nonsyndromic cleft lip with or without cleft palate is associated with developmental dyslexia in Chinese school-aged populations (PubMed)

Genetic polymorphism of nonsyndromic cleft lip with or without cleft palate is associated with developmental dyslexia in Chinese school-aged populations Developmental dyslexia (DD) is a neurodevelopment disorder characterized by reading disabilities without apparent etiologies. Nonsyndromic cleft lip with or without cleft palate (NSCL/P) is a structural craniofacial malformation featured by isolated orofacial abnormalities. Despite substantial phenotypic differences, potential linkage between

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2016 Journal of Human Genetics

153. A discriminant analysis prediction model of non-syndromic cleft lip with or without cleft palate based on risk factors. (PubMed)

A discriminant analysis prediction model of non-syndromic cleft lip with or without cleft palate based on risk factors. A risk prediction model of non-syndromic cleft lip with or without cleft palate (NSCL/P) was established by a discriminant analysis to predict the individual risk of NSCL/P in pregnant women.A hospital-based case-control study was conducted with 113 cases of NSCL/P and 226 controls without NSCL/P. The cases and the controls were obtained from 52 birth defects' surveillance

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2016 BMC Pregnancy and Childbirth

154. Barriers to Reconstructive Surgery in Low- and Middle-Income Countries: A Cross-Sectional Study of 453 Cleft Lip and Cleft Palate Patients in Vietnam. (PubMed)

Barriers to Reconstructive Surgery in Low- and Middle-Income Countries: A Cross-Sectional Study of 453 Cleft Lip and Cleft Palate Patients in Vietnam. Despite health system advances, residents of low- and middle-income countries continue to experience substantial barriers in accessing health care, particularly for specialized care such as plastic and reconstructive surgery.A cross-sectional household survey of patients seeking surgical care for cleft lip and/or cleft palate was completed (...) addressed. Patients rely on charitable care outside the centralized health care system; as a result, surgical treatment of cleft lip and palate is delayed beyond the standard optimal window compared with more developed countries. Using these data, the authors developed a more evidence-based framework designed to understand health behaviors and perceptions regarding reconstructive surgical care.

2016 Plastic and reconstructive surgery

155. Not All Clefts Are Created Equal: Patterns of Hospital-Based Care Use among Children with Cleft Lip and Palate within 4 Years of Initial Surgery. (PubMed)

Not All Clefts Are Created Equal: Patterns of Hospital-Based Care Use among Children with Cleft Lip and Palate within 4 Years of Initial Surgery. This study compares hospital-based care and associated charges among children with cleft lip, cleft palate, or both, and identifies subgroups generating the greatest cumulative hospital charges.The authors conducted a retrospective cohort study of cleft lip, cleft palate, or cleft lip and palate who underwent initial surgery from 2006 to 2008 in four (...) U.S. states. Primary outcome was hospital-based care-emergency, outpatient, inpatient-within 4 years of surgery. Regression models compared outcomes and classification tree analysis identified patients at risk for being in the highest quartile of cumulative hospital charges.The authors identified 4571 children with cleft lip (18.2 percent), cleft palate (39.2 percent), or cleft lip and palate (42.6 percent). Medical comorbidity was frequent across all groups, with feeding difficulty (cleft lip

2016 Plastic and reconstructive surgery

156. A multi-ethnic genome-wide association study identifies novel loci for non-syndromic cleft lip with or without cleft palate on 2p24.2, 17q23 and 19q13 (PubMed)

A multi-ethnic genome-wide association study identifies novel loci for non-syndromic cleft lip with or without cleft palate on 2p24.2, 17q23 and 19q13 Orofacial clefts (OFCs), which include non-syndromic cleft lip with or without cleft palate (CL/P), are among the most common birth defects in humans, affecting approximately 1 in 700 newborns. CL/P is phenotypically heterogeneous and has a complex etiology caused by genetic and environmental factors. Previous genome-wide association studies

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2016 Human molecular genetics

157. Epidemiologic Research on Malformations Associated with Cleft Lip and Cleft Palate in Japan (PubMed)

Epidemiologic Research on Malformations Associated with Cleft Lip and Cleft Palate in Japan To investigate malformations associated with cleft lip and cleft palate, we conducted surveys at neonatal intensive care units (NICUs) and other non-NICU facilities and to determine whether there are differences among facilities. The regional survey investigated NICU facilities located in Oita Prefecture, including 92 patients with cleft lip and palate (CLP) or cleft palate (CP) that occurred between (...) 2004 and 2013, and the national survey investigated oral surgery, plastic surgery, and obstetrics and gynecology facilities located in Japan, including 16,452 patients with cleft lip (CL), CLP, or CP that occurred since 2000. The incidence per 10,000 births was 4.2, 6.2, and 2.8 for CL, CLP, and CP, respectively, according to the national survey, and 6.3 and 2.9 for CLP and CP, respectively according to the regional survey. These results indicated comparable incidences between the two surveys

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2016 PloS one

158. Correlations between initial cleft size and dental anomalies in unilateral cleft lip and palate patients after alveolar bone grafting (PubMed)

Correlations between initial cleft size and dental anomalies in unilateral cleft lip and palate patients after alveolar bone grafting Objective To determine in individuals with unilateral cleft lip and palate the correlation between initial cleft size and dental anomalies, and the outcome of alveolar bone grafting. Methods A total of 67 consecutive patients with non-syndromic unilateral complete cleft lip and palate (UCLP) were included from the cleft lip and palate-craniofacial center, Uppsala (...) University Hospital, Sweden. All patients were operated by the same surgeon and treated according to the Uppsala protocol entailing: lip plasty at 3 months, soft palate closure at 6 months, closure of the residual cleft in the hard palate at 2 years of age, and secondary alveolar bone grafting (SABG) prior to the eruption of the permanent canine. Cleft size was measured on dental casts obtained at the time of primary lip plasty. Dental anomalies were registered on radiographs and dental casts obtained

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2016 Upsala journal of medical sciences

159. Correlation of vermilion symmetry to alveolar cleft defect in unilateral cleft lip repair. (PubMed)

Correlation of vermilion symmetry to alveolar cleft defect in unilateral cleft lip repair. Asymmetry is a major problem in repaired unilateral cleft lip (UCL). One of the important manifestations of this is the asymmetry of the vermilion. The aim of this study was to correlate the severity of the asymmetry in the vermilion to the size of the alveolar defect. Twenty patients aged between 6 and 18 months with complete unilateral cleft lip, alveolus, and palate were included. An impression of each (...) patient's alveolus at the time of cheiloplasty was taken using silicon rubber base material, and a study cast was prepared. The width of the cleft alveolus was measured on these casts using a transparent grid. Frontal photographs were taken at 6 months postoperative and vermilion symmetry was measured as the ratio between the cleft and non-cleft sides. The results obtained in this study showed a direct correlation between the size of the alveolar defect and the vermilion symmetry in repaired UCL

2016 International Journal of Oral and Maxillofacial Surgery

160. Cleft characteristics and treatment outcomes in hemifacial microsomia compared to non-syndromic cleft lip/palate. (PubMed)

Cleft characteristics and treatment outcomes in hemifacial microsomia compared to non-syndromic cleft lip/palate. The goal of this study was to describe the clinical characteristics and treatment outcomes of patients with hemifacial microsomia (HFM) and cleft lip/palate (CL/P), and to compare them to a historic cohort of patients with non-syndromic CL/P treated at the same centre. A retrospective review of patients with HFM and CL/P was performed; the main outcome measures assessed were cleft (...) type/side, surgical outcome, midfacial retrusion, and speech. Twenty-six patients (13 male, 13 female; mean age 22.7±14.9, range 1-52 years) with cleft lip with/without cleft palate (CL±P) were identified: three with cleft lip (12%), two with cleft lip and alveolus and an intact secondary palate (8%), and 21 with cleft lip and palate (CLP) (81%; 15 unilateral and six bilateral). Four patients (19%) had a palatal fistula after palatoplasty. Twelve of 22 patients aged >5 years (55%) had midfacial

2016 International Journal of Oral and Maxillofacial Surgery

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