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Cleft Lip

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161. Caregivers' perception of speech and language status and related needs in children with cleft lip and palate. (PubMed)

Caregivers' perception of speech and language status and related needs in children with cleft lip and palate. Comprehensive management for communication disorders in individuals with CLP was provided in a community based program in two rural districts in Tamilnadu, India. This program provides services at the community to empower the families about CLP and treatment options.To document the caregiver perceptions' of communication status and needs in children with repaired CLP.Six Focus Group

2018 International Journal of Pediatric Otorhinolaryngology

162. Bone-anchored maxillary protraction in a patient with complete cleft lip and palate: A case report. (PubMed)

Bone-anchored maxillary protraction in a patient with complete cleft lip and palate: A case report. Sagittal maxillary deficiency is frequently observed in patients with operated unilateral complete cleft of the lip and palate. Treatment for moderate to severe Class III malocclusion usually relies on LeFort I surgery for maxillary advancement after the end of growth. This case report describes bone-anchored maxillary protraction in a 10-year-old white boy with unilateral complete cleft (...) improvement in facial convexity (+14.6°). No posterior rotation of the mandible occurred with a slight closure of the gonial angle. Visualization of 3-dimensional color-coded maps showed an overall forward maxillary displacement. The bone-anchored maxillary protraction results for this patient are a promising orthopedic therapy for patients with unilateral complete cleft of the lip and palate, with the advantage of achieving much earlier improvement of facial esthetics and functional occlusion, compared

2018 American journal of orthodontics and dentofacial orthopedics

163. Assessment modalities of non-ionizing three-dimensional images for the quantification of facial morphology, symmetry, and appearance in cleft lip and palate: a systematic review. (Full text)

Assessment modalities of non-ionizing three-dimensional images for the quantification of facial morphology, symmetry, and appearance in cleft lip and palate: a systematic review. The use non-ionizing three-dimensional (3D) imaging in cleft lip and palate is an emerging field, but properly designed methods for the assessment of these images are not well established. Therefore, the aim of this study was to review the current literature on the modalities of assessment of non-ionizing 3D images (...) for the quantification of facial morphology, symmetry, and appearance in cleft lip and palate, and to assess the method error of these modalities. A systematic literature search was conducted using MEDLINE (PubMed), Cochrane Central Register of Controlled Trials, Web of Science, and Embase. Cross-sectional studies with prospective or retrospective data collection, using non-ionizing 3D imaging, with a subjective or objective outcome assessment and including at least 10 cleft lip and/or palate patients were

2018 International Journal of Oral and Maxillofacial Surgery

164. Interdisciplinary approach for a patient with unilateral cleft lip and palate. (PubMed)

Interdisciplinary approach for a patient with unilateral cleft lip and palate. The oral rehabilitation of patients with cleft lip and palate is a challenge. The aim of this case report was to underline the importance of a sequential interdisciplinary approach to correct functional problems and improve facial esthetics for a patient with unilateral cleft lip and palate. Few clinical reports have described this treatment in a teenager. The patient, a girl, age 12.6 years, had a complete right (...) cleft lip and palate with a Class II molar tendency and a full Class II canine relationship on the right side, and a full Class II molar relationship with a canine Class I on the left side. Transposed, impacted, and anomalously shaped teeth and crowding added to the patient's problems. Treatment included maxillary expansion and maxillary and mandibular extractions. An interdisciplinary approach was necessary to achieve proper occlusion and better esthetics.Copyright © 2018 American Association

2018 American journal of orthodontics and dentofacial orthopedics

165. 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

166. One-Stage vs. Two-Stage Repair of Asymmetric Bilateral Cleft Lip: A 20-Year Retrospective Study of Clinical Outcome. (PubMed)

One-Stage vs. Two-Stage Repair of Asymmetric Bilateral Cleft Lip: A 20-Year Retrospective Study of Clinical Outcome. Both one- and two-stage approaches have been widely used for patients with asymmetric bilateral cleft lip. There are insufficient long-term outcome data for comparison of these two methods. The purpose of this retrospective study was to compare the clinical outcome over the past 20 years.The senior author's (L.J.L.) database was searched for patients with asymmetric bilateral (...) cleft lip from 1995 to 2015. Qualified patients were divided into two groups: one-stage and two-stage. The postoperative photographs of patients were evaluated subjectively by surgical professionals and laypersons. Ratios of the nasolabial region were calculated for objective analysis. Finally, the revision procedures in the nasolabial area were reviewed. Statistical analyses were performed.A total of 95 consecutive patients were qualified for evaluation. Average follow-up was 13.1 years. A two

2018 Plastic and reconstructive surgery

167. Use of Routine Prospective Functional and Aesthetic Patient Satisfaction Measurements in Secondary Cleft Lip Rhinoplasty. (Full text)

Use of Routine Prospective Functional and Aesthetic Patient Satisfaction Measurements in Secondary Cleft Lip Rhinoplasty. Patients, governments, health care providers, and insurance companies show an increased interest in health outcomes, especially in centralized medical care, such as cleft lip nose treatment. Transparent outcome reporting requires a thorough methodological design, dedicated prospective data collection process, and, preferably, no interference with the efficacy of daily (...) practice.To describe the implementation of an automated and prospective secondary cleft lip rhinoplasty outcome routine.A prospective analytic cohort pilot study was conducted among 123 consecutive patients referred for secondary cleft lip rhinoplasty from July 1, 2014, to March 31, 2018, at an academic teaching hospital.Secondary cleft lip rhinoplasty or revision.Preoperative and 3- and 12-month postoperative scores on the Nasal Obstruction Symptom Evaluation scale (range 0-100, lower scores indicate

2018 JAMA facial plastic surgery

168. Influence of infancy care strategy on hearing in children and adolescents: A longitudinal study of children with unilateral lip and /or cleft palate. (Full text)

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

2018 International Journal of Pediatric Otorhinolaryngology

169. 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 Controlled trial quality: predicted high

170. Gene-Gene Interactions among SPRYs for Nonsyndromic Cleft Lip/Palate. (PubMed)

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

2018 Journal of Dental Research

171. Falling through the gap: Dental treatment experiences of patients affected by cleft lip and/or palate. (PubMed)

Falling through the gap: Dental treatment experiences of patients affected by cleft lip and/or palate. In the UK, one in 600–700 infants is born with a cleft lip and/or palate (CL/P). Previous research has identified patients with CL/P to be at high risk of long-term oral health issues. Yet, few of these patients are currently accessing community dental care.To assess patients' dental treatment experiences and their suggestions for improving services.Five focus groups were conducted with 24 (...) adults with CL/P. Thematic analysis was performed on the data.Participants perceived local dental practitioners to lack knowledge about CL/P and its treatment. Consequently, some participants had stopped visiting a dental practice altogether. Participants were also largely unaware of the specialist CL/P services they are entitled to.Suggestions are made for the integration of improved training and resources for local dental practitioners. Closer communication between specialist cleft teams and local

2018 British Dental Journal

172. Evolution of Acquired Middle Ear Cholesteatoma in Patients With Ectrodactyly, Ectodermal Dysplasia, Cleft Lip/Palate (EEC) Syndrome. (PubMed)

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

2018 Otology and Neurotology

173. Multi-modal Characterization of the Mature Septal Deformity and Airspace Associated with Unilateral Cleft Lip and Palate. (PubMed)

Multi-modal Characterization of the Mature Septal Deformity and Airspace Associated with Unilateral Cleft Lip and Palate. The nasal deformity that accompanies cleft conditions is often acknowledged as the most difficult obstacle to restoring facial balance in affected children. Despite considerable progress in the treatment of cleft lip and palate, the outcomes of cleft septorhinoplasty have proven variable and difficult to predict, possibly because of incomplete understanding of the underlying (...) anatomical deformities. The authors sought to characterize unilateral cleft septal and dorsal deformities through a detailed morphologic model based on photogrammetric, qualitative, and quantitative computerized tomographic image analysis.Twenty-five consecutive patients with a unilateral cleft nasal deformity without prior septorhinoplasty were included.Dorsal angulation, as measured by the nasal dorsal angle, consistently deviated away from the cleft side at a mean angle of 8.9 degrees. In a majority

2018 Plastic and reconstructive surgery

174. Nasoalveolar Molding Therapy may Offer Positive Effects on Unilateral Clefts of Lip and/or Palate. (PubMed)

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.

2018 Journal of Evidence Based Dental Practice

175. Extreme maxillomandibular discrepancy in unilateral cleft lip and palate: Longitudinal follow-up in a patient with mandibular prognathism. (PubMed)

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

2018 American journal of orthodontics and dentofacial orthopedics

176. Therapeutic effect of a cleft lip teat on infants with respiratory and feeding disorders: Two case reports. (Full text)

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

2018 Medicine

177. Influence of Repaired Cleft Lip and Palate on Layperson Perception following Orthognathic Surgery. (PubMed)

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

2018 Plastic and reconstructive surgery

178. 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

179. 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

180. Philtrum reconstruction in unilateral cleft lip repair. (PubMed)

Philtrum reconstruction in unilateral cleft lip repair. The philtrum is an important aesthetic structure in the midface. A number of philtrum reconstruction techniques have been advocated for secondary cleft lip revision procedures. Conventional surgical management involves end-to-end orbicularis oris muscle approximation during primary cleft lip repair, often resulting in a flat lip appearance that requires secondary revision surgery at a later stage. A novel modification of the approximation (...) of the orbicularis oris muscle is described that may be implemented with any cleft lip technique in order to create an accentuated philtrum column for a natural looking philtrum. The muscle roll technique results in eversion of the orbicularis oris muscle, successfully recapturing the philtrum column topography. This is achieved by utilizing two inverted horizontal sutures, with an additional philtrum takedown suture placed in the region of the dimple to accentuate the philtrum anatomy and three-dimensional

2018 International Journal of Oral and Maxillofacial Surgery

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