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At least 253 records · Page 14Linked to original sources
PubMed1990

The Sri Lankan Cleft Lip and Palate Project: the unoperated cleft lip and palate.

Since 1984, the Sri Lankan Cleft Lip and Palate Project has developed a large surgical and research program collecting records on over 500 subjects with unrepaired cleft lip and palate. In addition, 410 operations were performed by Project and will be followed by individual reports on facial growth and morphology, speech, surgical and anesthetic aspects, and the otologic significance of cleft palate in this issue and subsequent ones.

Adolescent↗
PubMed1999

Palatal tubercles, palatal tori, and mandibular tori: prevalence and anatomical features in a U.S. population.

The prevalence and features of 3 types of exostoses commonly encountered during periodontal surgery were studied in a sample of 328 modern American skulls drawn from the collection at the American Museum of Natural History. Measurements were made of the height, width, and breadth of exostoses. The relationship to teeth or other skeletal structures was also recorded. Palatal tubercles were observed in 56% of all skulls (69% of all dentate skulls), with higher prevalences among males and African-Americans. Palatal tubercles were commonly associated with second and third molars, and were usually directly lateral to and a mean of 11.4 mm from the greater palatine foramen. Mandibular tori were observed in 27% of all skulls (42% of dentate skulls), with higher prevalences seen among African-Americans and males. The importance of these findings relates to the frequent need for exostosis removal to permit proper flap adaptation, especially in the posterior maxilla, and to the potential use of the mandibular and palatal tori as sources of autogenous cortical bone.

Adolescent↗
PubMed1991

Tridimensional architecture of the lamina propria in the mouse soft palate, with special reference to the connective tissue papilla of the palatal papilla.

The NaOH cell-maceration method was applied to the oral surface of the mouse soft palate to demonstrate the tridimensional architecture of the connective tissue papillae (CTP) of the "palatal papillae", and of the openings of the glandular ducts. The CTP of the palatal papillae extremely differed from those of any types of the lingual papillae, and appeared as elliptical wall. Within the elliptical wall, there existed the semicircular or circular internal ridge which surrounded the round depression corresponding to the taste bud. The openings of the glandular ducts were rimmed by the collagen fibers running concentrically. Many fibrils derived from the concentrical fibers, turned to the sagittal direction and then concentrated into the sagittal fibers in the vicinity of the openings.

Animals↗
PubMed1999

Effects of variation in timing of palatal repair on articulation skills in complete cleft lip and palate cases--a retrospective study.

The effects of variation in the timing of palatal repair on articulation skills in complete cleft lip and palate was evaluated from fifty subjects. The present study confirmed that development of articulation was similar in the groups operated upon before 24 months and between 24 to 36 months. The insignificant difference suggests that articulation was good irrespective of the early or medium timing of palatal repair.

Adolescent↗
PubMed1989

[Epidemiological investigation of cleft lip and/or palate. II. Incidence of cleft lip and palate among Japanese babies in Gifu prefecture 1986 to 1987].

Since 1981 we have been conducting investigations in Aichi Prefecture where our institution is located in close cooperation with Medical Association of Obstetrics-Gynecologists and member physicians of the Midwives Association. In addition, we surveyed 111 institutions in Gifu Prefecture for the patient who was delivered from January 1, 1986 to December 31, 1987 to learn the incidence and type classification of cleft lip and/or palate in the general population Gifu. Consequently, we acquired the date of 20667 newborns. It was found as a result that 35 babies had these abnormalities and that ratio of the birth of such newborns was one for 590.5 deliveries. Among 35 cleft infants 12 (34.3%) with cleft lip and palate, 5 (14.3%) cleft palate. Looking at the estimates from the results of our investigation, the annual number of newborns with these disease in the Gifu Prefecture was 41.6 to 41.9 in 1986, 33.5 to 33.6 in 1987 with 95 percent confidence limits.

Cleft Lip↗
PubMed1993

The need for orthognathic surgery in patients born with complete cleft palate or complete unilateral cleft lip and palate.

The purpose of the study was three fold: (1) to assess the need for orthognathic surgery in complete cleft palate and complete cleft lip and palate patients treated in Liverpool, (2) to determine the effect of timing of operation, technique and the number of operations on the need for orthognathic surgery and (3) to establish a more standardised method of assessing the need of orthognathic surgery in cleft lip and palate patients.

Adolescent↗
PubMed1979

Occlusion, arch dimensions, and craniofacial morphology after palatal surgery in a group of children with clefts in the secondary palate.

A mixed longitudinal study of the occlusion and arch dimensions from 4 to 11 years of age was made on fifty-five children with solitary palatal clefts. A cephalometric study was also made on thirty of these patients when they were approximately 10 years of age. The palatal closure was made by means of a modified von Langenbeck procedure at a mean age of 1 year 9 months. The frequency of cross-bite in the deciduous dentition was comparable with that in children without clefts. As in other studies, an impairment of the occlusion was seen with increasing age. The children showed retrognathic faces and the difference between the cleft children and the noncleft children was of the same magnitude as in other studies. It was found that the arch dimensions and the craniofacial morphology were influenced by the size of the cleft, while the occlusion was not. The craniofacial morphology in the present investigation was comparable to that in other studies where a push-back technique had been used, but the frequency of cross-bite was lower. Thus, it would appear that the type of surgery influences the occlusion more than it affects the craniofacial morphology.

Cephalometry↗
PubMed1996

Congenital palatal ulcers in newborn infants with cleft lip and palate: diagnosis, frequency, and significance.

Congenital decubital ulcers were found in 94% of newborn infants with unilateral cleft lip and palate in the course of a systematic study of a large cohort study (N = 52). The procedures for diagnosis, documentation, and follow-up are described. The ulceration area at birth varied over a wide range. The ulcerations were usually located in the posterior part of the vomer. Sonographic evidence supports the hypothesis that the ulcerations are caused mechanically by the motor activity of the tongue during the fetal and newborn period. The decubital ulcer disappeared in each case within 5 days following the implementation of a palatal plate.

Cleft Lip↗
PubMed1979

Styloid, velar, and pharyngeal muscles in cleft palate. Anatomical findings in elderly cadaver with unrepaired cleft palate.

Dessection of the musculature of the palate, pharynx, and styloid process was carried out in a cadaver aged 78 years with an unrepaired complete cleft palate. A new muscle named "the accessory stylohyoid" was found to be attached to the styloid process and the lesser cornu of the hyoid bone bilaterally. Anatomical changes in other muscles especially the stylopharyngeus and palatopharyngeus are described. The functions of these muscles are discussed on the basis of the anatomical findings and previous observations of other investigators.

Aged↗
PubMed1990

Use of a buccal musculomucosal flap to close palatal fistulae after cleft palate repair.

Forty-two patients aged 4 to 13 (mean 7 years) had palatal fistulae closed with a buccal musculomucosal flap. The pedicle was divided approximately 2 weeks after the initial operation. Complete closure at the first attempt was obtained in 69% of the cases though, when the fistulae were large and extended to the anterior hard palate, the results were not as good (36%). Almost no detrimental after-effects occurred at the donor site. The buccal musculomucosal flap was found to be a useful alternative to a tongue flap.

Adolescent↗
PubMed2006

A double buccal fat pad flap for middle palate defect closure--a new technique for palate closure.

In this article a new method of closing palatal defects by means of buccal fat pad flaps is reported. A double buccal fat pad flap in association with Le Fort I osteotomy approach was adopted to remove tumours of the palate and nasal fossae. The technique is described in a case of adenocarcinoma arising from the nasal septum and its indications and advantages are discussed.

Adenocarcinoma↗
PubMed2001

Repair of bilateral cleft lip, alveolus and palate Part 3: Follow-up criteria and late results.

The last part of this series outlines closure of the hard palate with various modifications depending on the remaining width of the cleft. Additionally the necessity and parameters of follow-up documentation are emphasized and detailed. For the two patients shown in Parts 1 and 2, the corresponding data are given. Accumulated facial growth curves of all the other patients treated the same way are also given. The main results are: (A) lip and nose can be reconstructed much more easily after repositioning of the premaxilla and (B) the reported anterior growth delay following use of the Latham appliance could not be confirmed during the ongoing follow-up. Copyright 2001 European Association for Cranio-Maxillofacial Surgery.

Journal Article↗
PubMed1997

Free flap closure of recurrent palatal fistula in the cleft lip and palate patient.

Recurrent palatal fistulas present a particularly vexing problem for the cleft surgeon. In this setting, the cycle of repair followed by breakdown results in increasing scar formation with associated soft tissue contracture and a resultant increase in fistula size. This pernicious cycle of events renders random local tissue transfers obsolete. As such, the cleft surgeon must look to tongue flaps or local axial pattern flaps as a means of bringing well-vascularized, pliable tissue into the defect. Although this approach has been the standard of care for the last few decades, we believe that the modern-day success rates of free tissue transfers (95%) make them a viable, one-stage means of closing these defects. In this report we present our clinical experience with recurrent palatal fistulas and highlight the effective use of the dorsalis pedis-first dorsal metatarsal artery free flap as a means of repair.

Child↗
PubMed2004

Submucous cleft palate: a grading system and review of 40 consecutive submucous cleft palate repairs.

OBJECTIVES: This study was designed to determine whether velar surgery was worthwhile for submucous cleft palate (SMCP) and evaluate whether results were dependent on the degree of the anatomical abnormality. DESIGN: A prospective study of a consecutive series of patients fulfilling the entry criteria, assessed blindly from records arranged randomly. PATIENTS: Fifty-eight patients diagnosed with SMCP and operated on by a single surgeon between June 1991 and April 1997 were reviewed. Forty patients fulfilled the entry criteria. Minimum follow-up was 6 years. INTERVENTION: Radical reconstruction of the soft palate musculature was performed by one surgeon using the operating microscope. A scoring system was devised for grading the anatomical severity of submucous cleft (SMCP score). MAIN OUTCOME MEASURES: Postoperative hypernasality and nasal emission scores and the degrees of improvement were considered the primary outcome measures, and the degree of velopharyngeal closure was also assessed. RESULTS: There were highly significant improvements in hypernasality, nasal emission, and velopharyngeal closure. A preoperative gap size of more than 13 mm was associated with less satisfactory outcomes, but gap size was not predictive of improvement. Severity of the SMCP did not correlate with the degree of preoperative speech abnormality but was a significant predictor of outcome of surgery, with the less severe (total SMCP score of 0 to 3) having less satisfactory end results and lesser degrees of improvement. Patients with less abnormal muscle anatomy had lesser degrees of improvement. CONCLUSION: Repair of the muscle abnormality in SMCP is recommended as the first line of treatment in most cases.

Adolescent↗
PubMed1997

Palatal configuration in complete bilateral cleft lip and palate infants before and after cheiloplasty.

OBJECTIVE: The purpose of this study was to analyze the three-dimensional configuration of the premaxilla, vomer, and lateral segments in bilateral cleft lip and palate (BCLP) infants and to investigate the early changes in the configuration following one- and two-stage cheiloplasty. METHODS: This study consisted of 10 complete BCLP infants. One-stage operations were performed in five patients according to Manchester's method at 4 months of age. Two-stage operations were done for the remaining five patients using a triangular flap according to Tennison's method, at 4 and 8 months of age. Serial plaster models before and after the cheiloplasty were measured with a computer-controlled, highly accurate, contact-type measuring apparatus. Temporal changes in the configuration and form of the premaxilla were observed using an automatic superimposition method. The inclination and deviation of the vomer were evaluated using an approximation technique to a straight line with least squares. The distance between the lateral segments and a three-dimensional coordinate of the incisal point were also measured. RESULTS AND CONCLUSIONS: The following differences in palatal configuration between the one- and two-stage cheiloplasties were observed: 1) In the two-stage group, the premaxilla shifted toward the cleft edge where the cheiloplasty was performed in both first- and second-stage operations. After the two-stage operation, the premaxilla did not shift greatly, and the premaxilla in cases 4 and 5 shifted downward and toward the cleft edge of the lateral segments where the first operation was performed. Protrusion of the premaxilla remained in the two-stage group. 2) In the one-stage group, the premaxilla in case 4 descended downward and backward without twisting or bending. The premaxilla of the other patients descended downward with twisting and bending. 3) Patients in the two-stage group had a stronger tendency toward medial collapse of the lateral segments than did those in the one-stage group.

Calcium Sulfate↗
PubMed2002

Cephalometric analysis in submucous cleft palate: comparison of cephalometric data obtained from submucous cleft palate patients with velopharyngeal competence and incompetence.

OBJECTIVE: The purpose of this study was to investigate the relationship between craniofacial and nasopharyngeal morphology and velopharyngeal function in submucous cleft palate. DESIGN AND PATIENTS: Fifty-two lateral cephalometric radiographs of 46 submucous cleft palate (SMCP) patients with velopharyngeal competence (24 patients) and incompetence (22 patients) at 4 and 7 years of age were studied. The patients had not received any surgical or orthodontic treatment prior to cephalography being performed. RESULTS: Significant differences were found between cephalometric variables (N-Ba, N-S-Ba angle) in children with velopharyngeal competence and incompetence. However, the results of our study showed that cephalometric data alone are not useful for predicting velopharyngeal function and can not serve as an absolute prognostic indicator. CONCLUSION;There are many factors that can influence velopharyngeal function in SMCP patients. Cephalometric data did not demonstrate a strong relationship to velopharyngeal function.

Age Factors↗
PubMed1994

Dentofacial morphology in adolescent or early adult patients with cleft lip and palate after a treatment regimen that included vomer flap surgery and pushback palatal repair.

Dentofacial morphology was evaluated in 94 adolescent or early adult patients born with unilateral or bilateral cleft lip and palate. As well as lip closure, the primary treatment included vomer flap surgery and pushback palatal repair. Roentgencephalometric measurements as well as classification of the patients into different classes of dentofacial deformity indicated development of bimaxillary retrognathia with severe midfacial deficiency in about a quarter of the cases. Our results were similar to those reported by other teams who used similar surgical regimen.

Adolescent↗
PubMed2002

[Palatal distractor. An innovative approach for palatal expansion].

BACKGROUND: A method is introduced using a newly developed palatal distractor, which allows rapid transversal widening in cases of maxillary compression. METHODS: After osteotomy of the palate parallel to the sutura palatina mediana as well as to the lateral walls of the maxillary sinuses, the applied distractor permitted a transversal widening of 7.5 mm within 3 weeks. During the 3-month period of retention, multibanded orthodontic therapy could be performed. DISCUSSION: Because of the short treatment period, absence of recurrence, and easy handling for the patient this method is recommended for clinical use.

Bone Plates↗