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At least 271 records · Page 15Linked to original sources

[Otological findings in adults with isolated cleft palate or cleft lip, jaw, and palate].

BACKGROUND: Children with cleft palate often develop middle ear ventilation disorders due to chronic Eustachian tube dysfunction. This may lead to hearing loss. The insertion of ventilation tubes is a widely accepted measure to avoid sequelae of middle ear ventilation disorders and hearing loss. On the other hand, long-term therapy with ventilation tubes may inflict iatrogenic complications. The objective of the study was the evaluation of otoscopic and audiometric long-term findings in adult cleft patients who had been treated with ventilation tubes since childhood when chronic otitis media with effusion had been observed. PATIENTS AND METHODS: Ninety-two cleft palate patients had been followed up otoscopically and audiometrically for years. The average age was 19.3 years (minimum: 14, maximum: 39 years) at the time the last status was taken. RESULTS: Otoscopy revealed a perforation of the tympanic membrane in 3.8% of the 184 ears. 12% of the patients developed cholesteatoma, however three quarters of these occurred after age 11. 86.4% of the 92 patients had normal hearing in pure tone audiometry. CONCLUSION: Compared with adult cleft patients who did not receive ventilation tubes, our patients had a similar low incidence of eardrum perforations but a higher incidence of cholesteatomas while hearing loss occurred less often. Whether the higher incidence of cholesteatomas is caused iatrogenically or due to a longer follow-up period remains unclear. Whether the use of long-lasting ventilation tubes affects the incidence of cholesteatomas must be proved in further studies.

Adolescent↗

The versatile palatal island flap: its use in soft palate reconstruction and nasopharyngeal and choanal atresia.

The mucoperiosteal island flap, first designed to provide nasal lining during pushback lengthening of a short cleft palate, has been used to assist in reconstruction of large soft palate defects following resection for cancer, to create and maintain patency of the velopharyngeal aperture after stenosis and to maintain patency of the nasal airway after resection of bony choanal atresia.

Adolescent↗

Facial balance in cleft lip and palate. I. Normal development and cleft palate.

A full understanding of balanced facial growth, based on a complete knowledge of the anatomy and physiology of the region, is essential if cleft lip and palate is to be treated successfully. The cleft abnormality is the cause of underdevelopment and subsequent loss of function. Cleft surgery must aim to restore normal anatomy and physiology with emphasis on muscle reconstruction of the lip and soft palate if normal facial development is to be achieved.

Adult↗

Three-dimensional dental arch and palatal form changes after extraction and nonextraction treatment. Part 3. Transversal and sagittal palatal form.

The purpose of this study was to investigate changes in the palatal form in patients treated with and without premolar extractions. Records collected at pretreatment, at bracket removal, at the end of retention, and 5 years out of retention were examined. Stone casts were mounted on an articulator with an anatomic face-bow and a central wax record, and measurements were made with a 3-dimensional digitizer. The hypothesis that orthodontic treatment with premolar extractions changes the palatal form was verified.

Adolescent↗

Bony palatal necrosis in a diabetic patient secondary to palatal rotational flap.

Donor site necrosis is a very rare complication of palatal rotational flaps. The aim of this case report is to present a 43-year-old female, Type I diabetic patient with a chronic oroantral fistula in the right second molar region. The patient had bony necrosis in the donor site following palatal rotational flap operation. The treatment approach and the alternative methods are discussed.

Adult↗

Skeletal stability of Le Fort I osteotomy in patients with isolated cleft palate and bilateral cleft lip and palate.

The skeletal stability of Le Fort I osteotomy was evaluated retrospectively in 14 patients with isolated cleft palate (CP, mean age 27.2 years) and 11 patients with bilateral cleft lip and palate (BCLP, mean age 23.7 years). The osteotomy was fixed with titanium plates and the osteotomy gap was grafted with autologous bone. Neither intermaxillary fixation nor occlusal splints were used postoperatively. Skeletal stability was analysed both horizontally and vertically by cephalograms taken shortly before operation, immediately afterwards, and at six months and at one year postoperatively. In the CP group the mean maxillary horizontal advancement (point A) was 4.7 mm (range 0.3-7.8) and the mean vertical lengthening 3.6 mm (range 0.7-6.1). One year postoperatively the mean relapse was 8.5% (0.4 mm) horizontally and 16.7% (0.6 mm) vertically. In the BCLP group the mean horizontal advancement was 5.3 mm (range 0.2-10.7) and the mean vertical lengthening 7.3 mm (range 0.6-11.8). The mean postoperative relapse was 9.4% (0.5 mm) horizontally and 17.8% (1.3 mm) vertically. The skeletal stability and relapse were similar in both cleft types although BCLP patients had more residual cleft problems and their mean surgical advancement was greater. There was great individual variation.

Adolescent↗

Repair of bilateral clefts of lip, alveolus and palate Part 2: Concomitant lip closure and columella lengthening after lip adhesion.

Lip repair and synchronous columella lengthening in bilateral clefts of the lip, alveolus and palate following lip adhesion according to the method outlined in Part 1 is described in this part of the paper. Together with lip and nose repair the gingivo-periosteoplasty can also be performed when the alveolar process is perfectly aligned and the greater and lesser segments abutt onto each other. Copyright 2001 European Association for Cranio-Maxillofacial Surgery.

Journal Article↗

Histological features of the palatal mucosa in denture sore mouth. Densities of mast cells in the lamina propria and histological features in the epithelium of the denture bearing and non-denture bearing human palatal mucosa in comparison with patients suffering from denture sore mouth.

A histological investigation was carried out on biopsy specimens taken from patients suffering from denture sore mouth. The results were compared with those obtained in previous investigations on denture and non-denture-wearers. The sections were studied by standardized quantitative morphometric methods. After 4 years the denture bearing palatal epithelium from both groups, the denture wearers and the patients suffering from a denture sore mouth did not show changes in mean thickness of the epithelium from both groups, the denture wearers and the patients suffering from a denture sore mouth did not show changes in mean thickness of the epithelium compared with the controls. The mitotic index in denture bearing epithelium from patients suffering from denture sore mouth was three times lower than in the epithelium of the normal denture wearers. The three groups of patients investigated did not show differences in density of mast cells in the lamina propria of their palatal epithelium.

Adult↗

Craniofacial morphology and growth comparisons in children with Robin Sequence, isolated cleft palate, and unilateral complete cleft lip and palate.

OBJECTIVE: Comparison of early craniofacial morphology and growth in children with nonsyndromic Robin Sequence (RS), isolated cleft palate (ICP), and unilateral complete cleft lip and palate (UCCLP). SUBJECTS: One hundred eight children with cleft: 7 with RS, 53 with ICP, and 48 with UCCLP were included in the study. The children were drawn from the group of all Danish children with cleft born 1976 through 1981. METHOD: Three-projection infant cephalometry. RESULTS: The craniofacial morphology in the RS, ICP, and UCCLP groups had some common characteristics: a wide maxilla with decreased length and posterior height, wide nasal cavity, short mandible, bimaxillary retrognathia, and reduced pharyngeal airway. The shortest mandible was found in RS followed by ICP and UCCLP; the pharyngeal airway was reduced in RS and ICP, compared with UCCLP; and the maxillary complex and nasal cavity were wider in UCCLP than in the other groups. The amount of facial growth in all three groups was similar; however, the direction was more vertical in UCCLP than in RS and ICP. CONCLUSION: Except for a shorter RS mandible, the facial morphology of infants with RS and ICP was similar, as was the amount of facial growth and the growth pattern. The differences in facial morphology can be ascribed to the difference in the primary anomaly. The amount of facial growth was similar in the three groups; however, the growth pattern showed a more vertical direction in UCCLP than in RS and ICP. It is hypothesized that the mandibular retrognathia in RS represents the outer end of that of the ICP distribution.

Analysis of Variance↗

Birth weight and gestational age of newborns with cleft lip with or without cleft palate and with isolated cleft palate.

The birth weight and gestational age of 1368 newborns with isolated cleft lip with or without cleft palate and 582 with isolated cleft palate were compared to those of matched healthy controls. The results indicate that fetuses with oral clefts are at elevated risk of having low and very low birth weight, but not of having a premature birth. Speculations on a relationship between these findings and the presence of oral clefts are presented.

Adult↗

Separate clefts of the lip and the palate. A variant of cleft lip and palate.

Separate clefts of the lip and of the palate (CL-CP) may belong to the same etiological class as the cleft lip with or without cleft palate CL(P), or a child may have two separate anomalies, CL and CP. This theory was tested in Finnish cleft patients. Among 2471 cleft cases, there were 66 CL-CP (2.7%). Adequate medical records were available for 62 children: 45 boys (73%) and 17 girls (27%). Familial occurrence was recorded in 6 cases (10%). Of the cleft cases among the near relatives, 5 were CL(P) and one CP. The prevalence of hypodontia was 37% among 38 subjects studied, as compared with 8.2% in the CL-, 29.8% in the CP- and 48.1% in the CLP controls. Conical elevations of the lower lip were observed in none, as compared with 0.8% of the CL(P)- and 39% of the CP controls. It was therefore assumed that the CL-CP belongs to the same etiological class as the CL(P).

Adolescent↗

Relationship between genetic anomalies of different levels and deviations in dermatoglyphic traits. Part 6: Dermatoglyphic peculiarities of males and females with cleft lip (with or without cleft palate) and cleft palate--family study.

The present study was carried out to evaluate the effect of polygenic morbidity with respect to Cleft Palate and Cleft Lip with or without Cleft Palate (CL) in males and females based on dermatoglyphic traits (DT) and indices of intraindividual diversity (Div), fluctuating (FA) and directional (DA) asymmetry. The main objectives of the present study were as follows: a) to find DT and FA indices, which could be "marker" traits and could indicate the degree of developmental instability of the organism; b) to explore the possibility of using DT, FA, Div and DA indices of CL patients and their parents and to predict the likelihood of the disease appearing in the offsprings of apparently healthy individuals. The samples were of 106 CL patients (59 males and 47 females) and 156 of their parents (67 fathers and 89 mothers), all Israeli Jews. The prints were collected in the Beilinson (Petah-Tikva) and Rambam (Haifa) and Hadassah (Mount Scopus, Jerusalem) Hospitals, or in the abodes of the CL patients. The results were compared with the control group of healthy women and men whose data are detailed in our previous publication. Interpretation of the prints were done according to the methods and included identification of patterns, ridge counts and the measurements of distances and angles in the palms, 79 DT for every individual, 28 continuous traits, 9 discrete traits, 11 indices of Div, 15 DA indices and 16 FA indices. In CL groups increased FA indices values were found and a decreased sexual dimorphism in DT of the CL and parental groups as compared to the control--this both in terms of the number of significant differences, as well as in values of the traits (e.g. smaller differences between the male and female values). The above mentioned findings were partly confirmed also by the discriminant analysis. The values of DT parents were generally similar to those of the control. The best discrimination was obtained between the CL and control groups (70.44% between CL males and control males and 83.47% between CL females and control females). Over 50% of the DT variables were found to be suitable for including into the discriminant function.

Adolescent↗

Evaluation of prenatal diagnosis of cleft lip with or without cleft palate and cleft palate by ultrasound: experience from 20 European registries. EUROSCAN study group.

Ultrasound scans in the mid-trimester of pregnancy are now a routine part of antenatal care in most European countries. Using data from registries of congenital anomalies a study was undertaken in Europe. The objective of the study was to evaluate prenatal detection of cleft lip with or without cleft palate (CL(P)) and cleft palate (CP). All CL(P) and CPs suspected prenatally and identified at birth in the period 1996-98 were registered from 20 Congenital Malformation Registers from the following European countries: Austria, Croatia, Denmark, France, Germany, Italy, Lithuania, Spain, Switzerland, The Netherlands, UK, Ukraine. These registries followed the same methodology. A total of 709,027 births were covered; 7758 cases with congenital malformations were registered. Included in the study were 751 cases reported with facial clefts: 553 CL(P) and 198 CP. The prenatal diagnosis by transabdominal ultrasound of CL(P) was made in 65/366 cases with an isolated malformation, in 32/62 cases with chromosomal anomaly, in 30/89 cases with multiple malformations and in 21/36 syndromic cases. The prenatal diagnosis of CP was made in 13/198 cases. One hundred pregnancies were terminated (13%); in 97 of these the cleft was associated with other malformations.

Cleft Lip↗

Optical non-contact 3D profilometry of the palate in subjects with cleft lip and/or palate.

Within the framework of a research project concerning hard palate morphometry in facial clefts, optical non-contact 3D profilometry based on the Fourier transform method was applied. The article discusses the principle of Fourier transform profilometry, the procedure for image acquisition and processing, as well as the merits of this method in the study of palate morphology.

Cleft Lip↗

The relationship between hypodontia in the second premolar region and heredity of cleft, lip and palate in children with isolated cleft palate.

The aim of the investigation was to study the relationship between hypodontia in the second premolar region and heredity of cleft lip and palate (CLP) in children with isolated cleft palate (CP). The following null-hypothesis was tested: The heredity for CLP will not give rise to higher prevalence of hypodontia in the second premolar region of the maxilla and the mandible in CP-patients. The material consisted of 188 children born with non-syndromic CP (77 boys and 111 girls). Surgical files initiated at birth and panoramic radiographs at ten years of age have been studied concerning heredity for CLP and hypodontia of second premolars. For all CP-children, irrespective of hereditary background the prevalence of second premolar hypodontia did not differ significantly. However, there was a tendency to higher prevalence of hypodontia of the lower second premolars. The null-hypothesis: The heredity for CLP will not give rise to higher prevalence of hypodontia in the second premolar region of the maxilla and the mandible in CP-patients was not rejected.

Anodontia↗

[Isolated cleft palates compared to cleft palates associated with Pierre Robin syndrome].

The purpose of this study was to evaluate two variables associated with isolated cleft palate and cleft palate related to Pierre Robin syndrome, namely, sexual incidence and dental anomalies. The study demonstrated that there are more dental anomalies associated with the Pierre Robin syndrome and that girls are more affected than boys in both instances.

Cleft Palate↗

[Results of palatal, linguographic and phoniatric studies in patients with pseudoprogeny after cleft palate surgery].

In 27 patients with cleft palate and pseudoprogeny the osteotomy according to Le Fort I and in 7 patients the accessory oblique osteotomy were performed. The phoniatric evaluations as well as the palatal and linguographic examinations proved the amelioration of the articulation in the second zone. The dental occlusions were also better as well as the speech intelligibility.

Adolescent↗