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PubMed2005

[Classification and repairing investigation of the whistling deformities in the patients with bilateral cleft lip or bilateral cleft lip and cleft palate after primary cleft lip repair].

OBJECTIVE: To classify the whistling deformities of the patients with bilateral cleft lip or bilateral cleft lip and cleft palate after primary cleft lip repair. METHODS: According to exposure degrees of the gum and the crown of the anterior upper incisors, 136 patients with whistling deformities after primary repair of bilateral cleft lip at the Department of Oral and Maxillofacial Surgery of Xiang Ya Hospital, Central South University were examined and the whistling deformities were classified into four grades. Grade I: the crowns of the left and the right upper incisors were exposed about one-second. Grade II: the whole crowns of the upper incisors were exposed or plus the exposure of the crowns of medial sagittal portion of the left and the right upper lateral incisors. Grade III: the whole crowns of two upper incisors and one-second of the attached gum of two upper incisors or the crowns and one-second of attached gum of the two upper incisors with over two-third of transverse crowns of the lateral incisors were exposed. Grade IV: the crowns and corresponding attached gum of the upper incisors and over two-third of medial sagittal crowns of the upper lateral incisors were exposed. The relation between the degrees of the whistling deformities and the primary procedures of the bilateral cleft lip or the bilateral cleft lip and cleft palate was analyzed. RESULTS: Sixty patients (44.2 percent) had grade I whistling deformities; forty-seven patients (34.5 percent) were Grade II; 16 patients (11.8 percent) were Grade III; 13 cases (9.5 percent) were Grade IV. The results showed that grade I and grade II whistling deformities were obviously more (about 3.7 times) than grade IlI and grade IV whistling deformities. CONCLUSIONS: Classification of whistling deformities provided the objective basis for the selection of operation techniques of cleft lip.

Adolescent↗
PubMed1989

The relationship between craniomandibular dysfunction and malocclusion in white children with unilateral cleft lip and cleft lip and palate.

An epidemiologic study was conducted on white children with unilateral cleft lip and cleft lip and palate to investigate the relationship between craniomandibular dysfunction and malocclusion. The results showed no statistically significant correlations between each clinical sign and symptom of craniomandibular dysfunction and each type of malocclusion. When the definitional symptoms of craniomandibular dysfunction were aggregated, a statistically significant correlation was found only with anterior crossbite. Anterior crossbite, in most of the subjects with cleft lip and cleft lip and palate, is associated with skeletofacial growth disturbances. It is suggested, therefore, that the relationship between skeletofacial pattern and craniomandiubular dysfunction be investigated.

Child↗
PubMed1980

Segregation of HLA in sibs with cleft lip or cleft lip and palate: evidence against genetic linkage.

The segregation of HLA haplotypes (A, B, and C loci) was studied in eight families in which two sibs were affected with cleft lip or cleft lip and palate. HLA typing was performed in parents and sibs and in specific cases, other family members. Segregation of HLA haplotypes did not differ significantly from random Mendelian expectation. Three of the eight affected sib pairs differed in both HLA haplotypes, which is not expected if there is close linkage with susceptibility to clefting. Thus, it is very unlikely that spontaneous cleft lip or cleft lip and palate is closely linked to HLA.

Chromosome Mapping↗
PubMed1987

A psychosocial study of Icelandic individuals with cleft lip or cleft lip and palate.

Questionnaires were sent to 63 Icelandic individuals with cleft lip and cleft lip and palate who had undergone surgical repair of those defects. The questions focused on the following areas: social characteristics, clinical characteristics, attitudes toward consequences of clefts, and attitudes toward appearance and treatment. The CL and CLP groups were compared, as were females and males. A comparison group was used with respect to two social factors. The data indicated relatively good psychosocial adjustment. However, fewer individuals were married or living together in the cleft group than in the comparison group. The subjects did not perceive that cleft lip or palate had influenced their lives to a great extent, yet females seemed to be more self-conscious than males in respect to how others viewed their appearance. Overall, the subjects were satisfied with the treatment and the members of the treatment team. However, their expectations exceeded the actual outcome of surgery. Suggestions are offered for future research.

Adult↗
PubMed1989

Evaluation of craniomandibular dysfunction in children 6 to 10 years of age with unilateral cleft lip or cleft lip and palate: a clinical diagnostic adjunct.

It is becoming increasingly apparent that a clinical evaluation for craniomandibular dysfunction in children is important for predicting future problems in adults. Because of the dysmorphology inherent in children with clefts, there is potential for craniomandibular dysfunction in many cases. The prevalence of craniomandibular dysfunction in white children with unilateral cleft lip or cleft lip and palate from 6 to 10 years of age was investigated. Thirty children (22 males and eight females) were examined. Craniomandibular dysfunction was detected clinically by the following criteria: mandibular movements; deflection of the mandible on opening; temporomandibular joint (TMJ) sounds; and muscle and temporomandibular joint tenderness to palpation. Information related to subjective symptoms (headaches, difficulties in opening wide, pain in the temple region, pain in opening wide, pain in chewing, and reported clicking) was collected by interview. The results showed that the prevalence of objective and subjective symptoms was 76.6 and 53.3 percent, respectively. The most frequent symptom was muscle tenderness (60 percent), followed by temporomandibular joint tenderness (26.6 percent), temporomandibular joint sounds (20 percent), and headaches (16.6 percent). Statistically significant differences by cleft type were not found in the prevalence of any objective or subjective symptom. Significant correlation was found only between temporomandibular joint tenderness and muscle tenderness. Because the overall prevalence of symptoms is shown to be high in the sample studied, routine dental examinations of patients with clefts should include an evaluation of the masticating system.

Child↗
PubMed2000

Open tip rhinoplasty along with the repair of cleft lip in cleft lip and palate cases.

This paper is a report on a procedure to perform open tip rhinoplasty at the time of lip repair in unilateral and bilateral cleft lip and palate deformity. A total of 69 patients who had this operation between 1994 and 1997 have been reviewed. Conventionally there is hesitation to do radical nasal correction for the cleft lip patient because of the fear of possible growth retardation. The present technique, while it achieves excellent postoperative results constantly, does not entail any more trauma to the cartilage complex than any of the conventional closed rhinoplasty techniques. Early results obtained by this method appear to be superior to those by closed rhinoplasty techniques.

Child, Preschool↗
PubMed1993

Dental cast study of adult patients with untreated unilateral cleft lip or cleft lip and palate in indonesia compared with surgically treated patients in The Netherlands.

To determine differences in maxillary and dentoalveolar relationships between untreated and treated patients having unilateral clefts of the lip and alveolus (UCLA) or lip and palate (UCLP), dental cast assessments were done on 70 untreated adult Indonesian patients (UCLA-I, UCLP-I) and 67 Dutch patients, surgically treated in infancy (UCLA-D, UCLP-D). The Indonesian group consisted of 44 UCLA-I and 26 UCLP-I patients, and the Dutch group of 24 UCLA-D and 43 UCLP-D patients. In the UCLA-I patients, deformities occurred in that part of the dentoalveolar complex that surrounds the cleft. Lip repair in the UCLA-D group more frequently caused deformities in the incisor and buccal areas on the cleft side. In the UCLP-I patients, deformities were present in the incisor and cuspid areas on the cleft side. The buccal segments showed collapse both on the cleft and noncleft sides. Lip and palate repair in the UCLP-D group caused significantly more deformities in the incisor, cuspid, and buccal areas up to the level of the first molars, both on the cleft and noncleft sides. Surgical treatment seems to cause maxillary and dentoalveolar deformities up to the first molars more frequently, but these are not as pronounced as one would expect: following the practiced surgical regimen, the deformities were usually mild. Negative effects of surgical intervention seem to be antagonized by the restored integrity of the lip and palate leading to orientation of maxillary parts and correction of tongue position, which in turn has a molding effect on the maxilla and mandible.

Adolescent↗
PubMed2004

Epidemiology of cleft lip and cleft palate in Pakistan.

Clinical and epidemiologic studies of defined geographic populations can serve as a means of establishing data important for the diagnosis, treatment, and counseling of patients with cleft lip and cleft palate. Several descriptive epidemiologic studies have been carried out in many countries worldwide; however, no such study has ever been performed in Pakistan. Population-based data on the incidence of cleft lip and palate were obtained from birth registry information in northern Pakistan. A total of 117 cases from 61,156 live births reported were identified. The incidence for cleft lip and/or cleft palate was 1.91 per 1000 births (one per 523 births). Cleft lip alone (42 percent) was noted more frequently than isolated cleft palate (24 percent) and combined cleft lip and palate deformities (34 percent). Boys were more commonly affected by cleft lip and cleft lip with cleft palate, whereas girls predominated in the isolated cleft palate cases. Consanguineous marriages were observed in 32 percent of parents versus 18 percent in matched controls. Only 32 percent of cleft mothers received formal prenatal counseling, monthly examinations, and regular laboratory testing during the entirety of the pregnancy. Nutritional and vitamin supplements were given to only 28 percent of mothers of cleft children versus 59 percent in matched controls. Descriptive statistics were used to assess pertinent risk factors associated with cleft lip and palate. The acquisition of incidence and associated data has generated baseline information on the magnitude of cleft lip and cleft palate in Pakistan. It is hoped that this information can be used for appropriate resource use, cleft lip and cleft palate prevention programs, and counseling programs with Pakistan-specific data.

Adult↗
PubMed1978

HLA phenotype frequencies in individuals with cleft lip and/or cleft palate.

The HLA types of 133 patients with cleft lip and/or cleft palate were determined. Caucasian patients with isolated cleft palate showed a possible association with HLA. Ten of 11 male patients had HLA--A2 as compared to one out of eight female patients (P less than 0.005). Caucasian males with cleft lip and cleft palate had a slight increased frequency of HLA--Aw24 (P = 0.07) and Mexican-American males with cleft lip and/or cleft palate showed an increase of antigen HLA-A28 (P = 0.07), though neither were statistically significant. Females with cleft lip and/or cleft palate from either racial group had no differences from the controls. The serum from 90 mothers of patients with cleft lip and/or cleft palate were reacted against their child's lymphocytes. Of these crossmatch tests, 12% were found to be positive. These preliminary results suggest that male patients with isolated cleft palate are worthy of further studies with respect of HLA associations.

Cleft Lip↗
PubMed1989

[Epidemiology of cleft lip and cleft palate in China].

During a period of 12 months (Oct. 1986 to Sep. 1987), 1,243,284 live and still births were monitored in 945 hospitals of 29 provinces cities and autonomous regions of China. A total of 2,265 cases of cleft lip and cleft palate were recorded, of which cleft lip with cleft palate accounted for 61.3%, isolated cleft lip for 30.5% and isolated cleft palate for 8.2%. The incidence of cleft lip and cleft palate in this country varied from 13.4 to 30.7 with a mean of 18.2 per 10,000. The total incidence of cleft lip and cleft palate in the rural area is higher (20.8 per 10,000) than that in the urban area (16.9 per 10,000) (P less than 0.01). A male preponderance (19.8 per 10,000) over the female (16.3 per 10,000) (P less than 0.01) was observed.

China↗