Quality of Life in Adolescents and Young Adults with Cleft Lip and Palate with and Without Speech Therapy During COVID-19.

OBJECTIVE: Cleft-related speech concerns can affect the quality of life (QOL) in patients with cleft lip and palate (CLP). During the coronavirus disease 2019 (COVID-19), in-person speech therapy (ST) was restricted due to fear of getting infected. This study aimed to compare QOL in patients with CLP with and without ST during the pandemic. DESIGN: Cross-sectional Study. SETTING: CLP team at Tehran University of Medical Sciences (TUMS). PATIENTS/PARTICIPANTS: Thirty-six CLP subjects with a mean age of 17.33 ± 4 years participated in two groups, including with and without ST. Fifteen subjects had cleft palate only (CPO) and others had CLP. INTERVENTIONS: ST group received at least 10 ST sessions, and group without ST didn't receive ST during COVID-19. MAIN OUTCOME MEASURE(S): A virtual link of demographic and QOL adolescent cleft (QoLAdoCleft) questionnaires were sent to fill out. Results were extracted and transferred to SPSS. RESULTS: Total and subscales' scores of QoLAdoCleft were lower in ST group than without ST but differences between them weren't statistically significant (P > .05). Furthermore, according to cleft type, there weren't any statistically significant differences in total, physical, and social subscales of QoLAdoCleft (P > .05); however, psychological subscale in CLP had a higher significant score than CPO (P < .05). CONCLUSIONS: QOL was weak in all patients with CLP, and receiving/not receiving ST couldn't make noticeable differences between them. It seems; COVID-19 pandemic can have an adverse effect on these results. Also, subjects with CLP had weaker psychological than CPO due to negative psychosocial feedback related to Orofacial deformities received from society.

Parental anxiety/incompliance and patients' complications during COVID-19 pandemic regarding nasoalveolar molding treatment of infants with cleft lip/palate.

OBJECTIVES: The ideal time for nasoalveolar molding (NAM) of infants with cleft lip and/or palate (CLP) is the first weeks after birth. The burden and responsibility that this method of treatment imposes on parents may result in incompliance. The coronavirus (COVID-19) pandemic and the redirection of health resources can make the situation worse. Therefore, this study evaluated the anxiety, complications, and incompliance of parents undergoing NAM during the COVID-19 pandemic. MATERIALS AND METHODS: Demographic data of 35 infants with CLP treated during the COVID-19 pandemic, compliance and level of anxiety of both parents in addition to their complications were reported. The association between different variables and incompliance was evaluated by simple and multiple logistic regressions. The level of significance was considered at P value less than 0.05. RESULTS: The highest level of parental anxiety related to the NAM process was the delay in ending the treatment. Meanwhile, the reason for the highest level of anxiety related to attending the treatment sessions was the probability of the infant's COVID-19 infection. Fathers expressed lower levels of anxiety than mothers, significantly. The most prevalent NAM complication was skin irritation. Parents of younger infants (≤28 days) and those with a history of COVID-19 infection were more compliant. CONCLUSIONS: COVID-19 pandemic caused a significant increase in the level of anxiety in both parents, mainly due to the delay in treatment ending and the possibility of infant's infection. Moreover, considering the importance of treatment time, parents of younger infants were more compliant with the NAM process.

Evaluation of Dimension and Bridging of Sella Turcica and Presence of Ponticulus Posticus in Individuals With and Without Cleft: A Comparative Study.

OBJECTIVE: Sella turcica abnormalities such as sella turcica bridging (STB) have been observed frequently among patients with craniofacial anomalies. Ponticulus posticus (PP) is an important structure and its presence causes complications during surgeries. Due to the importance of these structures, this study aimed to evaluate the prevalence of STB, PP, and dimensions of the sella turcica in individuals with and without cleft. DESIGN: A cross-sectional study. SETTING: Orthodontic and Radiology Departments in a public dental school, Tehran, Iran. PATIENTS: Eighty-three lateral cephalograms of individuals with cleft and ninety-two cephalograms of class I individuals without cleft. MAIN OUTCOME MEASURES: Length, depth, and maximum anterior-posterior diameter (APD) of sella turcica, presence of STB (classified as types 1, 2, and 3), and PP. RESULTS: In the group with cleft, 19.3% of individuals had type I, 65.1%, type II, and 15.7%, type III STB. In the group without cleft, 15.2% had type I, 73.9%, type II, and 10.9%, type III STB. In the group with cleft, 65.1% of individuals had no PP, 24.1%, incomplete, and 10.8%, complete PP while in the group without cleft, 56.5% had no PP, 29 31.5%, incomplete, and 12%, complete PP. CONCLUSION: The sella turcica dimensions, STB, and PP prevalence were not significantly different between individuals with and without cleft. The sella turcica length and prevalence of STB and PP were not affected by age, sex, and cleft type. However, the depth and the APD were affected by age.

The Effect of Photobiomodulation on Distraction Osteogenesis.

Distraction osteogenesis (DO) is a surgical procedure to increase bone height in different body parts. DO includes a surgical incision, wherein the bone is cut and a device is installed for further separation of the two ends by gradual unscrewing of the device screw. New bone gradually forms and fills the gap, and the bone height increases as such. Photobiomodulation (PBM) or low-level laser therapy (LLLT) enhances the formation of soft and hard tissue such as bone and can, therefore, accelerate the process of DO and shorten the duration of different surgical phases of DO such as latency, activation, and consolidation. Different laser types with variable exposure settings and protocols have been used for this purpose. The gallium-aluminum-arsenide (GaAlAs) diode laser is the most commonly used laser type for LLLT. This study reviews 18 published articles on the effects of LLLT on DO and summarizes their findings to further elucidate this topic.

Two-Dimensional Analysis of the Size of Nasopharynx and Adenoids in Non-Syndromic Unilateral Cleft Lip and Palate Patients Using Lateral Cephalograms.

OBJECTIVES: Cleft lip and palate (CLP) is the most common congenital anomaly of the head and neck region. The upper airway in CLP patients is affected by retarded maxillary growth. Small size of the nasopharynx can also lead to mouth breathing. This study aimed to compare the size of nasopharynx and adenoids in non-syndromic unilateral CLP (NSUCLP) patients and healthy controls two-dimensionally on lateral cephalograms. MATERIALS AND METHODS: This retrospective study was performed on 30 children with NSUCLP (mean age of 11.3 years) and 30 sex- and age-matched healthy controls with class I skeletal relationship. The bony boundaries of the nasopharynx, nasopharyngeal airway and adenoids were outlined on lateral cephalograms and their surface area was calculated and compared between the two groups. The percentage of nasopharynx occupied by the adenoids was calculated for each individual and compared between the two groups using independent t-test. RESULTS: Size of nasopharynx in NSUCLP children was significantly smaller than that in healthy controls (P=0.0001). Size of adenoids was significantly larger in NSUCLP children (P=0.0001). Size of nasopharyngeal airway was smaller in NSUCLP patients than controls (P=0.0001). Percentage of nasopharynx occupied by the adenoids was significantly greater in NSUCLP patients (P=0.0001). CONCLUSIONS: The size of nasopharynx is smaller while the size of adenoids is larger in NSUCLP children compared to healthy controls; this can lead to mouth breathing and velopharyngeal incompetence.