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1.
Hua Xi Kou Qiang Yi Xue Za Zhi ; 39(5): 560-565, 2021 Oct 01.
Artigo em Inglês, Chinês | MEDLINE | ID: mdl-34636204

RESUMO

OBJECTIVES: This study aimed to compare the postoperative outcome of the new and classical muscular reconstruction technique combined with nasal internal-fixation method for secondary deformity post unilateral cleft lip repair. A rationale is provided for the further surgical improvement of secondary deformities. METHODS: Sixty patients aged 4-18 years with secondary unilateral cleft lip-nose deformity were involved in this research. The deformities of 28 patients were repaired using the muscular force balance technique through nasal internal fixation method, and 32 were repaired using classical muscular reconstruction technique. Two-dimensional analysis was used to evaluate the nose-lip morphology of pre- and post-operative patients through standardized photographs seven days after surgery. RESULTS: Compared with preoperative nasal morphology in the muscular force balance technique group, the 7-days postoperative results of this group showed the significantly improved short-term outcomes in the correction of columellar deflection, alar rim angle, nasal shape, and the symmetry of alar base width, nostril width, nostril height, alar rim angle (P<0.05). CONCLUSIONS: The new muscular reconstruction technique with nasal internal-fixation method has a significant effect on nasal repair.


Assuntos
Fenda Labial , Rinoplastia , Fenda Labial/cirurgia , Humanos , Nariz/cirurgia , Período Pós-Operatório , Resultado do Tratamento
2.
Braz Dent J ; 32(2): 37-44, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34614059

RESUMO

This study aimed to analyze the maxillary growth and development of children with oral clefts using the innovative method of 3D-3D superimposition technique. Children with unilateral complete cleft lip (UCL) and unilateral cleft lip and palate (UCLP) participated in the study. The impressions of the dental arches were executed 1 day before and 1 year after lip repair surgery. A 3D laser scanner digitized the dental models and the stereophotogrammetry system software analyzed the 3D-3D superimpositions in two groups of matches (same child, UCL and UCLP) and one group of mismatches (different individuals). The differences were evaluated by Root Mean Square (RMS) and expressed in millimeters (mm). Kruskal-Wallis test followed by post-hoc Dunn test and Mann-Whitney test were assessed to compare the groups (α=5%). RMS was 1.34 mm (± 0.37) in UCL group, 1.41 mm (± 0.32) in UCLP group, and 3.38 mm (± 1.28) in mismatches group. RMS was significantly greater in mismatches than in matches groups (p<0.0001). No statistically significant differences occurred between genders. The 3D-3D superimposition technique showed the maxillary development after lip repair surgery in the anterior region of the palate. Thus, it is suggested that the cleft amplitude and the palatal segments proportion influenced the morphological heterogeneity and, consequently, the development and maxillary growth of children with orofacial cleft.


Assuntos
Fenda Labial , Fissura Palatina , Criança , Fenda Labial/cirurgia , Fissura Palatina/cirurgia , Feminino , Humanos , Masculino
3.
Cien Saude Colet ; 26(suppl 2): 3505-3515, 2021.
Artigo em Português | MEDLINE | ID: mdl-34468646

RESUMO

This study analyzed the delay in the primary surgical treatment of patients with cleft lip and palate in Brazil performed under the Unified Health System (SUS), and the effect of the sociodemographic context and municipal socioeconomic indicators on access to this treatment (2009-2013). Data from the Decentralized Hospital Information System relating to all hospital authorization forms paid for primary cleft lip and/or palate surgeries and socioeconomic data (2010) was used. The ages recommended by the American Cleft Palate-Craniofacial Association (12 months for lip surgeries and 18 months for palate surgeries) were used as parameters. The prevalence of delay observed in primary lip surgeries was 66.4% and in palate surgeries was 71.2%. The North and Northeast regions had the worst percentages of delay. Non-whites had a greater prevalence of delay in cleft lip surgeries with PR = 1.40 (1.30-1.50) and cleft palate surgeries with PR = 1.27 (1.21-1.33). The multilevel analysis identified the influence of self-reported skin color and Human Development Index (HDI) on the delay of primary lip surgery, and of HDI on the delay of palate surgery. The importance of social determination on the access to primary cleft lip and palate surgeries was evident.


Assuntos
Fenda Labial , Fissura Palatina , Brasil/epidemiologia , Fenda Labial/epidemiologia , Fenda Labial/cirurgia , Fissura Palatina/epidemiologia , Fissura Palatina/cirurgia , Humanos , Lactente , Análise Multinível , Estudos Retrospectivos , Estados Unidos
4.
Shanghai Kou Qiang Yi Xue ; 30(3): 243-246, 2021 Jun.
Artigo em Chinês | MEDLINE | ID: mdl-34476438

RESUMO

PURPOSE: To explore the mechanism of upper lip pressure on maxilla after cleft lip surgery. METHODS: ANSYS 17.0 software was used to add the upper lip soft tissue to the finite element model of maxilla with cleft palate, and the material properties was assigned to form a three-dimensional finite element model of maxilla with upper lip. The upper lip pressure was applied to the model and force analysis was performed in 2 groups. In the experimental group, upper lip pressure with cleft lip surgery was applied; in the control group, upper lip pressure in normal children of the same age was applied. RESULTS: Maxillary deformation in the experimental group was greater than that in the control group. Maxillary deformation occurred in three-dimensional direction, which was mainly in Z axis, followed by X axis and Y axis. The anterior segment of alveolar process was the most obvious,and from the anterior to the posterior, the change trend was gradually decreased. CONCLUSIONS: Maxillary growth is inhibited in three-dimensional direction,which is mainly sagittal growth inhibition,followed by transverse and vertical growth. The inhibition gradually decreases from anterior to posterior.


Assuntos
Fenda Labial , Fissura Palatina , Criança , Fenda Labial/cirurgia , Fissura Palatina/cirurgia , Análise de Elementos Finitos , Humanos , Lábio , Maxila/cirurgia
5.
BMJ Case Rep ; 14(9)2021 Sep 21.
Artigo em Inglês | MEDLINE | ID: mdl-34548295

RESUMO

Double lip or macrocheilitis is a rare facial anomaly, mostly congenital in origin. It commonly involves the upper lip than the lower lip. It may occur in isolation or as part of the Ascher's syndrome. It results due to deposition of excessive areolar tissue and non-inflammatory hyperplasia of labial mucosa gland of pars villosa. It may be acquired as a result of injury to the lips or lip-biting habit. The double lip becomes conspicuous when the lips are retracted during smiling resulting in the characteristic 'cupid's bow' appearance. This disfigurement can pose aesthetic and functional problems and may result in psychological distress. A surgical intervention is must for restoration of functions and to address the aesthetic concerns. The present article reports a case of non-syndromic double upper lip with triple labial frena and its surgical management with laser on one side and with scalpel on the other side.


Assuntos
Fenda Labial , Anormalidades da Boca , Procedimentos Cirúrgicos Reconstrutivos , Fenda Labial/cirurgia , Estética , Humanos , Lábio/cirurgia , Mucosa Bucal/cirurgia
6.
J Craniofac Surg ; 32(6): 2159-2162, 2021 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-34516070

RESUMO

INTRODUCTION: Within the treatment protocols of patients with cleft lip and palate, the nasoalveolar molding (NAM) acquire more followers every day.Their benefits have been well documented, but not equally their complications. The purpose of this study was to describe the complications produced during treatment with Grayson presurgical NAM in nonsyndromic infants with complete unilateral cleft lip and palate. METHODS: Bibliographic review on 8 databases using search algorithms. By applying the exclusion and inclusion criteria, 21 articles were detected, which were analyzed in full text. Complication, cause, and solution data were presented in supplemental tables. RESULTS: Complications are related to soft tissues, hard tissues, and those derived from care. SOFT TISSUES: irritation, ulceration, gingival, facial, or nasal bleeding. Candidiasis. An overexpanded nostril creation to improper placement or modifications of the nasal stent at home.The most frequent were lip and cheeks skin irritation by taping, and gingival ulceration due to excessive pressure. HARD TISSUES: misalignment of alveolar segments and the premature eruption of teeth. DERIVED FROM CARE: inadequate device retention, adherence problems to treatment, poor/excessive care of the caregiver, intolerance to the device, eating problems, breathing, and socioeconomic issues. CONCLUSIONS: The main complications occur in soft tissues, related to the retention mechanisms and an inadequate adjustment of the device.The benefits of NAM exceed the complications. It is necessary to know them to avoid any harmful results since they could prolong or stop the treatment, compromising the result. The active collaboration of the family in the insertion and maintenance of the device is crucial for success.


Assuntos
Fenda Labial , Fissura Palatina , Processo Alveolar/cirurgia , Fenda Labial/cirurgia , Fissura Palatina/cirurgia , Humanos , Lactente , Moldagem Nasoalveolar , Nariz , Cuidados Pré-Operatórios
7.
J Clin Pediatr Dent ; 45(4): 284-290, 2021 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-34534300

RESUMO

OBJECTIVE: To evaluate nostril morphology post-cheiloplasty after patients with unilateral cleft lip and palate (UCLP) use of the nasal creator device. STUDY DESIGN: This is a prospective study. Sixteen patients with nonsyndromic UCLP treated at Khon Kaen University underwent cheiloplasty and then wear the nasal creator device for 6 months. Three-dimensional images were taken, from which 5 lines and 8 landmark points were evaluated prior to (T0) and 1 day (T1), 1 month (T2), 3 months (T3), and 6 months (T4) after cheiloplasty. A Repeated Measure ANOVA was used to evaluate nostril changes between time periods and a paired t-test was used to compare values between the affected and non-affected side at T4 (P < .05). RESULTS: On the affected side, the nostril height significantly increased from T0 (2.46±0.89 mm) to T4 (4.22±1.03 mm), and the nostril width significantly decreased from T0 (9.46±2.57 mm) to T4 (7.34±1.41 mm). On the non-affected side, the nostril height significantly increased from T0 (3.39±0.78 mm) to T4 (4.65±1.07 mm), and the nostril width was not significantly different from T0 (6.00±1.25 mm) to T4 (6.59±0.95 mm). The alar base width was not significantly different between T0 (30.18±2.72 mm) and T4 (29.82±1.69 mm). Nostril height and width were not significantly different by T4 when comparing the affected and non-affected sides. CONCLUSION: Using nasal creator device for 6 months significantly increased the nostril height and decreased nostril width and alar base width after cheiloplasty.


Assuntos
Fenda Labial , Fissura Palatina , Fenda Labial/cirurgia , Fissura Palatina/diagnóstico por imagem , Fissura Palatina/cirurgia , Humanos , Nariz/cirurgia , Fotogrametria , Estudos Prospectivos , Tailândia , Resultado do Tratamento
8.
BMJ Open ; 11(8): e046798, 2021 08 16.
Artigo em Inglês | MEDLINE | ID: mdl-34400450

RESUMO

OBJECTIVE: To systematically assess the efficacy and safety of dexmedetomidine as an anaesthesia adjuvant for cleft lip and palate (CLP) repair in children. DESIGN: Systematic review and meta-analysis. DATA SOURCES: PubMed, Embase, Cochrane, China National Knowledge Infrastructure (CNKI), China Science and Technology Journal Database (VIP) and Wanfang (up to October 2020). Studies in languages other than English and Chinese were excluded. ELIGIBILITY CRITERIA FOR SELECTING STUDIES: Randomised controlled trials (RCTs) evaluating the impact of dexmedetomidine on emergence agitation (EA), the need for postoperative rescue analgesics, postoperative nausea and vomiting (PONV), and other adverse events in paediatric patients during CLP repair. DATA EXTRACTION AND SYNTHESIS: The quality of evidence was assessed by using the Cochrane Review Methods and the Grading of Recommendations Assessment, Development and Evaluation approach. Data were screened, extracted and assessed by two independent authors. Outcomes were reported as a risk ratio (RR) with a 95% CI. A random-effect model was used when heterogeneity was detected. RESULTS: Thirteen studies including 1040 children met the inclusion criteria. The incidence of EA was significantly decreased in the dexmedetomidine group (RR, 0.19; 95% CI 0.10 to 0.36; p<0.00001; I2=56%) as compared with the control group. Paediatric patients receiving dexmedetomidine had lower postoperative analgesic requirements (RR, 0.27; 95% CI 0.10 to 0.73; p=0.01; I2=84%) and a lower incidence of respiratory adverse events (RR, 0.49; 95% CI 0.31 to 0.78; p=0.003; I2=0%). There were no significant differences in the risk of PONV and cardiovascular adverse events. CONCLUSIONS: There was a lack of high-quality studies in this field. Perioperative administration of dexmedetomidine reduced the need for postoperative rescue analgesics and the incidence of EA in children without side effects undergoing CLP repair. However, further verification with larger samples and higher-quality RCTs is needed.


Assuntos
Anestesia , Fenda Labial , Dexmedetomidina , Criança , Fenda Labial/cirurgia , Dexmedetomidina/uso terapêutico , Humanos , Palato , Náusea e Vômito Pós-Operatórios/epidemiologia , Náusea e Vômito Pós-Operatórios/prevenção & controle
9.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi ; 35(8): 1021-1026, 2021 Aug 15.
Artigo em Chinês | MEDLINE | ID: mdl-34387432

RESUMO

Objective: To evaluate the effectiveness of autologous costal cartilage-based open rhinoplasty in the correction of secondary unilateral cleft lip nasal deformity. Methods: Between January 2013 and June 2020, 30 patients with secondary unilateral cleft lip nasal deformity were treated, including 13 males and 17 females; aged 14-41 years, with an average of 21.7 years. Among them, 18 cases were cleft lip, 9 cases were cleft lip and palate, and 3 cases were cleft lip and palate with cleft alveolar. The autologous costal cartilage-based open rhinoplasty was used for the treatment, and the alar annular graft was used to correct the collapsed alar of the affected side. Before operation and at 6-12 months after operation, photos were taken in the anteroposterior position, nasal base position, oblique position, and left and right lateral positions, and the following indicators were measured: rhinofacial angle, nasolabial angle, deviation angle of central axis of columella, nostril height to width ratio, and bilateral nasal symmetry index (including nostril height, nostril width, and nostril height to width ratio). Results: The incisions healed by first intention after operation, and no complications such as acute infection occurred. All 30 patients were followed up 6 months to 2 years, with an average of 15.2 months. During the follow-up, the patients' nasal shape remained good, the tip of the nose and columella were basically centered, the back of the nose was raised, the collapse of the affected side of nasal alar and the movement of the feet outside the nasal alar were all lessened than preoperatively. The basement was elevated compared to the front, and no cartilage was exposed or infection occurred. None of the patients had obvious cartilage absorption and recurrence of drooping nose. Except for the bilateral nostril width symmetry index before and after operation, there was no significant difference ( t=1.950, P=0.061), the other indexes were significantly improved after operation when compared with preoperatively ( P<0.05). Eleven patients (36.7%) requested revision operation, and the results were satisfactory after revision. The rest of the patients' nasal deformities were greatly improved at one time, and they were satisfied with the effectiveness. Conclusion: Autologous costal cartilage-based open rhinoplasty with the alar annular graft is a safe and effective treatment for secondary unilateral cleft lip nasal deformity.


Assuntos
Fenda Labial , Fissura Palatina , Cartilagem Costal , Rinoplastia , Fenda Labial/cirurgia , Fissura Palatina/cirurgia , Feminino , Humanos , Masculino , Septo Nasal/cirurgia , Nariz/cirurgia , Resultado do Tratamento
10.
Trials ; 22(1): 572, 2021 Aug 28.
Artigo em Inglês | MEDLINE | ID: mdl-34454599

RESUMO

BACKGROUND: An alveolar cleft commonly affects 75% of cleft lip and palate patients. While it is common practice to provide a course of orthodontic treatment before alveolar bone grafting, there are no previous high-quality studies reporting on the benefits of this type of treatment. AIM: The aim of the study is to evaluate the effectiveness of pre-alveolar bone graft orthodontics for unilateral non-syndromic cleft palate patients. METHOD: The PABO trial is a multicentric, parallel, two-arm, single-blinded randomised controlled trial. The inclusion criteria include unilateral cleft alveolus patients requiring bone graft and between the age group of 8 and 13 years with erupted upper central incisors. Participants will be recruited at three centres across India. Participants will be randomised to orthodontic treatment or no orthodontic treatment group. Both groups of participants will have alveolar bone graft surgery and will be followed up for 6 months after surgery. The primary outcome will be the success of the alveolar bone graft measured by anterior oblique radiograph and secondary outcomes include quality of life, cost analysis and quality of the dento-occlusal outcome. Data analysis will be carried out by an independent statistician at the end of the study. DISCUSSION: This study is the first to evaluate the effect of orthodontics on alveolar bone graft success. The increased burden of care for these patients with multiple treatments required from multiple specialists from birth to adult life highlights the need for reducing unnecessary treatment provision. TRIAL REGISTRATION: Clinical Trials Registry - India, CTRI/2020/10/028756 . Trial prospectively registered on 29 October 2020. .


Assuntos
Enxerto de Osso Alveolar , Fenda Labial , Fissura Palatina , Ortodontia , Adolescente , Adulto , Criança , Fenda Labial/diagnóstico por imagem , Fenda Labial/cirurgia , Fissura Palatina/diagnóstico por imagem , Fissura Palatina/cirurgia , Humanos , Qualidade de Vida , Ensaios Clínicos Controlados Aleatórios como Assunto
11.
Biomed Res Int ; 2021: 4572397, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34435043

RESUMO

Background: The orthognathic strategies to treat patients with a concave profile but different tissue conditions remain controversial. The aim of this case-control study was to investigate the outcome predictability of orthognathic surgery in cleft lip and palate (CLP) patients and matched controls. Methods: Fifty consecutive CLP and 45 matched non-CLP patients who received whole-piece Le Fort I and bilateral sagittal split osteotomy to correct class III skeletal relations were enrolled. The outcome discrepancies (ODs) from simulations among all groups were evaluated with consideration of the possible influences from planned surgical movements (PSM). Receiver operating characteristic curves were used to determine threshold values of PSMs that yielded clinically relevant OD. Results: Unilateral CLP (UCLP) patients had comparable postsurgical OD to non-CLP patients in both jaws, whereas bilateral CLP (BCLP) patients had greater deviations from predicted results. Vertical movement of the A - point > 1.33 mm and yaw correction > 1.65° in the BCLP patients was associated with clinically relevant maxillary OD. Conclusions: The OGS outcomes of BCLP patients were less predictable than those of the UCLP and noncleft patients. Vertical movements of the A - point > 1.33 mm and yaw correction > 1.65° in BCLP patients increased OD to a clinically relevant extent.


Assuntos
Cefalometria/métodos , Fenda Labial/cirurgia , Fissura Palatina/cirurgia , Imageamento Tridimensional/métodos , Maxila/cirurgia , Procedimentos Cirúrgicos Ortognáticos/métodos , Estudos de Casos e Controles , Fenda Labial/diagnóstico por imagem , Fissura Palatina/diagnóstico por imagem , Humanos , Maxila/diagnóstico por imagem , Estudos Retrospectivos , Resultado do Tratamento
12.
Ann Plast Surg ; 87(2): 161-164, 2021 08 01.
Artigo em Inglês | MEDLINE | ID: mdl-34253699

RESUMO

BACKGROUND: Alar rim defects develop in most cases as a result of burns, trauma, or tumor excision. Congenital alar rim defects are rare, with an incidence of 1 in 20,000 to 40,000 live births. Tessier classification is the most commonly used classification system for craniofacial defects. Facial clefts involving the nose are categorized as types 0, 1, 2, and 3, whereas cranial clefts with nose lesions are categorized as types 11, 12, 13, and 14. The patterns of nasal clefts are extremely variable, ranging from a simple notch of alar margin to complex craniofacial cleft involving the lip, nose, eyelid, brow, forehead, and underlying bone. PATIENTS AND METHODS: This study was conducted at Fayoum University Hospital on 8 male patients who present with congenital alar rim defects (Tessier number 1 cleft). Surgeries were performed under general anesthesia with orotracheal intubation. A full-thickness incision was created along the whole alar subunit, keeping the ala attached only laterally (laterally based alar full-thickness flap). The alar flap was advanced and rotated medially and inferiorly and sutured to the anatomical place in 2 layers, skin and mucosa. Follow-up was done at least 1.5 years postoperatively. RESULTS: The study was conducted on 8 male patients presenting with congenital alar rim defects (Tessier number 1 cleft). The mean age of patients was 14.2 years, and the cleft was unilateral in 4 patients (50%) and bilateral in 4 patients (50%). The patients were assessed both aesthetically and functionally and followed at 1.5 years postoperatively. The aesthetic outcome was assessed according to both patients' and author's evaluations of the scar appearance, alar symmetry, nostril symmetry, and general satisfaction. CONCLUSIONS: Laterally based alar subunit rotation advancement flap is a reliable option for reconstruction of congenital alar rim defects (Tessier number 1 cleft) with the advantages of being an easy single-stage procedure with good tissue matching and nostril symmetry and only limitation of extremely wide defects with deficient tissues between the ala and tip.


Assuntos
Fenda Labial , Rinoplastia , Adolescente , Fenda Labial/cirurgia , Estética , Humanos , Masculino , Nariz/cirurgia , Rotação , Retalhos Cirúrgicos
13.
Ann Plast Surg ; 87(2): 194-198, 2021 08 01.
Artigo em Inglês | MEDLINE | ID: mdl-34253700

RESUMO

INTRODUCTION: We analyzed the perceptions of participants and faculty members in simulation-based comprehensive cleft care workshops regarding comprehensive cleft care delivery in developing countries. METHODS: Data were collected from participants and faculty members in 2 simulation-based comprehensive cleft care workshops organized by Global Smile Foundation. We collected demographic data and surveyed what they believed was the most significant barrier to comprehensive cleft care delivery and the most important intervention to deliver comprehensive cleft care in developing countries. We also compared participant and faculty responses. RESULTS: The total number of participants and faculty members was 313 from 44 countries. The response rate was 57.8%. The majority reported that the most significant barrier facing the delivery of comprehensive cleft care in developing countries was financial (35.0%), followed by the absence of multidisciplinary cleft teams (30.8%). The majority reported that the most important intervention to deliver comprehensive cleft care was creating multidisciplinary cleft teams (32.2%), followed by providing cleft training (22.6%). We found no significant differences in what participants and faculty perceived as the greatest barrier to comprehensive cleft care delivery (P = 0.46), or most important intervention to deliver comprehensive cleft care in developing countries (P = 0.38). CONCLUSIONS: Our study provides an appraisal of barriers facing comprehensive cleft care delivery and interventions required to overcome these barriers in developing countries. Future studies will be critical to validate or refute our findings, as well as determine country-specific roadmaps for delivering comprehensive cleft care to those who need it the most.


Assuntos
Fenda Labial , Fissura Palatina , Fenda Labial/cirurgia , Fissura Palatina/cirurgia , Humanos , Inquéritos e Questionários
14.
Artigo em Inglês | MEDLINE | ID: mdl-34299755

RESUMO

Cleft lip and palate is the most frequent birth anomaly, with increasing reported rates of complications, such as palate fistulae. Current studies concerning the occurrence rate of cleft lip and palate (CLP) report 2 to 10 cases in 10,000 births. The purpose of this study was to investigate the existence of factors that could predict the occurrence of fistulae after cleft lip and palate surgery. A retrospective study was performed by collecting and analyzing data from all patients who were operated for cleft lip and/or palate in the Maxillo-Facial Department of the Emergency Clinical County Hospital of Cluj-Napoca, Romania, between 2010 and 2020. We investigated the existing evidence for possible links between the number of fistulae observed after the primary palatoplasty and the age at which the primary palatoplasty was performed, the sex of the patient, the type of cleft, the timing of the surgical corrections, and the presence of comorbidities. A total of 137 cases were included for analysis. A significant link between the number of fistulae and the type of cleft was found (with fistulae occurring more frequently after the surgical correction of CLP-p < 0.001). No evidence was found for the existence of significant links between the number of fistulae and the patient's sex, the timing of surgery, or the presence of comorbidities. This study concluded that the incidence of palatal fistulae appears to be influenced by the type of cleft (CLP), but not by the sex of the patient, the timing of surgery, or the presence of comorbidities.


Assuntos
Fenda Labial , Fissura Palatina , Fenda Labial/epidemiologia , Fenda Labial/cirurgia , Fissura Palatina/epidemiologia , Fissura Palatina/cirurgia , Humanos , Lactente , Prognóstico , Estudos Retrospectivos , Romênia/epidemiologia
15.
Zhonghua Kou Qiang Yi Xue Za Zhi ; 56(7): 697-700, 2021 Jul 09.
Artigo em Chinês | MEDLINE | ID: mdl-34275227

RESUMO

To evaluate the efficacy of rotation cross-advancement flap method in repairing the nasolabial deformity of complete unilateral cleft lip. A retrospective study was performed to analyze the children who were treated by using the rotating cross-advancement flap for repairing the complete unilateral cleft lip at the Fujian Medical University Union Hospital from October 2018 to July 2019. The clinical data such as patient's lip height, lip length, nostril height, nostril width, nostril area and so on were collected at the pre-operation, post-operation and following-up visits respectively and used to evaluate the efficacy of the treatment. Six children were included in the present study. The ratios of lip height on noncleft side to cleft side were 2∶1 at the pre-operation time. The ratios of nostril height on the noncleft side to the cleft side were about 2∶1. The ratios of the width and the area of the nostril were 1∶2 to 1∶3. At the post-operation time, the ratios of length and height of the lip at the cleft side to the noncleft side were around 1∶1. The shape of the nostrils and nasolabial fold were almost symmetrical between the cleft side and noncleft side. The shapes of the nasal sill were acceptable and the postoperative scars were not obvious. There were no obvious incision healing complications and the treatment effects were satisfactory. Rotation cross-advancement flap method was safe and reliable for repairing the nasolabial deformities in children with complete unilateral cleft lip.


Assuntos
Fenda Labial , Criança , Fenda Labial/cirurgia , Humanos , Nariz/cirurgia , Estudos Retrospectivos , Rotação , Retalhos Cirúrgicos , Resultado do Tratamento
16.
BMC Pediatr ; 21(1): 309, 2021 07 09.
Artigo em Inglês | MEDLINE | ID: mdl-34243736

RESUMO

BACKGROUND: When evaluating speech in children with cleft palate with or without cleft lip (CP/L), children with known syndromes and/or additional malformations (CP/L+) are usually excluded. The aim of this study was to present speech outcome of a consecutive series of 5-year-olds born with CP/L, and to compare speech results of children with CP/L + and children with CP/L without known syndromes and/or additional malformations (CP/L-). METHODS: One hundred 5-year-olds (20 with CP/L+; 80 with CP/L-) participated. All children were treated with primary palatal surgery in one stage with the same procedure for muscle reconstruction. Three independent judges performed phonetic transcriptions and rated perceived velopharyngeal competence from audio recordings. Based on phonetic transcriptions, percent consonants correct (PCC) and percent non-oral errors were investigated. Group comparisons were performed. RESULTS: In the total group, mean PCC was 88.2 and mean percent non-oral errors 1.5. The group with bilateral cleft lip and palate (BCLP) had poorer results on both measures compared to groups with other cleft types. The average results of PCC and percent non-oral errors in the CP/L + group indicated somewhat poorer speech, but no significant differences were observed. In the CP/L + group, 25 % were judged as having incompetent velopharyngeal competence, compared to 15 % in the CP/L- group. CONCLUSIONS: The results indicated relatively good speech compared to speech of children with CP/L in previous studies. Speech was poorer in many children with more extensive clefts. No significant differences in speech outcomes were observed between CP/L + and CP/L- groups.


Assuntos
Fenda Labial , Fissura Palatina , Criança , Pré-Escolar , Fenda Labial/complicações , Fenda Labial/cirurgia , Fissura Palatina/complicações , Fissura Palatina/cirurgia , Humanos , Fala , Síndrome
17.
Rev. Soc. Odontol. La Plata ; 31(60): 7-12, jul. 2021. ilus
Artigo em Espanhol | LILACS | ID: biblio-1284434

RESUMO

Objetivo: Describir el plan de tratamiento completo para el manejo de pacientes con fisura labio alvéolo palatina (F.L.A.P.), basado en nuestra experiencia clínica de más de 40 años. Casos clínicos: En nuestro protocolo consideramos fundamental el tratamiento ortopédico, teniendo en cuenta los tiempos de crecimiento y desarrollo del maxilar superior de cada paciente, para luego aplicar las técnicas quirúrgicas en un maxilar armónico, con un éxito más predecible. Se describirá una serie de casos clínicos con seguimiento de pacientes. Conclusión: Con este protocolo que pregonamos desde hace muchos años, nos diferenciamos principalmente de otras propuestas por considerar los tiempos biológicos de cada paciente en cuanto a crecimiento y desarrollo, y no por basarnos en tiempos quirúrgicos preestablecidos. Aplicando este protocolo obtenemos resultados predecibles que entendemos que solo son posibles de evaluar, al realizar el seguimiento del paciente hasta completar su desarrollo (AU)


Objective: To describe the comprehensive treatment plan aimed at managing patients with cleft lip and palate (CLP) on the basis of our more than forty years of clinical experience. Case reports: e orthopedic treatment is deemed fundamental in the present protocol, which takes into account the maxilla growth and development periods of each individual patient, to later perform a surgical technique in a harmonized maxilla, with a more predictable success. Clinical cases with the patient follow-up shall be described. Conclusion: e main difference between the present protocol that has been held for many years and others proposed approaches mainly lies in considering the unique growth and developmental biological stages of each patient and not in drawing on pre-established surgical timing. When applying this protocol, predictable results are achieved and they are only meant possible to be assessed during the thorough patient follow-up (AU)


Assuntos
Humanos , Masculino , Feminino , Recém-Nascido , Lactente , Pré-Escolar , Criança , Adolescente , Adulto , Obturadores Palatinos , Fenda Labial/cirurgia , Fissura Palatina/cirurgia , Ortopedia/métodos , Equipe de Assistência ao Paciente , Periósteo/cirurgia , Desenvolvimento Maxilofacial
19.
J Clin Pediatr Dent ; 45(3): 204-207, 2021 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-34192752

RESUMO

OBJECTIVE: To investigate the effect of lip closure on reduction of cleft palates when no pre-surgical infant orthopedics (PSIO) are used. STUDY DESIGN: Retrospective patient chart-review in our department for Cranio-Maxillofacial Surgery at the University Medical Centre Freiburg, Germany. 19 patients at the age of 5.9 ± 2.1 months with surgical treatment of uni- (UCLP), or bilateral cleft lip and palate (BCLP) without any use of PSIO were included. RESULTS: Early soft tissue correction of the lip leads to an effective reduction of the maxillary arch without any use of PSIO. The presented conventional and digital measurements appeared to be reliable. A successful reduction of the cleft width (UCLP = 3.88 ± 2.42mm, BCLP = 7.33 ± 5.00mm), the width of the alveolar arch (1.91 ± 1.36mm) and the sagittal depth of the alveolar arch (3.07 ± 2.71 mm) could be achieved with the presented workflow. CONCLUSIONS: Cleft reduction was obtainable without PSIO when lip closure after Tennison-Randall was performed.


Assuntos
Fenda Labial , Fissura Palatina , Ortopedia , Fenda Labial/cirurgia , Fissura Palatina/cirurgia , Arco Dental , Humanos , Lactente , Estudos Retrospectivos
20.
Cleft Palate Craniofac J ; 58(7): 888-893, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-34128403

RESUMO

OBJECTIVE: This study aims to document the experience of an indigenous surgical mission on the occurrence of unrepaired cleft in 2 visits to Minna, North-Central Nigeria. DESIGN: This retrospective study involved participants with orofacial cleft anomaly at 2 surgical outreaches held in Minna in 2011 and 2017. Baseline data were initially obtained from case files of patients at both programs. Data collected were analyzed employing appropriate statistical tests for continuous and categorical variables. SETTING: Two outreach programs in Minna, North-Central Nigeria by Cleft and Facial Deformity Foundation in 2011 and 2017. RESULTS: A total of 117 participants with cleft anomaly were encountered at both surgical outreach programs. The sample prevalence of unrepaired cleft was 61.5% with an overall mean age (standard deviation) of 10 (13.2) years. Most participants presented with unilateral complete cleft lip (70.8%) which was more common on the left side and had no family history of orofacial cleft (54.2%). Information on the surgical program was mostly obtained via friends and relatives in 32.6% and lack of wherewithal to offset the expense of cleft surgery and supportive treatment represented the most common reason for the delay of surgical repair (50%). CONCLUSION: We found a high proportion of patients with unrepaired cleft in our sample which may mirror happenings in other developing world centers. We advocate continued collaborations between indigenous missions and international funding agencies to further encourage continued repair of unrepaired cleft in developing centers.


Assuntos
Fenda Labial , Fissura Palatina , Criança , Fenda Labial/epidemiologia , Fenda Labial/cirurgia , Fissura Palatina/epidemiologia , Fissura Palatina/cirurgia , Humanos , Nigéria , Prevalência , Estudos Retrospectivos
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