Auditory and language skills in children with cleft lip and palate.

OBJECTIVES: to investigate auditory and language skills in children with repaired cleft lip and palate. METHODS: The sample was composed of 22 children registered at the hospital where the study was conducted, seven to nine years old, 50% being female, with repaired unilateral cleft lip and palate (right or left), without associated malformations. Auditory skills were assessed using four central auditory processing tests: Random Gap Detection Test, Dichotic Digit Test, Dichotic Non-Verbal Test, Sustained Auditory Attention Ability Test. Language performance was evaluated by four standardized instruments: Illinois Psycholinguistic Skills Test, Peabody Picture Vocabulary Test, Token Test and Phonological Skills Profile. The association between auditory and language skills was evaluated by the Fisher exact test at a significance level of 5% (p<.05). RESULTS: The central auditory processing tests evidenced that only one child presented adequate performance in all skills analysed, five children presented impaired performance in all skills, and 16 exhibited deteriorations in one to three auditory skills, highlighting that temporal resolution was the most impaired skill (81%). Concerning language, three children presented adequate performance in all tests applied, and Visual Association and Auditory Association were the most impaired skills (40%). No association was observed between deteriorations in auditory and language skills. CONCLUSION: There was high occurrence of impairment of auditory skills, which compose the central auditory processing, as well as of language skills, with greatest impairment of receptive language.

Auditory and language skills in children with cleft lip and palate.

OBJECTIVES: to investigate auditory and language skills in children with repaired cleft lip and palate. METHODS: The sample was composed of 22 children registered at the hospital where the study was conducted, seven to nine years old, 50% being female, with repaired unilateral cleft lip and palate (right or left), without associated malformations. Auditory skills were assessed using four central auditory processing tests: Random Gap Detection Test, Dichotic Digit Test, Dichotic Non-Verbal Test, Sustained Auditory Attention Ability Test. Language performance was evaluated by four standardized instruments: Illinois Psycholinguistic Skills Test, Peabody Picture Vocabulary Test, Token Test and Phonological Skills Profile. The association between auditory and language skills was evaluated by the Fisher exact test at a significance level of 5% (p<.05). RESULTS: The central auditory processing tests evidenced that only one child presented adequate performance in all skills analysed, five children presented impaired performance in all skills, and 16 exhibited deteriorations in one to three auditory skills, highlighting that temporal resolution was the most impaired skill (81%). Concerning language, three children presented adequate performance in all tests applied, and Visual Association and Auditory Association were the most impaired skills (40%). No association was observed between deteriorations in auditory and language skills. CONCLUSION: There was high occurrence of impairment of auditory skills, which compose the central auditory processing, as well as of language skills, with greatest impairment of receptive language.

Itinerário terapêutico de crianças com fissura labiopalatina / Itinerario terapéutico del niño con labio y paladar hendido / Therapeutic itinerary of children with cleft lip and palate

Resumo Objetivo conhecer o itinerário terapêutico de crianças com fissuras de lábio e/ou palato. Método estudo descritivo de natureza qualitativa realizado com famílias de crianças com fissura labiopalatina. A coleta de dados ocorreu entre junho e julho de 2022 por meio de entrevistas semiestruturadas, e aplicou-se a análise de conteúdo temática. Resultados participaram oito famílias e emergiram três categorias: I) Enfrentando o desconhecido: diagnóstico de fissura labiopalatina na criança - notaram-se sentimentos de choque, medo e incerteza que permeiam durante o diagnóstico precoce ou tardio; II) Um caminho árduo: pausas e recomeços durante o itinerário terapêutico - observou-se que as famílias percorreram caminhos diferentes devido à especificidade da configuração familiar e da própria fissura; III) Tecendo a rede de apoio para o cuidado - mostrou-se ser de extrema necessidade o apoio dos amigos, família, profissionais e instituições de saúde. Conclusões e implicações para prática o itinerário terapêutico de crianças com fissura labiopalatina é árduo e acompanhado de desafios, que se iniciam no diagnóstico e permanecem após o nascimento. Espera-se que os resultados deste estudo suscitem o diálogo entre os profissionais de saúde e se familiarizem com as necessidades dessa população e possam atuar nos diferentes pontos de atenção à saúde.

Resumen Objetivo conocer el itinerario terapéutico de los niños con labio hendido y/o paladar hendido. Método estudio cualitativo descriptivo realizado con familias de niños con labio y paladar hendido. La recolección de datos se realizó entre junio y julio de 2022 mediante entrevistas semiestructuradas, y se aplicó análisis de contenido temático. Resultados participaron ocho familias y surgieron tres categorías: I) Frente a lo desconocido: diagnóstico de labio y paladar hendido en niños: se observaron sentimientos de shock, miedo e incertidumbre que permean durante el diagnóstico temprano o tardío; II) Un camino arduo: pausas e inicios durante el itinerario terapéutico - se observó que las familias siguieron caminos diferentes debido a la especificidad de la configuración familiar y de la propia hendidura; III) Tejer la red de apoyo para la atención: el apoyo de amigos, familiares, profesionales e instituciones de salud resultó ser extremadamente necesario. Conclusiones e implicaciones para la práctica el itinerario terapéutico de los niños con labio y paladar hendido es arduo y está acompañado de desafíos, que comienzan desde el diagnóstico y continúan después del nacimiento. Se espera que los resultados de este estudio fomenten el diálogo entre los profesionales de la salud y conozcan las necesidades de esta población y puedan actuar en los diferentes puntos de la atención en salud.

Abstract Objective to understand the therapeutic itinerary of children with cleft lip and/or palate. Method a descriptive qualitative study carried out with families of children with cleft lip and palate. Data collection took place between June and July 2022 through semi-structured interviews, and thematic content analysis was applied. Results eight families participated and three categories emerged: I) Facing the unknown: diagnosis of cleft lip and palate in children - feelings of shock, fear and uncertainty were noted that permeate during early or late diagnosis; II) An arduous path: pauses and beginnings during the therapeutic itinerary - it was observed that the families followed different paths due to the specificity of the family configuration and the cleft itself; III) Weaving the support network for care - support from friends, family, professionals and health institutions proved to be extremely necessary. Conclusions and implications for practice the therapeutic itinerary of children with cleft lip and palate is arduous and followed by challenges, which begin at diagnosis and continue after birth. It is hoped that the results of this study will encourage dialogue among health professionals and become familiar with the needs of this population and be able to act at different points of health care.

[Anesthesia in a child operated for cleft lip associated with Patau's syndrome]. / Anestesia em criança operada para lábio leporino associado à síndrome de Patau.

Patients with Patau's syndrome (Trisomy 13) have multiple craniofacial, cardiac, neurological and renal anomalies with very less life expectancy. Among craniofacial anomalies cleft lip and palate are common. These craniofacial and cardiac anomalies present difficulties with anesthesia. We therefore describe the anesthetic management in the case of a Trisomy 13 child for operated for cleft lip at 10 months of age.

[Ketamine as an adjunct to bupivacaine in infra-orbital nerve block analgesia after cleft lip repair]. / Cetamina como adjuvante de bupivacaína em bloqueio do nervo infraorbitário para analgesia após correção de lábio leporino.

OBJECTIVES: We conducted this study to investigate the safety and analgesic efficacy of the addition of Ketamine to Bupivacaine in bilateral extra-oral infra-orbital nerve block in children undergoing cleft lip surgeries. METHODS: Sixty patients were randomly allocated into two groups (n=30), Group B received infra-orbital nerve block with 2mL of 0.25% Bupivacaine and Group BK received 0.5mg.kg-1 Ketamine for each side added to 1mL of 0.5% Bupivacaine solution diluted up to 2mL solution to 0.25% Bupivacaine concentration. Assessment parameters included; hemodynamics, recovery time, time to first oral intake, postoperative Faces Legs Activity Cry Consolability (FLACC) scores, Four-point Agitation scores, analgesic consumption and adverse effects. RESULTS: Patients in Group BK showed lower postoperative FLACC scores during all recorded time points (p<0.0001). Two patients in Group BK versus 12 in Group B requested for postoperative rescue analgesia (p<0.001). There were no differences between groups in time, minutes (min), to first request for rescue analgesia. Patients in Group BK reported lower analgesic consumption (366.67±45.67 vs. 240.0±0.0mg, p<0.04). The time to first oral intake was significantly reduced in Group BK (87.67±15.41 vs. 27.33±8.68min, p<0.001). Lower postoperative Agitation scores were recorded in Group BK patients that reached a statistical significance at 45min (0.86±0.11 vs. 0.46±0.16, p<0.04) and in the first hour (h) postoperatively (1.40±0.17 vs. 0.67±0.14, p<0.003). Higher parent satisfaction scores were recorded in Group BK (p<0.04) without significant adverse effects. CONCLUSIONS: The addition of Ketamine to Bupivacaine has accentuated the analgesic efficacy of infra-orbital nerve block in children undergoing cleft lip repair surgeries.

Vírus e fissuras orofaciais: um histórico isolado e de associação / Viruses and orofacial clefts: an isolated and associational history / Virus y fisuras orofaciales: una historia aislada y asociativa

Os vírus são microrganismos comumente associados as doenças e infectam todos os seres vivos. Atuam de forma direta e indireta levando a pressão seletiva, com papel significativo e ainda em exploração no planeta. As fissuras orofaciais são anomalias congênitas de etiologia complexa e multifatorial, sendo as infecções virais durante a gestação um dos possíveis fatores etiológicos. A história da humanidade frente aos vírus e fissuras orofaciais de forma isolada é vasta, remontando a períodos antes de Cristo, seja por meio de leis para o controle de pragas e/ou por lendas de míticas criaturas deificadas e/ou demonizadas, cuja criação está fundamentada na Teoria Alegórica do surgimento das mitologias, demonstrando assim o interesse do ser humano e sua curiosidade em inovação e explicação destes assuntos. Considerando a relevância histórica, bem como a possível relação etiológica destes dois elementos, uma revisão da literatura foi realizada para apresentar a história mitológica e científica dos vírus e fissuras orofaciais, de forma isolada e associadas para fins de comparação. Para isso, foram utilizadas as bases PubMed/Medline, SciElo, LILACS e Portal Periódicos (CAPES) com os descritores: Virus, Anomalias/Anomalies, Virus and Anomalias/Virus and Anomalies, A History of viruses/História dos vírus, Virus and History/História and Virus, Virus and Myth/Virus and Mito, Anomalias and Mitos/Anomalies and Myths, Vampires and Virus/Vampiros and Virus. Enquanto o histórico mitológico é cheio de teorias contraditórias, o histórico cientifico acadêmico se revela coerente, porém resistente as novas áreas de atuação, não ponderando novas possibilidades e limitando a exploração científica, que só pôde ser alcançada nos séculos atuais. Quanto a associação, a linha de pesquisa relacionando vírus e fissuras orofaciais não possui nem meio século de existência, propiciando um grande campo a ser explorado e na mesma medida limitando os benefícios em prevenção que poderiam ser obtidos através destes estudos.

Viruses are microorganisms commonly associated with diseases that infect all living beings, they act directly and indirectly leading to selective pressure, their role on the planet is significant and still under exploration. Orofacial clefts are congenital anomalies that have a complex multifactorial etiology, with viral infections during pregnancy being one of the possible etiological factors. The history of humanity in the face of viruses and orofacial clefts in isolation is vast, dating back to periods before Christ, whether through laws for pest control and/or legends of mythical deified and/or demonized creatures, whose creation is fundamentalized in the Allegorical Theory of the emergence of mythologies, thus demonstrating the interest of human beings and their curiosity in innovation and explanation of these subjects. Considering the historical relevance, as well as the possible etiology relationship of these two elements, we carried out a literature review to present the mythological and scientific history of viruses and orofacial clefts, isolated and associated for comparison purposes. For this intent, the bases PubMed/Medline, SciElo, LILACS and Portal Periódicos (CAPES) were selected with the descriptors: A History of viruses/História dos vírus, Virus and History/História and Virus, Virus and Myth/Virus and Mito, Anomalias and Mitos/Anomalies and Myths, Vampires and Virus/Vampiros and Virus. While the mythological history is full of contradictory theories, the academic, scientific history proves to be consistent, but resistant to new areas of action, not considering new possibilities and limiting scientific exploration, which can only be achieved in the present centuries. As for the association, the line of research relating viruses and orofacial clefts does not even have half a century of existence, providing a large field to be explored and at the same time limiting the benefits of prevention that could be obtained through these studies.

Los virus son microorganismos comúnmente asociados a enfermedades que infectan a todos los seres vivos, actúan directa e indirectamente provocando presión selectiva, su papel en el planeta es significativo y aún en exploración. Las hendiduras orofaciales son anomalías congénitas que tienen una compleja etiología multifactorial, siendo las infecciones virales durante el embarazo uno de los posibles factores etiológicos. La historia de la humanidad frente a los virus y las hendiduras orofaciales de forma aislada es vasta, remontándose a períodos anteriores a Cristo, ya sea a través de leyes para el control de plagas y/o leyendas de criaturas míticas deificadas y/o demonizadas, cuya creación se fundamentaliza en la Teoría Alegórica del surgimiento de las mitologías, demostrando así el interés del ser humano y su curiosidad en la innovación y explicación de estos temas. Considerando la relevancia histórica, así como la posible relación etiológica de estos dos elementos, realizamos una revisión bibliográfica para presentar la historia mitológica y científica de los virus y las hendiduras orofaciales, aislados y asociados para fines de comparación. Para ello, se seleccionaron las bases PubMed/Medline, SciElo, LILACS y Portal Periódicos (CAPES) con los descriptores: A History of viruses/História dos vírus, Virus and History/História and Virus, Virus and Myth/Virus and Mito, Anomalias and Mitos/Anomalías y Mitos, Vampiros and Virus/Vampiros y Virus. Mientras que la historia mitológica está llena de teorías contradictorias, la historia académica, científica, se muestra coherente, pero resistente a nuevos campos de actuación, no considerando nuevas posibilidades y limitando la exploración científica, que sólo puede alcanzarse en los siglos actuales. En cuanto a la asociación, la línea de investigación que relaciona virus y hendiduras orofaciales no tiene ni medio siglo de existencia, proporcionando un gran campo a ser explorado y al mismo tiempo limitando los beneficios de prevención que podrían ser obtenidos a través de estos estudios.

Enxerto ósseo alveolar autógeno associado a biomateriais em fissura lábio palatina / Injerto óseo alveolar autógeno asociado a biomateriales en labio y paladar hendido / Autogenous alveolar bone graft associated with biomaterials in cleft lip and palate

Objetivo: Discutir a utilização do enxerto ósseo autógeno associado a biomateriais na reconstrução de defeito ósseo alveolar em paciente com fissura lábio palatina. Relato de caso: Paciente, 09 anos de idade, em tratamento no Serviço Integrado de Reabilitação de Anomalias Craniofaciais do Hospital São Marcos, Teresina - Piauí - Brasil, apresentando fissura lábio palatina unilateral, completa à esquerda, não sindrômica, submetido à queiloplastia aos 03 meses de idade, e palatoplastia aos 18 meses, resultando como sequela uma fístula oronasal, corrigida cirurgicamente quando a paciente completou 07 anos de idade. Aos 09 anos, realizou-se a cirurgia com enxerto ósseo alveolar, com osso autógeno associado a osso mineral tipo (Bio-Oss, Geistlich), protegido com membrana de colágeno (Bio-Gide, Geistlich) e membrana de Fibrina Rica em Plaqueta (PRF). Conclusão: O enxerto ósseo alveolar utilizando osso autógeno associado a osso mineral bovino, membrana de colágeno e membrana de Fibrina Rica em Plaquetas (PRF) assim como a intervenção cirúrgica na faixa etária citada na literatura mostraram-se eficientes para se atingir o sucesso terapêutico... (AU)

Objetivo: Discutir el uso de injerto óseo autógeno asociado a biomateriales en la reconstrucción del defecto óseo alveolar en un paciente con labio y paladar hendido. Reporte de caso: Paciente de 09 años de edad, en tratamiento en el Servicio Integrado de Rehabilitación de Anomalías Craneofaciales del Hospital São Marcos, Teresina - Piauí - Brasil, presentando labio y paladar hendido unilateral, completo a la izquierda, no sindrómico, sometido a queiloplastia a los 03 meses de edad, y palatoplastia a los 18 meses, resultando como secuela una fístula oronasal, corregida quirúrgicamente cuando el paciente completó 07 años de edad. A los 09 años de edad, se realizó una intervención quirúrgica con injerto óseo alveolar, con hueso autógeno asociado de tipo mineral (Bio-Oss, Geistlich), protegido con membrana de colágeno (Bio-Gide, Geistlich) y Membrana de Fibrina Rica en Plaquetas (PRF). Conclusión: El injerto óseo alveolar utilizando hueso autógeno asociado a hueso mineral bovino, membrana de colágeno y Membrana de Fibrina Rica en Plaquetas (PRF), así como la intervención quirúrgica en el rango de edad citado en la literatura, se mostraron eficientes para lograr el éxito terapéutico... (AU)

Objective: To discuss the use of autogenous bone graft associated with biomaterials in the reconstruction of alveolar bone defect in a patient with cleft lip and palate. Case Report: Patient, 09 years old, under treatment at the Integrated Service for Rehabilitation of Craniofacial Anomalies of the Hospital São Marcos, Teresina - Piauí - Brazil, presenting unilateral cleft lip and palate, complete to the left, not syndromic, underwent cheiloplasty at 03 months of age, and palatoplasty at 18 months, resulting as a sequela an oronasal fistula, surgically corrected when the patient turned 07 years old. At 09 years of age, surgery was performed with alveolar bone grafting, with autogenous bone associated with mineral bone type (Bio-Oss, Geistlich), protected with collagen membrane (Bio-Gide, Geistlich) and Platelet Rich Fibrin (PRF) membrane. Conclusion: Alveolar bone grafting using autogenous bone associated with bovine mineral bone, collagen membrane and Platelet Rich Fibrin Membrane (PRF) as well as surgical intervention in the age range cited in the literature were shown to be efficient in achieving therapeutic success... (AU)

Fisura labio palatina: revisión de la literatura / Cleft lip and palate: literature review

La formación del paladar ocurre entre la quinta y undécima semana de vida intrauterina producto de la unión del paladar primario y secundario. Por otra parte, la formación del labio superior ocurre entre la quinta y sexta semana del desarrollo, y se configura en su parte media por la fusión de los procesos nasales mediales y lateralmente, a expensas de los procesos maxilares. La prevalencia de las fisuras labiales y/o fisura palatina varía según las distintas etnias, con cifras entre 0,7 hasta 1,1 casos por 1000 nacidos vivos. El objetivo de este trabajo fue realizar una revisión bibliográfica sobre aspectos epidemiológicos, mecanismos genéticos moleculares y ambientales que influyen en la ocurrencia de la fisura labial, fisura palatina y fisura labio palatina. La búsqueda bibliográfica se realizó en las bases de datos PUBMED, SCOPUS, SPRINGER, SCIENCEDIRECT utilizando los términos en inglés "cleft lip and palate", "cleft lip", "cleft palate" y "embriology". Entre los criterios de inclusión se consideraron estudios realizados en humanos y animales, publicados entre los años 2015 y 2021. La búsqueda arrojó un total de 407 trabajos, de los cuales tras un filtro por título y resumen quedaron un total de 38 artículos, en los cuales se realizó un análisis de texto completo para finalmente seleccionar 26 artículos que abarcan temas genéticos-moleculares, ambientales, epidemiológicos y sindrómicos. Además se incorporaron por búsqueda manual, 6 documentos asociados a libros de texto, y artículos científicos, sin considerar el criterio inclusión de tiempo. Dentro de esta revisión se describe la fuerte asociación entre las fisuras orales y las mutaciones de genes Msx1, sonic hedgehog, proteínas morfogenéticas óseas y factor de crecimiento fibroblástico durante la migración de las células de la cresta neural y la modelación y formación del paladar. La ausencia de ácido fólico durante el desarrollo del paladar y la presencia de hipoxia por exposición a humo, son los factores ambientales observados con mayor frecuencia en malformaciones orofaciales.

SUMMARY: Palate formation occurs between the fifth and eleventh week of intrauterine life as a result of the union of the primary and secondary palate. On the other hand, the formation of the upper lip occurs between the fifth and sixth week of development, and is configured in its middle part by the fusion of the medial and lateral nasal processes, at the expense of the maxillary processes. The prevalence of cleft lips and / or cleft palate varies according to the different ethnic groups, with figures ranging from 0.7 to 1.1 cases per 1000 live births. The aim of this work was to carry out a literature review on epidemiological aspects, molecular and environmental genetic mechanisms that influence the occurrence of cleft lip, cleft palate and its embriology. The literature search was carried out in the databases PUBMED, SCOPUS, SPRINGER, SCIENCEDIRECT using the English terms "cleft lip and palate", "cleft lip", "cleft palate" and "embryology". Inclusion criteria included studies carried out in humans and animals, published between 2015 and 2021. The search yielded a total of 407 works, of which after a filter by title and abstract, a total of 38 articles remained, in which a text analysis was carried out complete to finally select 26 articles that cover genetic-molecular, environmental, epidemiological and syndromic topics. In addition, 6 documents associated with textbooks and scientific articles were incorporated by manual search, without considering the inclusion criterion of time. This review describes the strong association between oral fissures and mutations of genes Msx1, sonic hedgehog, bone morphogenetic proteins and fibroblast growth factor during migration of neural crest cells and palate shaping and formation. Lack of folic acid during palae development dar and the presence of hypoxia due to exposure to smoke, are the environmental factors most frequently observed in orofacial malformations.

Auditory and language skills in children with cleft lip and palate

Objectives: to investigate auditory and language skills in children with repaired cleft lip and palate. Methods: The sample was composed of 22 children registered at the hospital where the study was conducted, seven to nine years old, 50% being female, with repaired unilateral cleft lip and palate (right or left), without associated malformations. Auditory skills were assessed using four central auditory processing tests: Random Gap Detection Test, Dichotic Digit Test, Dichotic Non-Verbal Test, Sustained Auditory Attention Ability Test. Language performance was evaluated by four standardized instruments: Illinois Psycholinguistic Skills Test, Peabody Picture Vocabulary Test, Token Test and Phonological Skills Profile. The association between auditory and language skills was evaluated by the Fisher exact test at a significance level of 5% (p<.05). Results: The central auditory processing tests evidenced that only one child presented adequate performance in all skills analysed, five children presented impaired performance in all skills, and 16 exhibited deteriorations in one to three auditory skills, highlighting that temporal resolution was the most impaired skill (81%). Concerning language, three children presented adequate performance in all tests applied, and Visual Association and Auditory Association were the most impaired skills (40%). No association was observed between deteriorations in auditory and language skills. Conclusion: There was high occurrence of impairment of auditory skills, which compose the central auditory processing, as well as of language skills, with greatest impairment of receptive language.(AU)

Objetivos: Investigar las habilidades auditivas y lingüísticas en niños con labio leporino y paladar reparados. Métodos: La muestra se compuso de 22 niños registrados en el hospital en el que se realizó el estudio, de 7 a 9 años de edad, siendo el 50% niñas con labio leporino unilateral y paladar (derecho o izquierdo) reparados, sin malformaciones. Las habilidades auditivas se evaluaron utilizando 4 pruebas de procesamiento auditivo central: Random Gap Detection Test, Dichotic Digit Test, Dichotic Non-Verbal Test y Sustained Auditory Attention Ability Test. El desempeño lingüístico se evaluó utilizando diversos instrumentos estandarizados: Illinois Psycholinguistic Skills Test, Peabody Picture Vocabulary Test, Token Test y Phonological Skills Profile. La asociación entre las habilidades auditivas y lingüísticas se evaluó mediante la prueba exacta de Fisher, con un nivel de significación del 5% (p<0,05). Resultados: Las pruebas de procesamiento auditivo central evidenciaron que solo un niño presentó un desempeño adecuado en todas las habilidades analizadas, 5 niños presentaron una alteración del desempeño en todas las habilidades y 16 niños mostraron alteraciones en una de las 3 habilidades auditivas, subrayando que la resolución temporal fue la habilidad más deficiente (81%). Con relación al lenguaje, 3 niños presentaron un desempeño adecuado en todas las pruebas aplicadas, siendo las habilidades más deficientes la asociación visual y la asociación auditiva (40%). No se observó asociación entre las alteraciones de las habilidades auditivas y lingüísticas. Conclusión: Existió una alta incidencia de alteraciones de las habilidades auditivas que componen el procesamiento auditivo central, así como habilidades lingüísticas con gran alteración del lenguaje receptivo.(AU)

Modificación de Mulliken en la reparación de la fisura labial unilateral incompleta en Matanzas, 2016-2018 / Mulliken modification in the repair of incomplete unilateral cleft lip in Matanzas, 2016-2018

RESUMEN El impacto biológico, social, económico y psicológico que acarrea la fisura labial conlleva a aplicar nuevas modificaciones en la corrección quirúrgica de sus técnicas de tratamiento. El objetivo de esta investigación fue evaluar los resultados de la técnica quirúrgica de Rotación y Avance de Millard modificada por Mulliken en la corrección de la fisura labial unilateral incompleta en Matanzas. Se realizó un estudio de casos, longitudinal, prospectivo en el Hospital Docente Pediátrico «Eliseo Noel Caamaño¼ de Matanzas, entre 2016 y 2018. El universo estuvo constituido por menores de un año diagnosticados de fisura labial unilateral incompleta, que asistieron a la consulta de Cirugía Maxilofacial de dicho hospital, en el período en que se realizó la investigación y en los que para su tratamiento se empleó la técnica de Rotación y Avance de Millard modificada por Mulliken. Se trabajó con la totalidad del universo. Se utilizó estadística descriptiva. Los pacientes fueron intervenidos entre los 5 y 9 meses, predominó el color de piel blanca (75 %) y el sexo masculino (75 %). La altura labial y el ancho heminasal aumentaron más en el lado sano que en el fisurado. Al año de la intervención en el lado fisurado creció más el ancho transversal que en el sano en dos de los casos y también existió una diferencia mayor de 1 mm en la altura del bermellón. Se logró alcanzar simetría nasolabial en espejo del lado sano en todas las variables, excepto en la altura del bermellón en dos casos.

ABSTRACT The biological, social, economic and psychological impact caused by cleft lip leads to the application of new modifications in the surgical correction of its treatment techniques. The objective of this research was to evaluate the results of the Millard's rotation-advancement surgical technique modified by Mulliken in the correction of incomplete unilateral cleft lip in Matanzas. A longitudinal, prospective study was conducted at "Eliseo Noel Caamaño" Pediatric Teaching Hospital, in Matanzas between 2016 and 2018. The universe was made up of children under one year of age diagnosed with incomplete unilateral cleft lip, who come to the Maxillofacial Surgery consultation of this hospital, in the period in which the investigation was carried out and in whom, Millard 's rotation-advancement surgical technique modified by Mulliken was used for their treatment. We worked with the entire universe. Descriptive statistics was used. The patients underwent surgery between 5 and 9 months, white skin color (75%) and male gender (75%) predominated. Labial height and heminasal width increased more on the healthy side than on the cleft side. One year after the intervention, the transverse width grew more on the cleft side than on the healthy side in two of the cases, and there was also a difference greater than 1 mm in the vermilion height. Mirror-image nasolabial symmetry was achieved on the healthy side in all variables, except for vermilion height in two cases.

Religious/spiritual coping in informal caregivers of children with cleft lip and/or dysphagic palate / Coping religioso/espiritual en cuidadores informales de niños con labio leporino y/o fisura del paladar / Coping religioso/espiritual em cuidadores informais de crianças com fissura de lábio e/ou palato disfágicas

ABSTRACT Objectives: to identify the use of religious/spiritual coping in informal caregivers of children with cleft lip and/or palate, dysphagic, powered exclusively by probe. Methods: descriptive and cross-sectional study, including 30 informal caregivers. For data collection, a Sociodemographic Questionnaire and the Brief Religious/Spiritual Coping Scale were used. For statistical analysis, ANOVA, Student's t and Spearman's correlation tests were used, with a significance level of 5%. Results: the use of religious/spiritual coping was high among participants (mean=3.71), with a predominance of positive (mean=3.30) compared to negative (mean=1.88). It was evident that the greater the reported importance of religiosity/spirituality in the participants' lives, the greater the positive coping (p=0.001). Conclusions: informal caregivers used positive religious/spiritual coping as a way of coping with care demands related to the child's health condition. These findings point to the importance of including spirituality/religiosity as health indicators.

RESUMEN Objetivos: identificar el uso del coping religioso/espiritual en cuidadores informales de niños con labio leporino y/o fisura del paladar alimentado exclusivamente por sonda. Métodos: estudio descriptivo y transversal, incluyendo 30 cuidadores informales. La recolecta de datos, se utilizó una Encuesta Sociodemográfica y Escala de Coping Religioso/Espiritual Breve. Para el análisis estadístico, se utilizaron los test de ANOVA, t de Student y correlación de Spearman, con nivel de significación de 5%. Resultados: uso del coping religioso/espiritual fue alto entre los participantes (mediana=3,71), con predominio del positivo (mediana=3,30) comparado al negativo (mediana=1,88). Evidenciado que, cuanto mayor la importancia relatada de la religiosidad/espiritualidad en la vida de los participantes, mayor fue el coping positivo (p=0,001). Conclusiones: los cuidadores informales utilizaron el coping religioso/espiritual positivo como modalidad de enfrentamiento de demandas de cuidados relacionadas a condición de salud del niño. Esos hallados apuntan la importancia de incluir la espiritualidad/religiosidad como indicadores de salud.

RESUMO Objetivos: identificar o uso do coping religioso/espiritual em cuidadores informais de crianças com fissura de lábio e/ou palato, disfágicas, alimentadas exclusivamente por sonda. Métodos: estudo descritivo e transversal, incluindo 30 cuidadores informais. Para a coleta de dados, utilizou-se um Questionário Sociodemográfico e a Escala de Coping Religioso/Espiritual Breve. Para a análise estatística, utilizaram-se os testes de ANOVA, t de Student e a correlação de Spearman, com nível de significância de 5%. Resultados: o uso do coping religioso/espiritual foi alto entre os participantes (média=3,71), com predomínio do positivo (média=3,30) comparado ao negativo (média=1,88). Evidenciou-se que, quanto maior a importância relatada da religiosidade/espiritualidade na vida dos participantes, maior foi o coping positivo (p=0,001). Conclusões: os cuidadores informais utilizaram o coping religioso/espiritual positivo como modalidade de enfrentamento das demandas de cuidados relacionadas à condição de saúde da criança. Esses achados apontam a importância de incluir a espiritualidade/religiosidade como indicadores de saúde.

Depressão pós-parto em mães de bebês sem e com fissuras labiais, palatinas e labiopalatinas / Postpartum depression in mothers of babies without and with cleft lip and/or palate / Depresión postparto en las madres de bebés sin y con labio y/o paladar hendido

Depressão pós-parto (DPP) é um transtorno que afeta a saúde da mulher e a qualidade da relação mãe-bebê. Este estudo comparou a DPP de mães de bebês sem e com fissuras labiais, palatinas e labiopalatinas, e identificou as variáveis preditoras da DPP considerando a amostra como um todo. Participaram 120 mães, sendo 60 de bebês com fissuras e 60 de bebês sem condição de risco. Para a coleta foram utilizados: protocolo de entrevista e Escala de Depressão Pós-Parto de Edimburgo (EDPE). Resultados apontaram maior incidência de DPP em mães de bebês sem fissura (30%) do que em mães de bebês com fissura (20%). Porém, não houve diferenças estatisticamente significativas entre os grupos. As variáveis que explicaram a ocorrência de DPP foram: menor escolaridade materna, menor número de filhos, ausência de fissura no bebê, maior idade do bebê, e menor condição socioeconômica.

Postpartum depression (PPD) is a disorder that affects women's health and the quality of the mother-baby relationship. This study compared the PPD of mothers of babies without and with cleft lip and/or palate, and identified the predictor variables of PPD considering the sample as a whole. 120 mothers participated, 60 of babies with clefts and 60 of babies without risk condition. For data collection, were used the interview protocol and the Edinburgh Postnatal Depression Scale (EPDS). Results showed a higher incidence of PPD in mothers of babies without cleft (30%) than in mothers of babies with clefts (20%). However, there were no statistically significant differences between groups. The variables that explained the occurrence of PPD were: lower maternal education, fewer children, absence of cleft in the baby, older age of the baby, and lower socio economic status.

La depresión posparto (DPP) es un trastorno que afecta la salud de la mujer y la calidad de la relación madre-bebé. Este estudio comparó la DPP de madres de bebés sin y con labio y/o paladar hendido, e identificó las variables predictoras de DPP considerando la muestra en su conjunto. Participaron 120 madres, 60 de bebés con hendiduras y 60 de bebés sin condiciones de riesgo. Para la recolección de datos se utilizó el protocolo de entrevista y la Edinburgh Postnatal Depression Scale (EPDS). Los resultados mostraron una mayor incidencia de DPP en madres de bebés sin hendidura (30%) que en madres de bebés con hendidura (20%). Sin embargo, no hubo diferencias estadísticamente significativas entre los grupos. Las variables que explicaron la ocurrencia de DPP fueron: menor educación materna, menor número de hijos, ausencia de hendidura en el bebé, mayor edad del bebé y menor nivel socioeconómico.

Queiloplastia por técnica de Fisher: relato de caso / Fisher's cheiloplasty: case report

As fissuras labiopalatinas são as anomalias craniofaciais mais comuns, com uma prevalência mundial de 1 paciente para cada 1000 nascimentos, e de 1 para cada 650 nascidos no Brasil. O presente artigo relata um caso de um paciente com fissura labial unilateral completa, operado pela técnica de Fisher aos 10 meses, detalhando o método cirúrgico. Diversas técnicas de queiloplastias são descritas na literatura, com variáveis resultados estéticos e funcionais. No referido caso a técnica mostrou uma excelente qualidade de cicatriz, permitindo o trabalho fonoaudiológico para melhorar a motricidade oral... (AU)

As cleft lip and palate are the most common craniofacial anomalies, with a worldwide prevalence of 1 patient per 1000 births and 1 per 650 born in Brazil. This article reports a case of a patient with complete unilateral cleft lip, operated by Fisher's technique at 10 months, detailing the surgical method. Several cheiloplasty techniques are described in the literature, with several aesthetic and functional results. In this case, the technique showed an excellent quality of healing, allowing speech therapy to improve oral motor skills... (AU)

Clinical, tomographic, and postmortem aspects of a rare congenital Dicephalus Monauchenos Iniodymus in a Nelore calf produced in vitro from Brazil: case report / Aspectos clínicos, tomográficos e pós-morte de um raro Dicephalus Monauchenos Iniodymus congênito em um bezerro Nelore produzido in vitro no Brasil: relato de caso

The aim of this work was to report the occurrence of dicephalus iniodymus monauchenos in a Nellore newborn. A three-days old calf, from in vitro production, with duplication of the head and a history of cesarean birth was attended. On physical examination, the dicephalus, iniodymus and monauchenos, which were almost the same size and shape, had four eyes and four ears. Computed tomography showed the presence of two skulls fused with a common occipital foramen, two nasopharynxes, oropharynxes with the presence of a cleft lip and a cleft palate in the right head, which continued in a single esophagus and a single trachea. At necropsy, the presence of duplication of the cerebrum and cerebellum was observed, with union of the parts in the region of the trapezoid body of the brainstem and continued as a single spinal cord. This study characterizes the clinical, tomographic, and necropsy findings of a dicephalus Nelore neonate.(AU)

O objetivo deste trabalho foi relatar a ocorrência de Dicephalus Iniodymus Monauchenos em um neonato da raça Nelore de produção in vitro. Foi atendida uma fêmea bovina, de três dias de idade, com duplicação das cabeças e histórico de nascimento por meio de cesariana. No exame físico, observou-se a dicefalia, Iniodymus e Monauchenos, apresentando quatro olhos e quatro orelhas. Na tomografia computadorizada, constatou-se a presença de dois crânios fundidos com um forame occipital comum, duas nasofaringes, orofaringes com presença de lábio leporino e fenda palatina na cabeça direita, que continuavam em um único esôfago e em uma única traqueia. Na necropsia, observou-se a presença de duplicação do encéfalo e cerebelo, com união das partes na região do corpo trapezoide do tronco encefálico, que continuavam como uma única medula espinhal. Este estudo caracteriza os achados clínicos, tomográficos e de necropsia de um neonato Nelore dicefálico.(AU)

Genética de las fisuras labiopalatinas: una visión general de los factores de riesgo genéticos y ambientales / Genetics of Cleft Lip and Palate: An Overview of Genetic and Environmental Risk Factors / Genética de fissura labial e palatina: urna visão geral de atores de risco genético e ambiental

Resumen: las fisuras labiopalatinas son malformaciones congénitas del sistema estomatognático, se presentan por alteración de las estructuras anatómicas del cráneo, la cara y la cavidad bucal, debido a una falla en la fusión de tejidos en la embriogénesis; las malformaciones pueden ser del labio, el paladar duro, el velo del paladar, la mucosa palatina y en algunos casos de la cavidad nasal; por lo demás, afectan las estructuras que participan en las funciones del lenguaje, el habla y la audición. Objetivo: Identificar los factores genéticos y ambientales asociados a las fisuras labiopalatinas. Metodología: la revisión bibliográfica se realizó en bases de datos académicas PubMed, LILACS, OVID-MEDLINE usando lenguaje normalizado con términos DECS-LILACS: exposición a riesgos ambientales, fisura del paladar, labio leporino, genética, medicina de precisión y síndrome; se aplicaron filtros de búsqueda propios de las bases de datos, tipos de textos científicos e información relevante para la investigación. De acuerdo con los resultados de la búsqueda bibliográfica se encontró que la etiología de las fisuras es multifactorial y se asocia a factores genéticos y ambientales. La identificación de diversos genes relacionados con estas malformaciones ha permitido reconocer oportunamente cuándo una fisura es sindrómica o no sindrómica, lo que lleva a entender la interacción gen por gen, a identificar variantes funcionales y a comprender su importancia etiológica. Conclusiones: el estudio y el conocimiento acerca de los mecanismos moleculares que se encuentran involucrados en la formación de las fisuras labiopalatinas ha tomado fuerza gracias al entendimiento del genoma humano y al desarrollo de herramientas modernas de biología molecular que permiten identificar gran cantidad de datos de secuencia, haciendo que los genes candidatos aumenten constantemente. Esto permitirá un manejo oportuno de la enfermedad, la identificación del riesgo de ocurrencia y un tratamiento especializado mediante la medicina de precisión.

Abstract: cleft lip and palate are congenital malformations of the stomatognathic system; they occur due to an alteration of the anatomical structures of the skull, face and oral cavity, due to a failure in the fusion of tissues in embryogenesis; malformations can be of the lip, hard palate, soft palate, palatal mucosa, and in some cases of the nasal cavity; moreover, they affect the structures involved in the functions of language, speech, and hearing. Objective: To identify the genetic and environmental factors associated with cleft lip and palate. Methodology: the bibliographic review was carried out in PubMed, LILACS, OVID-MEDLINE academic databases using standardized language with decs-lilacs terms: exposure to environmental risks, cleft palate, cleft lip, genetics, precision medicine and syndrome; Search filters of the databases, types of scientific texts and information relevant to the research were applied. According to the results of the bibliographic search, it was found that the etiology of the fissures is multifactorial and is associated with genetic and environmental factors. The identification of various genes related to these malformations has made it possible to timely recognize when a cleft is syndromic or non-syndromic, which leads to understanding gene-by-gene interaction, identifying functional variants and understanding their etiological importance. Conclusions: the study and knowledge regarding the molecular mechanisms that are involved in the formation of cleft lip and palate has gained strength thanks to the understanding of the human genome and the development of modern molecular biology tools that allow the identification of large amounts of sequence data, causing the candidate genes to increase constantly.

Resumo: as fissuras labiopalatais são malformações congénitas do sistema estomatognático, ocorrem por alterado das estruturas anatómicas do crânio, face e cavidade oral, por falha na fusão dos tecidos na embriogênese; as malformações podem ser do lábio, palato duro, palato mole, mucosa palatina e, em alguns casos, da cavidade nasal; caso contrário, afetam as estruturas envolvidas nas funções da linguagem, fala e audição. Objetivo: Identificar os fatores genéticos e ambientais associados á fissura labiopalatal. Metodologia: a revisão bibliográfica foi realizada nas bases de dados académicas PubMed, LILACS, OVID-MEDLINE utilizando linguagem normalizada com termos DECS-LILACS: exposição a riscos ambientais, fenda palatina, lábio leporino, genética, medicina de precisão e síndrome; foram aplicados filtros de busca das bases de dados, tipos de textos científicos e informados relevantes para a pesquisa. Segundo os resultados a partir da pesquisa bibliográfica, foi constatado que a etiologia das fissuras é multifatorial e está associada a fatores genéticos e ambientais. A identificado de vários genes relacionados a essas malformações permitiu reconhecer em curto tempo quando urna fissura é sindrómica ou não sindrômica, o que leva ao entendimento da interação gene a gene, identificado de variantes funcionais e compreensão de sua importância etiológica. Conclusóes: o estudo e conhecimento sobre os mecanismos moleculares encontrados envolvidos na formação da fissura labiopalatal ganhou força graças á compreensão do genoma humano e o desenvolvimento de ferramentas modernas de biologia molecular que permitem a identificado de grandes quantidades de dados de sequênces, fazendo com que os genes candidatos aumentem constantemente. Isso permitirá a gestão atempada da doença, identificado do risco de ocorrência e tratamento especializado através da medicina de precisão.

Crecimiento transversal del maxilar con uso de placa ortopédica prequirúrgica en pacientes con fisura labiopalatina / Transverse growth of the maxilla with the use of a presurgical orthopaedic plate in patients with cleft lip and palate

RESUMEN Introducción: la ortopedia prequirúrgica en el tratamiento de la fisura labiopalatina constituye una pauta terapéutica controversial. Los investigadores que están a favor plantean que favorece el cierre de la fisura lo cual facilita la cirugía, y otros apoyan el criterio de limitar el crecimiento maxilar y provocar su colapso. Objetivo: determinar los efectos morfológicos en el crecimiento transversal del maxilar durante el período de uso de la placa ortopédica prequirúrgica en niños con fisura labiopalatina atendidos en el Hospital Provincial Universitario «José Luis Miranda» de Villa Clara, en el período de marzo de 2015 a junio de 2019. Métodos: se realizó un estudio de intervención longitudinal. La muestra estuvo conformada por 34 niños previo consentimiento de sus padres o tutores. La información se obtuvo a través de: la entrevista, el examen clínico y mediciones; se aplicaron pruebas estadísticas como el test de Wilcoxon y el estadístico exacto de Fisher. Resultados: en la muestra estudiada predominaron los pacientes del sexo masculino y la fisura transforamen. Con el uso de la placa ortopédica prequirúrgica el maxilar mostró un crecimiento uniforme con un incremento de 5,6 mm de la distancia intercanina y de 5,2 mm de la distancia postgingival desde el nacimiento hasta la cirugía del paladar. La media de crecimiento entre el nacimiento y la cirugía del labio fue de 2,7 y 2,6 mm para la distancia intercanina y postgingival, respectivamente. Conclusiones: la ortopedia prequirúrgica favorece el crecimiento transversal del maxilar con un incremento uniforme de su ancho anterior y posterior.

ABSTRACT Introduction: presurgical orthopaedics in the treatment of cleft lip and palate constitutes a controversial therapeutic guideline. Researchers who are in favour state that it favours fissure closure which facilitates surgery, and others support the criterion of limiting maxillary growth and causing its collapse. Objective: to determine morphological effects on the transverse growth of the maxilla during the period of use of the presurgical orthopaedic plate in children with cleft lip and palate treated at "José Luis Miranda" Provincial University Hospital in Villa Clara from March 2015 to June 2019. Methods: a longitudinal intervention study was carried out. The sample consisted of 34 children with the prior consent of their parents or guardians. The information was obtained through interview, clinical examination and measurements; Wilcoxon's test and Fisher's exact test were applied as statistical tests. Results: male patients and transforamen fissure predominated in the studied sample. The maxilla showed, with the use of the presurgical orthopaedic plate, a uniform growth with an increase of 5.6 mm in the intercanine distance and a 5.2 mm increase in the post-gingival distance from birth to palate surgery. The mean growth between birth and lip surgery was 2.7 and 2.6 mm for intercanine and post-gingival distance, respectively. Conclusions: presurgical orthopaedics favours transverse growth of the maxilla with a uniform increase in its anterior and posterior width.

Problemas del habla asociados a la disglosia labial y palatal / Speech disorders associated with labial and palatal cleft

RESUMEN Fundamento: según la Organización Mundial de la Salud, el paladar y labio fisurado son malformaciones del aparato estomatognático que producen problemas conocidos como disglosia labial y palatal. Estas afectan a una de las funciones del aparato estomatognático como es la fonación. Objetivo: analizar los problemas bucofonatorios asociados a la disglosia labial y palatal. Métodos: se realizó un estudio de tipo no experimental, descriptivo de corte trasversal. La población de estudio estuvo conformada por 62 pacientes de la Fundación Operación Sonrisa Ecuador, de los cuales se seleccionaron 42 mediante un muestreo no probabilístico intencional. La técnica que se utilizó fue la observación con sus instrumentos la historia clínica y el algoritmo de la escala del habla. Resultados: la escala del habla nasolabial, dentopalatina, test de esfuerzo y el total mostraron una correlación negativa escasa con los trastornos de la salud bucodental agrupados. Por otro lado, la escala del habla test de esfuerzo evidenció una asociación negativa débil con relación a los trastornos de salud bucodental agrupadas. La escala nasolabial provocado y velofaríngea no mostraron correlación en ningún nivel con respecto a los trastornos de la salud bucodental agrupados. Conclusiones: la mayor dificultad en la producción de los fonemas fue dentopalatina en /t/, /d/, /l/, /rr/, /ll/. Dentro de la escala del habla, la media del indicador test de esfuerzo mostró la evaluación más baja.

ABSTRACT Background: according to the World Health Organization, the cleft lip and cleft palate are oral disorders that produce speech problems. These ones affect one of the functions of the stomatognathic system such as phonation. Objective: to analyze the oral problems associated with labial and palatal cleft. Methods: a non-experimental, descriptive, transversal study was carried out. The population was constituted of seventy-two patients whose medical records which were filled out by professionals in different health areas of Operation Smile, forty-two of them were selected based on criteria through intentional non-probabilistic sampling. The observation was applied as technique and its instrument was the medical records and the speech algorithm. Results : the nose-labial speech scale, dent-palatine, stress test and the total showed a low negative correlation with the grouped oral pathologies. On the other hand, the stress test speech scale showed a weak negative association in relation to the grouped oral disorders. The provoked nasolabial scale and velopharyngeal did not correlate at any level with respect to the grouped oral pathologies. Conclusion: the greatest difficulty in the production of phonemes was dent-palatine in / t /, / d /, / l /, / rr /, / ll /. The speech scale showed that the average of the effort test indicator showed the lowest evaluation.

Tratamiento del Fisurado Labio Alvéolo Palatino (FLAP): casos clínicos y tratamiento interdisciplinario / Treatment of the cleft lip and palate (CLP) patient: case reports and interdisciplinary treatment

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)

Religiosidade, espiritualidade e autoestima em adolescentes com fissura de lábio e palato: estudo correlacional / Religiosidad, espiritualidad y autoestima en adolescentes con labio y paladar hendido: un estudio correlacional / Religiosity, spirituality, and self-esteem in adolescents with cleft lip and palate: a correlational study

RESUMO Objetivo Avaliar a correlação entre religiosidade, espiritualidade e autoestima em adolescentes com fissura de lábio e palato, uni e bilateral. Método Estudo correlacional e transversal, desenvolvido em um hospital público e terciário brasileiro, entre julho de 2018 e fevereiro de 2019. A amostra constou de 100 adolescentes divididos em dois grupos, G1 (fissura unilateral, 50 participantes) e G2 (fissura bilateral, 50 participantes). Para a coleta de dados, foram utilizados três instrumentos: Questionário Sociodemográfico, a Escala de Religiosidade de Durel e a Escala de Autoestima de Rosenberg. Utilizaram-se para a análise estatística os Testes Qui-Quadrado, Mann-Whitney, Correlação de Pearson e a análise das forças de correlação linear, com nível de significância de 5% (p ≥ 0,05). Resultados Apenas a religiosidade organizacional foi maior no G1 em comparação com o G2 (p = 0,03). A autoestima geral foi satisfatória em ambos os grupos; contudo, não houve diferença significante entre eles (p = 0,34). Não foram evidenciadas correlações de religiosidade e espiritualidade com a autoestima nos G1 e G2. Conclusão Adolescentes com fissura de lábio e palato, uni ou bilateral, apresentaram elevados níveis de religiosidade, espiritualidade e autoestima. Porém, não se evidenciou correlação entre essas variáveis.

RESUMEN Objetivo Evaluar la correlación entre religiosidad, espiritualidad y autoestima en adolescentes con labio y paladar hendido unilateral y bilateral. Método Estudio correlacional y transversal desarrollado en un hospital público y terciario de Brasil entre julio de 2018 y febrero de 2019. La muestra consistió en 100 adolescentes divididos en dos grupos, G1 (fisura unilateral, 50 participantes) y G2 (fisura bilateral, 50 participantes). Para la recogida de datos se utilizaron tres instrumentos: Cuestionario sociodemográfico, Escala de Religiosidad DUREL y Escala de Autoestima de Rosenberg. Para el análisis estadístico se utilizaron los testes de Chi-cuadrado, Mann-Whitney, correlación de Pearson y el análisis de la fuerza de correlación lineal, con un nivel de significación del 5% (p ≥ 0,05). Resultados Sólo la religiosidad organizacional fue mayor en el G1 en comparación con el G2 (p = 0,03). La autoestima general fue satisfactoria en ambos grupos, pero no hubo diferencias significativas entre ellos (p = 0,34). No se evidenciaron correlaciones de religiosidad y espiritualidad con la autoestima en G1 y G2. Conclusión Los adolescentes con labio y paladar hendido unilateral o bilateral presentan elevados niveles de religiosidad, espiritualidad y autoestima. Sin embargo, no se evidenció una correlación entre estas variables.

ABSTRACT Objective To evaluate the correlation between religiosity, spirituality, and self-esteem in adolescents with uni- and bilateral cleft lip and palate. Method Correlational and cross-sectional study developed in a public and tertiary hospital in Brazil between July 2018 and February 2019. The sample comprised 100 adolescents divided into two groups: G1 (unilateral cleft, 50 participants) and G2 (bilateral cleft, 50 participants). For data collection, three instruments were used: Sociodemographic Questionnaire, DUREL Religion index, Rosenberg self-esteem scale. Statistical analysis was performed with the tests Chi-squared, Mann-Whitney, Pearson Correlation, and analysis of linear correlation strength, with a 5% significance level (p ≥ 0.05). Results Only organizational religiosity was higher in G1 when compared with G2 (p = 0.03). The overall self-esteem was satisfactory for both groups; however, there was no significant difference between them (p = 0.34). No correlation between religiosity and spirituality with self-esteem were identified for G1 and G2. Conclusion The adolescents with uni- or bilateral cleft lip and palate presented high levels of religiosity, spirituality, and self-esteem. However, no correlation between these variables was identified.

Revisión narrativa: Evaluación e intervención fonoaudiológica en niños con labio fisurado / Narrative review: Speech-language therapy evaluation and intervention in children with cleft lip

El labio fisurado se define como una anomalía congénita de la cabeza y el cuello, observándose una mayor incidencia en personas del sexo masculino. El tratamiento por excelencia es la intervención quirúrgica, en la búsqueda de una adecuada funcionalidad y un buen resultado estético, para cumplir con este objetivo es necesario el trabajo interprofesional, en el cual participa el fonoaudiólogo, durante el proceso de evaluación e intervención terapéutica. El objetivo de la revisión narrativa fue abordar principalmente los procesos de evaluación e intervención fonoaudiológica en niños con labio fisurado. Para su desarrollo fue realizada una búsqueda de información en las bases de datos PubMed, Scopus y Lilacs, posteriormente fue realizado un análisis crítico de la información. En la presente revisión narrativa se proponen realizar un recuento sobre aspectos relacionados con la historia de la clasificación del labio fisurado, factores etiológicos, procesos de intervención quirúrgica realizada en los niños con labio fisurado, que permitan comprender el proceso de la evaluación clínica fonoaudiológica en las áreas de deglución, lenguaje, habla, voz y las propuestas de intervención terapéutica en niños con labio fisurado de acuerdo con las evidencias presentadas en la literatura.

Cleft lip is defined as a congenital anomaly of head and neck, with a higher incidence in males. The treatment par excellence is surgical intervention seeking to achieve functionality and the best aesthetic result) for this the interprofessional work is necessary, in which the speech pathologist participates on the evaluation process and therapeutic intervention in swallowing, speech and language. The objective of this narrative review was to primarily address the processes of evaluation and speech therapy intervention in children with cleft lip. For its development, a search of information in PubMed, Scopus and Lilacs databases, subsequently a critical analysis of the information was made. This narrative review proposed to make a synthesis of the history, the etiological factors and the surgical intervention processes that are performed in children with cleft lip, this allows to understand the actions and importance of the speech pathologist's work in the processes of evaluation with specific protocols that involve all areas; swallowing, language, speech, voice, hearing and speech pathologist therapy intervention in children with cleft lip, based on the evidence that allows to acknowledge positive results, being promising for this population the implementation of summer camps