Three-dimensional tooth crown size symmetry in cleft lip and cleft palate

Objective: to identify the most effective and affordable method to diagnose various types of fetal cleft lip and palate, the use of which is possible in the majority of specialized obstetric care facilities. Material and methods. The study included the results of ultrasound examination of fetuses (59 cases) in various modes with cleft lip and palate of various types within gestational periods from 16 to 36 weeks. Results. The sensitivity indices of the generally accepted method of two-dimensional B-mode ultrasound have been determined for diagnosing all types of clefts, which amounted to 81.3 %, and the sensitivity for diagnosing cleft palate and cleft lip and palate amounted to 80.3 %. The sensitivity indices of the newly developed diagnostic method (ultrasound elastography of the palate) have been determined, which amounted to 89.8 % in the diagnosis of all types of clefts, and 90.2 % in the diagnosis of cleft palate and cleft lip and palate (46/51). Demonstration of the image of the fetal face obtained during the three-dimensional B-mode reconstruction to its future parents helps the family to make a more balanced and correct decision on further pregnancy tactics. In cases of cleft palate, a new visualization diagnostic criterion has been defined - tongue bifurcation. MRI of the fetal head is not an effective and affordable method for the diagnosis of facial clefts, which can be widely used in practice. Conclusion: It is advisable and necessary to conduct an obligatory study of the karyotype in fetuses with crevices identified during imaging examination at any gestational age. As a new diagnostic criterion for cleft palate, detected by B-mode ultrasound, tongue bifurcation can be used. The utilization of the EN method in combination with the developed coloristic criteria for RHN and RN increases their prenatal detection in general population by 9.9 %. At the same time, the detectability of all types of crevices increases by 8.5 %. In order to objectify the explanations about the essence of revealed defects of the face and structures of the oral cavity, it is necessary to demonstrate a three-dimensional sonogram of the fetal face obtained during three-dimensional B-mode reconstruction to its future parents. MRI of the fetal head cannot be recommended as an effective and affordable method for diagnosing facial clefts due to the impossibility to obtain a satisfactory image in most cases.

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Prenatal Diagnosis of Fetal Cleft Lip and Palate with Three-Dimensional Ultrasound Information Technology

Scientific Programming ◽

10.1155/2021/1531724 ◽

2021 ◽

Vol 2021 ◽

pp. 1-7

Author(s):

Xinglong Deng ◽

Suhui He ◽

Qiumei Wu ◽

Zongjie Weng ◽

Minmin Yang ◽

...

Keyword(s):

Prenatal Diagnosis ◽

Cleft Palate ◽

Detection Rate ◽

Cleft Lip ◽

Cleft Lip And Palate ◽

Ultrasound Examination ◽

Three Dimensional ◽

Two Dimensional ◽

Bilateral Cleft Lip ◽

Cleft Lip Palate

Objective. To evaluate the three-dimensional ultrasound paper cleft lip and palate deformities in applications in prenatal diagnosis. Methods. 25 cases of cleft lip and palate fetus, 20–32 weeks of gestational age, with the maternal age of 22–44 years, were examined by prenatal ultrasound in our hospital; conventional two-dimensional ultrasound examination was performed after a cleft lip, and the application of three-dimensional ultrasound imaging surface and a transparent imaging showed the alveolar process and the palate of the fetus. Also, the results of two-dimensional ultrasound and postnatal (or after induction) results were compared. Results. Of the 25 cases, there were 6 cases of postpartum induction or simply unilateral cleft lip, 17 cases of unilateral cleft palate, and two cases of bilateral cleft lip palate. There was no significant ( P > 0.05 ) difference of two- and three-dimensional ultrasound detection rate of pure cleft lip; two-dimensional ultrasound cleft palate detection rate was 36.8% (7/19), and three-dimensional ultrasound cleft palate detection rate was 89.5% (17/19). The two methods showed a statistically significant ( P < 0.05 ) difference in the detection rate of cleft palate. Conclusion. Three-dimensional ultrasound can significantly improve the diagnostic accuracy of prenatal cleft palate.

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Three-Dimensional Analysis of Cleft Palate Topology in Newborn Infants with Reference to the Cranial Skeleton

The Cleft Palate-Craniofacial Journal ◽

10.1597/1545-1569_1998_035_0379_tdaocp_2.3.co_2 ◽

1998 ◽

Vol 35 (5) ◽

pp. 379-395 ◽

Cited By ~ 9

Author(s):

Margit Bacher ◽

Gernot Göz ◽

Thinh Pham ◽

Ulrike Bacher ◽

Olga Werner ◽

...

Keyword(s):

Cleft Palate ◽

Coordinate System ◽

Cleft Lip ◽

Three Dimensional ◽

Newborn Infants ◽

Geographic Area ◽

Primary Outcome Measure ◽

Physical Models ◽

Midsagittal Plane ◽

Starting Point

Objective To describe a method of determining the three-dimensional topology of the palatal crest relative to a reproducible anthropomorphic coordinate system in newborn infants with unilateral cleft palate. For this purpose, physical models of the maxilla and face were analyzed by computer morphometry. Design The study was limited to infants referred to the craniofacial center during the first 11 days after birth. Setting The study was performed at a craniofacial center servicing a large geographic area. Participants The method was applied to 12 infants with unilateral cleft lip, alveolus, and palate (eight patients with left-side clefts and four with right-side clefts). Main outcome Measures The three-dimensional topology of the palatal crest referenced to an anthropometric coordinate system was the primary outcome measure. The anthropometric reference system is defined by the tragus points and the midpoint of a line connecting the endocanthia. Results The topology of the maxillary crests of the patients was characterized by considerable variability. The center of the premaxilla as defined by the attachment of the frenulum was frequently displaced by several millimeters from the midsagittal plane. The displacement was to the left in infants with right-side clefts and to the right in infants with left-side clefts. The premaxilla can be rotated by more than 30° relative to the normal position. No significant retroposition of the minor segment as determined by the location of the tuber points was found. Several morphometric anomalies were found to be correlated linearly. Conclusions We propose that the morphologic deviations are in part caused by the neuromotor activity of the tongue and of the interrupted M. orbicularis oris. The data can serve as the starting point for a longitudinal study of craniofacial development in children with cleft palate and for studies on the efficacy of different therapeutic approaches.

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