scholarly journals OROFACIAL CLEFTING –AN EXTENSIVE REVIEW

2021 ◽  
Vol 5 (9) ◽  
Author(s):  
T. Ashiq ◽  
Srikrishnan Rajendran Sri Ramkumar ◽  
N. Mugunthan ◽  
R.S. Uma ◽  
Iyyanar Jayaraj ◽  
...  
Keyword(s):  
Environmental Factors ◽  
Cleft Palate ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Clinical Manifestations ◽  
The United States ◽  
World Health ◽  
Upper Respiratory Tract ◽  
Facial Cleft ◽  
Facial Clefts

Groove in the palatal vault makes an abnormal communication between oral and nasal cavity is known as oro-facial cleft. It is an uncommon presentation in day-to-day clinical practice. According to World Health Organization, children with the complaint of oro-facial clefts found to be high in India. Children are commonly suffering from functional and aesthetical problems due to Oro-facial clefting. Globally, an estimated 200,000 babies are born with a cleft lip, palate or both each year in the United States. Etiology may be congenital or acquired. Palatal and Alveolar cleft defects are the most common etiological factors. Cleft lip and cleft palate can sometimes develop in combination with a syndrome due to genetic causes. The acquired causes may be infections, trauma, postsurgical complications, neoplasms, periapical pathology, radio and chemo necrosis. Clinical features like defective speech, and upper respiratory tract and ear infections, fetid odor, bad taste, nasal regurgitation of food are the associated consequences of oro-nasal communication. Therefore, this malformation syndrome is an important public health problem. Many cleft palate and cleft lip develops due to the combination of genetic and environmental factors. There are more than 400 genes linked to formation of cleft lip and palate. Some environmental factors associated with cleft include medications, deficiency of folic acid, and cigarette, drugs or alcohol conception   during pregnancy. In this article we review the anatomy, embryology, epidemiology clinical manifestations and treatment options of the oro-facial cleft Key words: Oro-facial Cleft, Classification, , Anatomy , Embryology, Morphology, Incidence, Congenital Anomaly        

Global Cleft Lip and Palate Outreach: A Google Trends Analysis

2021 ◽  
pp. 105566562110698
Author(s):  
Joshua P Weissman ◽  
Narainsai K Reddy ◽  
Nikhil D Shah ◽  
Arun K Gosain
Keyword(s):  
Cleft Palate ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
The Philippines ◽  
Google Trends ◽  
World Health ◽  
Patient Awareness ◽  
Number Of Patients ◽  
Who Indicators ◽  
Cleft Surgery

Understanding patient awareness of cleft lip and/or palate (CL/P) and evaluating demand for necessary procedures may serve to better target future efforts in global outreach. We utilized internet search query data from Google Trends for the terms: “cleft lip,” “cleft palate,” “cleft lip and palate,” “cleft surgery,” and “cleft repair” from January 2004 to January 2021. Relative search volumes (RSV) recorded for the top 5 highest displaying countries and top 3 available regions within those countries were compared against global outreach by Operation Smile and Smile Train, as measured by the number of patients treated. World Health Organization (WHO) indicators were used to validate the RSV values for each country and better understand the current infrastructure and need for cleft care in those countries. Globally, there was an increase in RSV for the terms “cleft lip,” “cleft palate,” “cleft repair,” and “cleft surgery” between 2004 and 2021. For “cleft lip,” the countries with the highest displaying RSVs included: Ghana (100%), Zimbabwe (97%), Nepal (78%), the Philippines (64%), and Kenya (52%). Countries with high RSVs and moderate to high WHO indicators included Ghana, Kenya, India, Nigeria, and Zimbabwe. Countries with high RSVs and poor WHO indicators included Nepal and Pakistan. Some countries had specific regions with high search demand that are not currently targeted for global outreach. Using Google Trends’ data may help find more feasible locations and targeted care for efforts in global outreach with better patient awareness and turnout where demand for CL/P is increasing.

Hospitalization, Breast-Milk Feeding, and Growth in Infants with Cleft Palate and Cleft Lip and Palate Born in Denmark

2008 ◽  
Vol 45 (6) ◽  
pp. 628-632 ◽  
Author(s):  
Lisa H. V. Smedegaard ◽  
Dorthe R. N. Marxen ◽  
Jette H. V. Moes ◽  
Eva N. Glassou ◽  
Cand Scientsan
Keyword(s):  
Breast Milk ◽  
Cleft Palate ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
First Year ◽  
Health Visitors ◽  
Facial Clefts ◽  
Growth References ◽  
First Year Of Life ◽  
Milk Feeding

Objective: To evaluate if the duration of postpartum hospitalization, duration of breast-milk feeding, and growth during the first year of life in infants with cleft lip and palate (CLP) and cleft palate (CP) are comparable to infants without facial clefts. Design: Prospective data collection using a registration chart developed by the authors. Setting: Special health care of infants with CLP/CP born in Denmark. Participants: All mature infants with CLP/CP born in 2003 and 2004 were included. Of 165 infants, 115 participated in the study. Intervention: In Denmark, parents of children with CLP/CP receive counseling. This counseling is managed by specially trained health visitors/nurses and is initiated at birth. The counseling seeks to support parents’ confidence in having an infant with CLP/CP and to initiate a relationship between the infant and the parents. Main Outcome Measures: Duration of postpartum hospitalization, duration of breast-milk feeding, and weight and length at birth, 5 months of age, and 12 months of age. Results: Hospitalization was 4 days and comparable to that of infants without CLP/CP. The infants with CLP/CP received breast milk but for a shorter period compared with infants without CLP/CP. Weights at birth, 5 months of age, and 12 months of age were identical with Danish growth references. Conclusion: The authors find the results satisfactory and believe that the counseling provided by the health visitors/nurses plays a part in the results.

scholarly journals A study to assess the nutritional status of children with cleft lip and/or cleft palate and its correlation with breast feeding at a tertiary health care centre

2018 ◽  
Vol 5 (4) ◽  
pp. 1594
Author(s):  
Abhilasha Sampagar ◽  
Bhavana Lakhkar ◽  
Ashok Sampagar ◽  
Jayanth Wagha
Keyword(s):  
Nutritional Status ◽  
Cleft Palate ◽  
Breast Feeding ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
World Health ◽  
Severe Malnutrition ◽  
Healthy Children ◽  
Female Ratio ◽  
Nutritional Status Of Children

Background: Cleft lip with or without cleft palate is one of the most common congenital anomalies. In 2008, the World Health Organization included cleft lip and palate in their Global Burden of Disease initiative. The incidence of cleft lip and palate in India is enormous: one in 781 live births. The growth of children with these deformities is often impaired in comparison to healthy children. Several studies describe a growth lag in either weight or height of cleft children. The objective of the study was to observe the nutritional status of children with cleft lip and/or cleft palate and its correlation with breastfeeding.Methods: A cross sectional study was conducted at Department of Pediatrics, AVBRH Sawangi (Meghe), Wardha for the period of two years from August 2010 to March 2012. All children below 15 years with cleft lip and/or palate admitted in the pediatric ward, NICU or postnatal ward were included in the study. A Total  of 200 children were included in the study and analyzed.Results: Male to female ratio was 1.4:1. The commonest type of defect was both the defects present together (62%) which was significantly more than individual defects (א2=23.98, p<0.0001). It was followed by isolated cleft lip (25.5%) and isolated cleft palate (12.5%). Malnutrition was more common in children who were deprived of breast milk (χ2=22.61, Significant). Significantly more children (69.6%) below the age group of 5 yrs were malnourished. (χ2=16. Significant).Conclusions: Our results confirm that, malnutrition is more prevalent in children with orofacial clefts. Lack of breast feeding is a significant contributor to severe malnutrition and recurrent infections in these children.

scholarly journals Comparing Plastic Surgery and Otolaryngology Management in Cleft Care: An Analysis of 4,999 Cases

2017 ◽  
Vol 10 (4) ◽  
pp. 271-277 ◽  
Author(s):  
Kevin T. Jubbal ◽  
Dmitry Zavlin ◽  
Shola Olorunnipa ◽  
Anthony Echo ◽  
Edward P. Buchanan ◽  
...  
Keyword(s):  
Cleft Palate ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
The United States ◽  
Surgical Approaches ◽  
Nasal Reconstruction ◽  
Improvement Program ◽  
Primary Specialty ◽  
Significant Difference ◽  
Procedure Type

Care for patients with cleft lip and palate is best managed by a craniofacial team consisting of a variety of specialists, including surgeons, who are generally plastic surgeons or otolaryngologists trained in the United States. The goal of this study was to compare the surgical approaches and management algorithms of cleft lip, cleft palate, and nasal reconstruction between plastic surgeons and otolaryngologists. We performed a retrospective analysis of the American College of Surgeons’ National Surgical Quality Improvement Program Pediatric database between 2012 and 2014 to identify patients undergoing primary repair of cleft lip, cleft palate, and associated rhinoplasty. Two cohorts based on primary specialty, plastic surgeons and otolaryngologists, were compared in relation to patient characteristics, 30-day postoperative outcomes, procedure type, and intraoperative variables. Plastic surgeons performed the majority of surgical repairs, with 85.5% ( n = 1,472) of cleft lip, 79.3% ( n = 2,179) of cleft palate, and 87.9% ( n = 465) of rhinoplasty procedures. There was no difference in the age of primary cleft lip repair or rhinoplasty. However, plastic surgeons performed primary cleft palate repair earlier than otolaryngologists ( p = 0.03). Procedure type varied between the specialties. In rhinoplasty, otolaryngologists were more likely to use septal or ear cartilage, whereas plastic surgeons preferred rib cartilage. Results were similar, with no statistically significant difference in terms of mortality, reoperation, readmission, or complications. Significant variation exists in the treatment of cleft lip and palate based on specialty service with regard to procedure timing and type. However, short-term rates of mortality, wound occurrence, reoperation, readmission, and surgical or medical complications remain similar.

scholarly journals Improving the efficiency of prenatal diagnosis of cleft lip and palate

2020 ◽  
pp. 36-42
Author(s):  
A. N. Chukanov
Keyword(s):  
Cleft Palate ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Three Dimensional ◽  
Obstetric Care ◽  
Ultrasound Elastography ◽  
Fetal Head ◽  
Sensitivity Indices ◽  
Facial Clefts ◽  
Diagnostic Criterion

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.

scholarly journals Fatores de Riscos na Fissura Labiopalatina Não Sindrômica

UNICIÊNCIAS ◽  
2021 ◽  
Vol 24 (1) ◽  
pp. 86-93
Author(s):  
Carla Meliso Rodrigues Silvestre ◽  
Renata Cristina Giroto Ferreira da Silva ◽  
Ageo Mario Candido da Silva ◽  
Walkiria Shimoya Bittencourt ◽  
Yolanda Benedita Abadia Martins de Barros ◽  
...  
Keyword(s):  
Risk Factors ◽  
Environmental Factors ◽  
Literature Review ◽  
Cleft Palate ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
First Trimester ◽  
Human Beings ◽  
Factors Associated ◽  
Narrative Literature Review

As anomalias craniofaciais representam um grupo amplo de malformações congênitas que afetam uma grande proporção da sociedade mundial. Entre essas se encontram as fissuras de lábio e/ou de palato, anomalia orofacial mais frequente entre os seres humanos que ocasionam problemas estéticos e funcionais nos indivíduos afetados.  A etiologia das fissuras labiopalatinas isoladas ou não-sindrômicas é complexa e multifatorial, associadas à fatores hereditários e ambientais. Este estudo teve como objetivo relatar os fatores genéticos e ambientais associados à etiologia desse tipo de malformação, através de uma revisão narrativa de literatura, a partir das bases de dados: PubMed e Scielo. Os descritores utilizados foram: cleft palate AND cleft lip AND etiology AND risk factors. Incluíram-se artigos nos idiomas inglês e português publicados em periódicos nacionais e internacionais acerca da temática da pesquisa. Baseado na revisão de literatura se pode identificar que os fatores ambientais como: fumo, consumo de álcool, consumo de medicamentos, o não uso de suplementação com polivitamínicos e ácido fólico, exposição a agrotóxicos, idade dos genitores podem aumentar a chance de ocorrência das fissuras labiopalatinas. O acompanhamento gestacional durante o primeiro trimestre gestacional se faz necessário, a fim de monitorar os fatores de risco associados com as fissuras labiopalatinas não sindrômicas.   Palavras-chave: Fissura Palatina. Fenda Labial. Etiologia. Fatores de Risco.   Abstract Craniofacial anomalies represent a broad group of congenital malformations that affect a large proportion of world society. Among them are cleft lip and / or palate, the most frequent orofacial anomaly among human beings that cause aesthetic and functional problems in the affected individuals. The etiology of isolated or non-syndromic cleft lip and palate is complex and multifactorial, associated with hereditary and environmental factors. This study aimed to report the genetic and environmental factors associated with the etiology of this type of malformation through a narrative literature review conducted in October 2020, using the PubMed and Scielo databases. The keywords used were cleft palate AND cleft lip AND etiology AND risk factors. Articles in English and Portuguese published in national and international journals about the research theme were included. Based on the literature review, it can be identified that environmental factors such as smoking, alcohol consumption, medication consumption, the non-use of supplementation with multivitamins and folic acid, exposure to pesticides, age of parents can increase the chance of cleft lip and palate occurrence. Gestational monitoring during the first trimester of pregnancy is necessary in order to monitor the risk factors associated with non-syndromic cleft lip and palate.   Keywords: Cleft Palate. Cleft Lip. Etiology. Risk Factors.

scholarly journals Weight Gain in Children with Cleft Lip and Palate without Use of Palatal Plates

2012 ◽  
Vol 2012 ◽  
pp. 1-4 ◽  
Author(s):  
Renato da Silva Freitas ◽  
Andrey Bernardo Lopes-Grego ◽  
Helena Luiza Douat Dietrich ◽  
Natacha Regina de Moraes Cerchiari ◽  
Tabatha Nakakogue ◽  
...  
Keyword(s):  
Weight Gain ◽  
Cleft Palate ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
World Health ◽  
First Year ◽  
Average Weight ◽  
Syndromic Diagnosis ◽  
Health Organization ◽  
First Year Of Life

Goals/Background. To evaluate children’s growth in the first year of life, who have cleft palate and lip, without the use of palatal plates. Materials/Method. Chart review was conducted, retrospectively, in the Center for Integral Assistance of Cleft Lip and Palate (CAIF), in Brazil, between 2008 and 2009. Results for both genders were compared to the data published by the World Health Organization (WHO) regarding average weight gain in children during their first year of life. Results. Patients with syndromic diagnosis and with cleft classified as preforamen were excluded, resulting in a final number of 112 patients: 56 male and 56 female. Similar patterns were seen comparing the two genders. Although it was observed weight gain below the average until the 11th month in male patients and until 9 months in female patients, both genders remained at the 50th percentile (p50) and improved after the 4th month of age for boys and the 9th month of age for girls. Conclusion. Children with cleft palate weigh less than regular children during their first months of life. At the end of the first year, weight gain is similar comparing normal and affected children. However, factors that optimized weight gain included choosing the best treatment for each case, proper guidance, and multiprofessional integrated care.

Eyeball Preservation With Purse-String Conjunctival Closure for Melting Corneal Ulcer in Rare Facial Cleft

2020 ◽  
pp. 105566562098063
Author(s):  
Cristiano Tonello ◽  
Raul G. Paula ◽  
Isabella P. Paula ◽  
Rodrigo B. Nunes ◽  
Nancy M. Kokitsu-Nakata ◽  
...  
Keyword(s):  
At Risk ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Corneal Ulcer ◽  
Craniofacial Skeleton ◽  
Purse String Suture ◽  
Purse String ◽  
Facial Cleft ◽  
Facial Clefts

Rare facial clefts are characterized by facial involvement that is not restricted to the lip, palate, and alveolus as in traditional cleft lip and palate. The craniofacial skeleton and the orbital structures are frequently affected in these conditions. Exposure of the eyeball, when not early treated, puts the function and the preservation of the eye at risk. We report the case of a 2-month-old boy admitted to our service with an extensive oral-ocular cleft and exposure of the eyeball with melting corneal ulcer treated with a conjunctival closure with a purse-string suture.

Pathogenetic justification for the use of immunotherapy for the treatment of recurrent co-infections of the upper respiratory tract in children with congenital cleft lip and palate

2020 ◽  
Vol 18 (4) ◽  
pp. 117-126
Author(s):  
I.V.Nesterova I.V.Nesterova ◽  
◽  
M.N.Mitropanova M.N.Mitropanova ◽  
G.A.Chudilova G.A.Chudilova ◽  
S.V.Kovaleva S.V.Kovaleva ◽  
...  
Keyword(s):  
Oral Cavity ◽  
Respiratory Tract ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Inflammatory Diseases ◽  
Clinical Manifestations ◽  
Microbiological Analysis ◽  
Upper Respiratory Tract ◽  
Congenital Cleft ◽  
Upper Respiratory

The synergism of the action of co-infecting microorganisms contributes to their overcoming the epithelial barrier, modification of the function of cells of the immune system (IS) and evading the immune response. In children with congenital cleft lip and palate (CCLP), despite elimination of the anatomical defect at an earlier age, the frequency of infectious and inflammatory diseases of the respiratory tract and oral cavity involving pathogen associations increases as they get older, at the same time defects in the functioning of IS are preserved. Objective. To develop immunotherapy program for children with CCLP, suffering from recurrent co-infections of the upper respiratory tract and oral cavity, based on the study of the dynamics of the microbial landscape transformation, IS dysfunction, clinical manifestations of infectious and inflammatory diseases of the upper respiratory tract and oral cavity in children with CCLP at different ages. Patients and methods. The study included 120 children from 1 to 12 years of age with CCLP at different stages of surgical treatment. The study was carried out: T and B lymphocytes, natural killer cells (FC500 "Beckman Coulter", USA), phagocytic and microbicidal functions of neutrophilic granulocytes (NG), serum IgA, IgM, IgG and sIgA levels in the oral fluid (ELISA), detection of microbial pathogens (microbiological analysis, ELISA) and viral (PCR). Results. Comprehensive examination of children with CCLP at different age periods, including characteristics of the clinical manifestations of infectious and inflammatory diseases, assessment of the microbial landscape of the oral cavity and upper respiratory tract with the identification of co-infection features, clarification of the variants of IS dysfunction, made it possible to reveal children with the most severe clinical manifestations of recurrent co-infections and to optimize treatment. Conclusion. The developed program of combined local interferon and systemic immunotherapy for immunocompromised children with CCLP contributes to the restoration of IS functions, anti-infective resistance and achievement of positive clinical effects in the form of regression of clinical signs of immunocompromise in patients with recurrent co-infections, which allows to obtain a protective effect and provide timely surgical care, to avoid complications in the postoperative period and at the stage of recovery, and by improving anti-infective immunity to enhance the quality of life of children with CCLP. Key words: children, congenital cleft lip and palate, co-infection, systemic immunity, microbiocenosis, immunotherapy

scholarly journals Relationship between dermatoglyphics and cleft lip and/or palate: a review of literature

2017 ◽  
Vol 21 (2) ◽  
pp. 20-25
Author(s):  
Cristian Díaz ◽  
Habib Barhoum
Keyword(s):  
Environmental Factors ◽  
Cleft Palate ◽  
Key Words ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Embryonic Tissue ◽  
Review Of Literature ◽  
Orofacial Clefts ◽  
Genetic And Environmental Factors ◽  
Period Of Gestation

This article reviews the concepts associated with dermatoglyphs such as their classification, characteristics and applications. It also reviews orofacial clefts such as cleft lip and palate and proposes a possible relationship between dermatoglyphics and these orofacial clefts, entities that are considered isolated at first, but considering that they are derived from the same embryonic tissue, the ectoderm, and their development is in the same period of gestation, making genetic and environmental factors that would influence the development of the asyndromic lip and / or palate could be reflected in the fingerprints and the type of pattern that they follow. Key words: Cleft lip, dermatoglyphics, cleft palate, fingerprint.

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