| 1. |
- Bakri, Sherif, 1980, et al.
(författare)
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Height of the palatal vault after two different surgical procedures: Study of the difference in patients with complete unilateral cleft lip and palate.
- 2012
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Ingår i: Journal of plastic surgery and hand surgery. - 2000-6764. ; 46:3-4, s. 155-158
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Tidskriftsartikel (refereegranskat)abstract
- Abstract The present study compared the height of the palatal vault in dental casts from 320 10-year-old children with unilateral cleft lip and palate (UCLP) operated on with the push-back technique according to Wardill-Kilner (W-K) with patients operated on with delayed hard palate closure (DHPC). The palatal height in patients operated on with the DHPC technique was found to be significantly higher than in patients operated on with the W-K technique. This coincides with better maxillary growth and better speech in the DHPC group.
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| 2. |
- Bakri, Sherif, et al.
(författare)
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Vertical Maxillary Growth After Two Different Surgical Protocols in Unilateral Cleft Lip and Palate Patients.
- 2014
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Ingår i: The Cleft palate-craniofacial journal : official publication of the American Cleft Palate-Craniofacial Association. - : SAGE Publications. - 1545-1569. ; 51:6, s. 645-650
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Tidskriftsartikel (refereegranskat)abstract
- Objective: The aim of the present study was to compare vertical maxillofacial growth in patients born with unilateral cleft lip and palate (UCLP) who were treated using two different surgical protocols. Design: A retrospective cohort study. Subjects: We studied 92 patients with complete UCLP (61 male and 31 female) treated at Sahlgrenska University Hospital in Gothenburg, Sweden: 46 consecutive patients born between 1965 and 1974 who were operated according to the Wardill-Kilner (W-K) protocol and 46 consecutive patients born between 1982 and 1989 who were operated according to the Gothenburg delayed hard palate closure (DHPC) protocol. Methods: We analyzed lateral cephalograms obtained at 10 years of age. Results: Patients treated according to the Gothenburg DHPC protocol had significantly greater anterior upper facial height, anterior maxillary height, overbite, and inclination of the maxilla than those treated with the W-K protocol. Both techniques led to similar posterior upper facial height. Conclusion: The Gothenburg DHPC protocol in patients with complete UCLP results in more normal anterior maxillary vertical growth and overbite and therefore increased maxillary inclination at 10 years of age.
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| 3. |
- Elander, Anna, 1955, et al.
(författare)
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Isolated cleft palate requires different surgical protocols depending on cleft type.
- 2017
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Ingår i: Journal of plastic surgery and hand surgery. - 2000-6764. ; 51:4, s. 228-234
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Tidskriftsartikel (refereegranskat)abstract
- A staged protocol for isolated cleft palate (CPO), comprising the early repair of the soft palate at 6 months and delayed repair of the eventual cleft in the hard palate until 4 years, designed to improve maxillary growth, was introduced. CPO is frequently associated with additional congenital conditions. The study evaluates this surgical protocol for clefts in the soft palate (CPS) and for clefts in the hard and soft palate (CPH), with or without additional malformation, regarding primary and secondary surgical interventions needed for cleft closure and for correction of velopharyngeal insufficiency until 10 years of age. Of 94 consecutive children with CPO, divided into four groups with (+) or without (-) additional malformations (CPS+or CPS-and CPH+or CPH-), hard palate repair was required in 53%, performed with small local flaps in 21% and with bilateral mucoperiosteal flaps in 32%. The total incidence of soft palate re-repair was 2% and the fistula repair of the hard palate was 5%. The total incidence of secondary velopharyngeal surgery was 17% until 10 years, varying from 0% for CPS-and 15% for CPH-, to 28% for CPS+and 30% for CPH+. The described staged protocol for repair of CPO is found to be safe in terms of perioperative surgical results, with comparatively low need for secondary interventions. Furthermore, the study indicates that the presence of a cleft in the hard palate and/or additional conditions have a negative impact on the development of the velopharyngeal function.
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| 4. |
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| 5. |
- Friede, Hans, 1938, et al.
(författare)
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Letter to the Editor.
- 2012
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Ingår i: The Cleft palate-craniofacial journal : official publication of the American Cleft Palate-Craniofacial Association. - : SAGE Publications. - 1545-1569. ; 49:4, s. 512-513
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
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| 6. |
- Friede, Hans, 1938, et al.
(författare)
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Long-Term, Longitudinal Follow-Up of Individuals with UCLP After the Gothenburg Primary Early Veloplasty and Delayed Hard Palate Closure Protocol: Maxillofacial Growth Outcome.
- 2012
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Ingår i: The Cleft Palate-Craniofacial Journal. - : SAGE Publications. - 1545-1569 .- 1055-6656. ; 49:6, s. 649-656
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Tidskriftsartikel (refereegranskat)abstract
- Abstract Objective: To study long-term maxillofacial development in a sample of patients born with unilateral cleft lip and palate (UCLP). The patients' palatal repair had been performed according to a two-stage protocol with early velar closure and delayed hard palate surgery. Design: Retrospective longitudinal cohort study. Subjects: The sample consisted of 50 consecutive patients with UCLP born from 1980 to 1989. All of them had been operated on at the Sahlgrenska University Hospital in Gothenburg, Sweden. Methods: Certain maxillary casts as well as lateral roentgencephalograms, obtained at 5; 10; 16; and 19 years of age, were analyzed. Results: Our patients' maxillofacial growth was very good even up to the final examination at early adulthood. We ascribe the advantageous midfacial morphology of our patients particularly to limited growth restriction from palatal scars due to the surgical protocol used in our cleft center. Conclusion: The two-stage protocol advocated by us for repair of the palatal cleft resulted in very satisfactory growth outcome. A palatal scar, that might impair maxillary development, was created only by the velar surgery. If this scar was located close to the posterior border of the hard palate, it might result in less maxillary growth restriction than if it was positioned further anteriorly. Key Words: Cephalometrics, cleft lip and palate, delayed hard palate repair, growth, maxilla, surgery.
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| 7. |
- Friede, Hans, 1938, et al.
(författare)
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Maxillary dental arch and occlusion in patients with unilateral cleft lip and palate treated with different delays in closure of the hard palate after early velar repair.
- 2006
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Ingår i: Scandinavian journal of plastic and reconstructive surgery and hand surgery / Nordisk plastikkirurgisk forening [and] Nordisk klubb for handkirurgi. - : Informa UK Limited. - 0284-4311. ; 40:5, s. 261-6
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Tidskriftsartikel (refereegranskat)abstract
- We wanted to find out if growth of the maxilla in 26 patients with unilateral cleft lip and palate (UCLP) was adversely affected by having the residual cleft of the hard palate repaired earlier than had been done previously in a 2-stage palatal closure protocol. The ages at repair of the hard palate of the present patients ranged from 38 to 89 months. Dental casts from ages about 3 years (before any repair of the hard palate), 5, 7, and 10 years of age were analysed. The results indicated that earlier repair of the cleft in the hard palate did not influence maxillary growth differently from the later repair.
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| 8. |
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| 9. |
- Friede, Hans, 1938, et al.
(författare)
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Two-stage palatal surgery with early veloplasty and delayed hard palate repair: A balanced view on speech and midfacial growth outcome
- 2013
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Ingår i: Cleft Lip and Palate; Diagnosis and management; Third edition; (S. Berkowitz editor). - Berlin Heidelberg 2013 : Springer-Verlag. - 9783642307690 ; , s. 413-437
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Bokkapitel (övrigt vetenskapligt/konstnärligt)abstract
- Today, there is general consensus that, particularly, the protocol for repair of the palate is crucial for normal speech development and adequate long-term midfacial growth in individuals affected with cleft lip and palate (CLP). About 90 years ago, a new two-stage palatal repair method was introduced. It was characterized by early veloplasty and later closure of the hard palate. Recent follow-up studies of this regimen have revealed excellent long-term outcome regarding maxillary growth and also satisfactory speech development, even if the hard palate surgery was delayed to the stage of early mixed dentition. A speech deviation, coined as “retracted oral articulation of anterior pressure consonants,” seemed to be a relatively common speech error, temporarily affecting about one third of our preschool children born with unilateral CLP. The prevalence of other, more severe cleft speech characteristics, such as symptoms of and related to velopharyngeal incompetence and the occurrence of glottal misarticulations in particular, was very low.
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| 10. |
- Havstam, Christina, 1963, et al.
(författare)
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Evaluation of VPI-assessment with videofluoroscopy and nasoendoscopy.
- 2005
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Ingår i: British journal of plastic surgery. - : Elsevier BV. - 0007-1226. ; 58:7, s. 922-31
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Tidskriftsartikel (refereegranskat)abstract
- The purpose of this study was to investigate how different amounts of visual assessment information influence the recommended treatment for velopharyngeal insufficiency (VPI). Is a patient presented with videofluoroscopy (VF) in lateral projection recommended the same treatment as when frontal projection, nasoendoscopy, or both, are added? Retrospective material with video recorded assessment of VPI was blinded and copied in random order. Each patient was then presented in four separate combinations: VF in lateral projection; VF in lateral and frontal projection; VF in lateral projection and nasoendoscopy; and VF in lateral and frontal projection and nasoendoscopy (all of the available assessment material). The cleft palate team of Göteborg, Sweden, mutually rated velopharyngeal function and recommended action based on the presented material. SUBJECTS: Nineteen consecutive patients (median age 7:5 years, range 4:4-19:7) investigated with VF in lateral and frontal projection and nasoendoscopy during 1997-99 at the cleft palate centre in Göteborg, Sweden. Post operative assessments were excluded. Percent agreement and Kappa calculations were used to compare the different combinations of parts of information to all of the available information. RESULTS: Thirteen of the 19 patients (68%) were recommended the same action regardless of the amount of presented information. Percent agreement (Kappa) between parts and all of the available information: VF in lateral projection 84% (0.75), VF in lateral and frontal projection 79% (0.74), and VF in lateral projection and nasoendoscopy 84% (0.72). CONCLUSIONS: VF in lateral projection is recommended to be the first step in visualising velopharyngeal function, and nasoendoscopy the next when further investigation is required.
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