| 1. |
- Andlin-Sobocki, Anna, et al.
(författare)
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Long-term influence of infant periosteoplasty on facial growth and occlusion in patients with bilateral cleft lip and palate
- 2012
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Ingår i: Journal of Plastic Surgery and Hand Surgery. - 2000-656X .- 2000-6764. ; 46:3-4, s. 229-234
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Tidskriftsartikel (refereegranskat)abstract
- This retrospective, long-term study evaluated the influence of two different treatment protocols, one including infant periosteoplasty, on facial growth and occlusion in patients with complete bilateral cleft lip and palate (BCLP). Thirty-five patients with records of 5-, 8- and I 6-19-year-olds were included. Sixteen of these received infant periosteoplasty (BCLP-pp) to the cleft alveolus in conjunction with lip repair and a one-stage closure of the palate. The remaining 19 patients with a two-stage closure of the palate did not have an infant periosteoplasty (BCLP-np). The bone formation induced by periosteoplasty in the BCLP-np group was insufficient and both groups had secondary bone grafting to the alveolar clefts before the eruption of the lateral incisor or the canine. Facial growth was evaluated with cephalometry at the recorded ages and dental arch relationships with the Huddart and Bodenham crossbite scores at the age of 16-19 years. Until 19 years a significant retrusion of the maxillary position (SNA) was observed in both groups. At 16-19 years of age there was no significant difference of maxillary protrusion (SNA), intermaxillary position (ANB), maxillary length (ss-pm) or vertical skeletal relationships (ML/NSL, MI/NL) between the two groups. However, a significant difference of the crossbite scores was found. The BCLP-pp group did not show more facial growth problems but more malocclusion and the insufficient bone formation of the alveolar clefts after infant periosteoplasty required a secondary bone grafting.
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| 2. |
- Falk Delgado, Alberto, et al.
(författare)
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The Skoog Lip Repair for Unilateral Cleft Lip Deformity : The Uppsala Experience
- 2018
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Ingår i: Plastic and reconstructive surgery (1963). - 0032-1052 .- 1529-4242. ; 141:5, s. 1226-1233
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Tidskriftsartikel (refereegranskat)abstract
- Background: The Uppsala Craniofacial Center has been treating patients with unilateral cleft lip deformity using the lip repair technique described by Tord Skoog. The aim of this study was to determine complications after lip surgery and the incidence and indications for lip revisions in all patients born with unilateral cleft lip from 1960 to 2004.Methods: All patients who were born from 1960 to 2004 with unilateral cleft lip, cleft lip and alveolus, or cleft lip and palate and underwent lip repair were studied retrospectively. The timing, indication, complications of the primary procedure, and type of secondary surgery were recorded. Kruskal-Wallis and Fisher’s exact tests were used, with Bonferroni correction.Results: The study included 443 patients. The total rate of early surgical complications was 6 percent (n = 26). Secondary surgery for short upper lip was performed in 3.8 percent (n = 17), 8.4 percent (n = 37) underwent reduction of excess vermillion, 8.6 percent (n = 38) underwent scar revision, 11 percent (n = 51) underwent revision for incongruent vermillion-cutaneous border, and 10 percent (n = 45) underwent revision for other indications. Altogether, 45 percent had no secondary revisions.Conclusion: In conclusion, the Skoog lip repair is associated with a low total revision rate, and a short-lip deformity is rare.CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.
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| 3. |
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| 4. |
- Hammarberg, Karin M., et al.
(författare)
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Facial clefts involving the midline in combination with intracranial anomalies : Case studies illustrating surgical treatment and medical substitution
- 2012
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Ingår i: Journal of Plastic Surgery and Hand Surgery. - 2000-656X .- 2000-6764. ; 46:3-4, s. 200-203
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Tidskriftsartikel (refereegranskat)abstract
- Malmö and Uppsala have been regional centres for the treatment of cleft lip and palate since the beginning of the 1950s. We have about 80 new cases every year and most patients have conventional oronasal clefts, either cleft lip and palate or isolated cleft palate. During a 10-year period we have come across four patients who have had varying degrees of midface dysplasia combined with intracranial anomalies. One child died at an early age, but the other three children were given medical substitution of hypopituitarism and have had their clefts reconstructed.
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| 5. |
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| 6. |
- Jabbari, Fatima, et al.
(författare)
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Optimization of Dental Status Improves Long-Term Outcome After Alveolar Bone Grafting in Unilateral Cleft Lip and Palate
- 2015
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Ingår i: The Cleft Palate-Craniofacial Journal. - : SAGE Publications. - 1055-6656 .- 1545-1569. ; 52:2, s. 210-218
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Tidskriftsartikel (refereegranskat)abstract
- Objective : To evaluate the importance of dental status for long-term outcome after alveolar bone grafting in patients with unilateral cleft lip and palate. Design : Retrospective longitudinal study. Setting : Cleft lip and palate-craniofacial center, Uppsala University Hospital, Sweden. Patients : A total of 67 consecutive patients with unilateral complete cleft lip and palate. Interventions : Secondary alveolar bone grafting, prior to the eruption of the permanent canine, was performed at the average age of 10.0 years (range, 8.5 to 12.0 years). Main Outcome Measures : Alveolar bone height was evaluated with the modified Bergland index at 1 and 10 years after surgery. Results : Of the patients, 97% had modified Bergland index grade I and the remaining 3% had modified Bergland index grade II at 1 year after surgery. At 10 years' follow-up, 43% showed modified Bergland index grade I; 55%, modified Bergland index grade II; and 2% (one patient), modified Bergland index grade III. The degree of dental anomalies in the cleft area, such as enamel hypoplasia, incisor rotation, incisor inclination, canine inclination, and oral hygiene registered preoperatively, all correlated negatively to the modified Bergland index at 10 years after surgery. Enamel hypoplasia (ρ = 0.70195, P < .0001), followed by canine inclination (ρ = 0.55429, P < .0001), showed the strongest correlation to reduced bone height in the cleft area. Conclusions : In patients with unilateral cleft lip and palate, excellent results from secondary alveolar bone grafting in terms of bone height in the alveolar cleft tend to decrease with time. This seems to be correlated with factors that might to some extent be treated preoperatively through adequate planning and execution of the orthodontic treatment.
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| 7. |
- Jabbari, Fatemeh, et al.
(författare)
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Skoog Primary Periosteoplasty versus Secondary Alveolar Bone grafting in Unilateral Cleft Lip and Alveolus : Long.term effects on alveolar Bone Formation and Maxillary Growth
- 2017
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Ingår i: Plastic and reconstructive surgery (1963). - 0032-1052 .- 1529-4242. ; 139:1, s. 137-148
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Tidskriftsartikel (refereegranskat)abstract
- Background: Clefts involving the alveolus are treated using one of two strategies: primary periosteoplasty at the time of lip repair or secondary alveolar bone grafting at mixed dentition. Most teams favor secondary alveolar bone grafting because of its high success rate, and concerns have been raised that primary periosteoplasty may interfere with maxillary growth. However, primary periosteoplasty may obviate the need for future bone grafting and is still practiced in some centers. Few studies compare the long-term outcomes of these two strategies.Methods: Fifty-seven consecutive patients born with unilateral cleft lip and alveolus were studied retrospectively. All patients underwent primary lip repair using Skoog's method; 28 patients underwent primary periosteoplasty at the time of lip repair and the remaining 29 underwent secondary alveolar bone grafting at mixed dentition. Occlusal radiographs obtained at ages 10 and 16 years were analyzed for alveolar bone height. Cephalometric analysis assessed growth at ages 5, 10, and 18 years.Results: Seventeen of 28 patients treated using primary periosteoplasty required later secondary bone grafting, and the bone height at age 16 years was lower in the primary periosteoplasty group (p < 0.0001). There was a more pronounced decrease in maxillary protrusion from ages 5 to 10 years in the primary periosteoplasty group (p < 0.03). However, at age 18 there was no significant difference in maxillary growth between the two groups.Conclusion: Primary periosteoplasty did not seem to inhibit long-term maxillary growth but was ineffective as a method of reconstructing the alveolar cleft.
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| 8. |
- Johansson Niemelä, Birgitta, 1948-, et al.
(författare)
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A Clinical Report : Mental health, Self-esteem and Social Interaction in Adolescents with CL/P in the Context of Re-constructive Surgery
- 2011
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Ingår i: Depression and anxiety (Print). - 1091-4269 .- 1520-6394. ; 1:102
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Tidskriftsartikel (refereegranskat)abstract
- Background:Self-esteem in children and adolescents with deviances in function and appearance has been studied with diverse results. The effect of cleft lip/ and palate on mental health, self-esteem and social interaction were studied in the context of reconstructive surgery. Comparing parents’ and children’s’ self-esteem reports was also of interest. Exploring these differences could help the understanding of future mental health in patients with CL/P and their need for reconstructive surgery. Methods:A descriptive study within an in-patient setting, Plastic Surgery Clinic, Uppsala University Hospital. Twenty-six CL/P patients between 13 and 19 years of age and their parents answered a specific condition questionnaire specially adapted for this study and Beck’s Youth Inventories the day before reconstructive surgery. Results:Mental health was affected while self-esteem was on a median-high level for this CL/P group. Parents rated their children to have higher self-esteem as they grew older. However, females reported a diminished level from primary to secondary school age. Attention on CLP was high. Twenty-three adolescents, or 85 % of resondents, wanted to change their appearance, Conclusion:Mental health was affected by CL/P, especially for those children that had been bullied. Specifically, the wish to change appearance was associated with high level of anxiety and depression. The specific condition questionnaires proved to be more informative than the standardized measure regarding self-esteem under development for the sake of differentiating between parent-adolescent estimation of self-esteem.
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| 9. |
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| 10. |
- Mani, Maria, et al.
(författare)
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Factors Related to Quality of Life and Satisfaction with Nasal Appearance in Patients Treated for Unilateral Cleft Lip and Palate
- 2013
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Ingår i: The Cleft Palate-Craniofacial Journal. - : SAGE Publications. - 1055-6656 .- 1545-1569. ; 50:4, s. 432-439
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To identify factors related to Quality of Life (QoL) and satisfaction with nasal appearance among patients treated for unilateral cleft lip and palate (UCLP).Design: Cross sectional population study with long-term follow-up.Patients/Settings:All patients with UCLP born between 1960-1987, treated at Uppsala University Hospital, were invited (n=109), 86 (79%) participated. Mean follow-up time was 35 years.Main outcome measures:QoL was measured with Short Form-36 (SF-36) and analyzed using mental and physical cluster scores (MCS and PCS). Nasal appearance was self-assessed with "Satisfaction with Appearance" questionnaire and by panel judgment. Multivariate regression analyses explored endogenous factors (age, gender, infancy cleft width, nasal function, nasolabial appearance) and exogenous factors (marital status, number of children, education level, operation method, number of rhinoplasties performed).Results:A larger cleft width in infancy was associated with less satisfaction with nasal appearance as adults. A lower mental health QoL was associated with less satisfaction with nasal appearance. Despite female gender being linked to less satisfaction with nasal appearance, it was associated with higher mental health QoL. Higher resistance during nasal breathing was associated to lower physical health QoL.Conclusions:Gender and infant cleft width may affect QoL and satisfaction with nasal appearance among adults. They are potential predictive factors for satisfaction with nasal appearance and QoL during adulthood. The correlation of nasal function impairment and decreased physical health QoL underlines the importance of treatment of nasal symptoms in these patients.
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