| 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. |
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| 4. |
- 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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| 5. |
- 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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| 6. |
- 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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| 7. |
- Lohmander, Anette, 1956, 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: Speech outcome.
- 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. ; 49:6, s. 657-671
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Tidskriftsartikel (refereegranskat)abstract
- Abstract Abstract Objective: To investigate long-term, longitudinal speech outcome in patients born with unilateral cleft lip and palate (UCLP) treated according to a two-stage primary palatal protocol with early veloplasty and delayed hard palate closure. Design: Retrospective, longitudinal cohort study. Setting: A University Hospital in Western Sweden. Subjects: A consecutive series of 55 patients from the total cohort of 65 were included. All patients had surgical procedures at Sahlgrenska University Hospital, Gothenburg, Sweden. Methods: Standardized audio recordings were blindly analyzed at 5, 7, 16, and 19 years of age, and after at a clinical visit at 10 years of age. Typical cleft speech variables were independently rated on ordinal scales. Intelligibility and perceived velopharyngeal function were also assessed. Prevalences of speech characteristics were determined, and inter- and intra agreement were calculated. Results: Prominent hypernasality, nasal air leakage, and retracted oral articulation at 5 years were markedly reduced throughout the years with low prevalences at age 16 and 19 years. Perceived velopharyngeal competence (VPC) was noted in 82 % at age 16 and 87 % at age 19 years along with normal intelligibility. Pharyngeal flap surgery was performed in six of the 55 patients (11 %). Conclusions: Long-term speech outcome in patients with two-stage palatoplasty with early soft palate repair was considered good and improved even before hard palate repair. The typical retracted oral articulation was quite frequent during the early ages, whereas non-oral misarticulations were almost non-existing implying good VPC. Keywords: Speech outcome, unilateral cleft lip and palate, longitudinal, long-term, two-stage repair.
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