| 1. |
- Karsten, A, et al.
(author)
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Dental occlusion after Veau-Wardill-Kilner versus minimal incision technique repair of isolated clefts of the hard and soft palate
- 2003
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In: The Cleft palate-craniofacial journal : official publication of the American Cleft Palate-Craniofacial Association. - : SAGE Publications. - 1055-6656. ; 40:5, s. 504-510
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Journal article (peer-reviewed)abstract
- To compare the Veau-Wardill-Kilner technique with a technique similar to the minimal incision technique described by Mendosa et al. on the basis of surgical complications and dentoalveolar status in the deciduous dentition. Design Retrospective study of medical and dental records and casts. Patients A consecutive series of 129 Caucasian children born with isolated cleft palate between 1980 and 1992. Main Outcome Measures From medical records, the variables of time for surgery, blood loss, complications in the immediate postoperative period, and frequency of fistulas were evaluated. On dental casts, the variables of sagittal, transversal, and vertical relations; structure of the palatal mucosa; and height of the palatal vault were studied. Results Time for surgery was shorter in the extensive clefts repaired with a Veau-Wardill-Kilner technique. Blood loss was higher using the Veau-Wardill-Kilner technique. The width of the upper jaw was significantly narrower in the Veau-Wardill-Kilner group, compared with the minimal incision group. Scar tissue and pits of the palate were more frequently found in the Veau-Wardill-Kilner group. Conclusions The minimal incision technique in this study has been shown to result in better development of the upper jaw with a better dental occlusion and palatal mucosa with significantly less scar tissue.
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| 2. |
- Lindman, Rolf, et al.
(author)
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Morphological characterization of the levator veli palatini muscle in children born with cleft palates
- 2001
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In: The Cleft Palate-Craniofacial Journal. - 1055-6656 .- 1545-1569. ; 38:5, s. 438-448
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Journal article (peer-reviewed)abstract
- OBJECTIVE: The aim of this study was to analyze, morphologically and biochemically, one of the soft palate muscles, the levator veli palatini (LVP), in children born with cleft palate.SUBJECTS AND METHODS: Biopsies were obtained from nine male and three female infants in connection with the early surgical repair of the hard and soft palate. Samples from five adult normal LVP muscles were used for comparison. The muscle morphology, fiber type and myosin heavy chain (MyHC) compositions, capillary supply, and content of muscle spindles were analyzed with different enzyme-histochemical, immunohistochemical, and biochemical techniques.RESULTS: Compared with the normal adult subjects, the LVP muscle from the infantile subjects with cleft had a smaller mean fiber diameter, a larger variability in fiber size and form, a higher proportion of type II fibers, a higher amount of fast MyHCs, and a lower density of capillaries. No muscle spindles were observed. Moreover, one-third of the biopsies from the infantile subjects with cleft LVP either lacked muscle tissue or contained only a small amount.CONCLUSIONS: The LVP muscle from children with cleft palate has a different morphology, compared with the normal adult muscle. The differences might be related to different stages in maturation of the muscles, changes in functional demands with growth and age, or a consequence of the cleft. The lack of contractile tissue in some of the cleft biopsies offers one possible explanation to a persistent postsurgical velopharyngeal insufficiency in some patients, despite a successful surgical repair.
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| 3. |
- Marcusson, Agneta, 1956-, et al.
(author)
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Quality of life in adults with repaired complete cleft lip and palate
- 2001
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In: The Cleft Palate-Craniofacial Journal. - 1055-6656 .- 1545-1569. ; 38:4, s. 379-385
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Journal article (peer-reviewed)abstract
- Objective: This study evaluated the quality of life in adult Swedish subjects with repaired complete cleft lip and palate (CLP).Design/Patients: Sixty-eight adults with repaired CLP were compared with a group of 66 adults without cleft matched by gender and age.Outcome Measures: The outcome measures included a self-report questionnaire concerning quality of life in general, well-being, and health-related quality of life.Results: The CLP group rated their quality of life significantly lower than did the control group in the areas of life meaning (p < .05), family life (p < .0001), and private economy (p < .01). There were no significant differences between the groups concerning well-being. In the CLP group, the health-related quality of life was significantly lower concerning global life (p < .0001), disturbance to life (p < .01), well-being (p < .0001), social contacts (p < .0001), and family life (p < .05) but significantly higher concerning ability to make the most of leisure time (p < .001) and to be active (p < .001).Conclusions: The CLP group perceived a marked impact of the handicap on their lives concerning global aspects, well-being, and social life. More practical and tangible aspects of their daily living, however, were not affected, and only some minor aspects of their quality of life in general were poor in comparison with the control group, which indicates a fairly good life adjustment in spite of the handicap.
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| 4. |
- Hutters, B, et al.
(author)
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Speech outcome following treatment in cross-linguistic cleft palate studies: methodological implications
- 2004
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In: The Cleft palate-craniofacial journal : official publication of the American Cleft Palate-Craniofacial Association. - : SAGE Publications. - 1055-6656. ; 41:5, s. 544-549
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Journal article (peer-reviewed)abstract
- In cross-linguistic studies of cleft palate speech outcome following treatment, treatment is the independent variable, speech outcome is the dependent variable, and the speakers’ language background is a background variable, like sex, age, and cleft type, which must be eliminated. This article focuses on language as a background variable and how it should be treated. The methodological problems are illustrated through a presentation of two cross-linguistic speech outcome studies. Conclusion When speakers of different language background are included in cleft palate studies of speech outcome following treatment, speech outcome data should be based on speech units that are phonetically identical across languages. This affects the make-up of the speech material used in the study. In practice, the requirement of phonetically identical speech units may not be totally met, and detailed information regarding the interaction between the cleft condition and speech sound production is still required to fully understand how the validity of data is affected if this requirement is not met.
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| 5. |
- Källén, Bengt
(author)
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Maternal drug use and infant cleft lip/palate with special reference to corticoids
- 2003
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In: The Cleft Palate - Craniofacial Journal. - : SAGE Publications. - 1545-1569 .- 1055-6656. ; 40:6, s. 624-628
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Journal article (peer-reviewed)abstract
- Objective: To study the association between maternal drug use in early pregnancy and orofacial cleft in the infant. Design: Register analysis based on prospectively collected information. Patients: All delivered women in Sweden July 1, 1995, through December 31, 2001. Main outcome measure: Presence of orofacial cleft in infant. Results: Prospective information on maternal drug use during the first trimester, as reported in early pregnancy, was studied in 1142 infants with orofacial clefts, isolated or with other malformations, excluding chromosome anomalies. Any drug use was not associated with clefts (odds ratio [OR] = 0.98, 95% confidence interval [95% CI] = 0.85 to 1.13), with isolated clefts (OR = 0.92) with isolated median cleft palate (OR = 1.03, 95% CI = 0.79 to 1.36) or with isolated cleft lip with or without cleft palate (OR = 0.86, 95% CI = 0.71 to 1.05). Reported use of multivitamins, folic acid, or 131, was not associated with a decrease in orofacial cleft risk (OR = 1.00, 95% CI = 0.63 to 1.52). ORs above 2 were seen for some drugs: sulfasalazine, naproxen, and anticonvulsants, but only a few exposed cases occurred. An association between glucocorticoid use and infant cleft was indicated and seemed to be strongest for median cleft palate. Conclusion: Maternal drug use seems to play only a small role for the origin of orofacial clefts, at least in Sweden.
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| 6. |
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| 7. |
- Pirttiniemi, P, et al.
(author)
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Dental maturation in children with shunt-treated hydrocephalus
- 2004
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In: The Cleft palate-craniofacial journal : official publication of the American Cleft Palate-Craniofacial Association. - : SAGE Publications. - 1055-6656. ; 41:6, s. 651-654
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Journal article (peer-reviewed)abstract
- The aim of this study was to examine the relationship between dental maturation and somatic development and to discover their possible deviations in children with shunt-treated hydrocephalus. Design Radiographs (orthopantomogram and hand-wrist radiograph) from children with shunt-treated hydrocephalus were analyzed with respect to the dental maturation and compared with values of an age- and sex-matched control group and population standards. Patients Forty-one children with shunt-treated hydrocephalus (27 boys and 14 girls) aged from 5 to 16 years (median age 11.0 years). Results The mean deviation of dental age from chronological age was significantly greater in the hydrocephalic group than in the control group. The mean value of dental age deviation was advanced in early pubertal stages but reduced in later pubertal stages. Conclusions These findings can be explained by changes in the endocrinological conditions, which are due to disturbed pituitary secretion. The present results could also partly reflect an adaptable developmental pathway in an otherwise strictly genetically determined process.
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| 8. |
- Sarnäs, Karl-Victor, et al.
(author)
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Maxillary and Mandibular Displacement in Hemifacial Microsomia: A Longitudinal Roentgen Stereometric Study of 21 Patients With the Aid of Metallic Implants.
- 2004
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In: The Cleft Palate - Craniofacial Journal. - : SAGE Publications. - 1545-1569 .- 1055-6656. ; 41:3, s. 290-303
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Journal article (peer-reviewed)abstract
- To record maxillary and mandibular displacement with articular growth and in response to bimaxillary surgical repositioning in patients with hemifacial microsomia (HFM) and to observe ipsilateral corpus/ramus growth in severely affected children. Design Prospective roentgen stereometric analysis (mean age 7 years 10 months to 18 years 0 months) and retrospective profile and panoramic roentgenograms. Mean total observation period was 9 years 1 month. Setting Department of Plastic and Reconstructive Surgery, Malmö University Hospital (Malmö, Sweden). Patients Twenty-one patients consecutively diagnosed from 1976 through 1988 with HMF, five of whom had bimaxillary surgery. Interventions Surgery was performed at the Department of Plastic and Reconstructive Surgery. Implants were inserted at the initial reconstructive surgical procedure under general anesthesia. Roentgen examinations were performed in connection with continued clinical evaluations and treatment. Main Outcome Measures Stereo roentgenograms were digitized at the Department of Orthopedic Surgery, Malmö University Hospital (Malmö, Sweden). Results Displacement of the jaws with articular growth and in response to bimaxillary surgical repositioning varied interindividually with no apparent common pattern. Relapse displacement occurred several years after bimaxillary surgery. Mandibular growth changes were found in the corpus/ramus area and alveolar process on the affected side. Conclusions A marked interindividual variability of maxillary and mandibular displacement indicates that the relevance of statistical analysis of HFM growth data may be questioned. We would suggest that precise and accurate longitudinal recordings of growth and response to surgery in individual HFM patients be more appropriate.
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| 9. |
- Lohmander, Anette, 1956, et al.
(author)
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Methodology for perceptual assessment of speech in patients with cleft palate: a critical review of the literature.
- 2004
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In: The Cleft palate-craniofacial journal : official publication of the American Cleft Palate-Craniofacial Association. - 1055-6656. ; 41:1, s. 64-70
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Journal article (peer-reviewed)abstract
- OBJECTIVE AND DESIGN: This review of 88 articles in three international journals was undertaken for the purpose of investigating the methodology for perceptual speech assessment in patients with cleft palate. The articles were published between 1980 and 2000 in the Cleft Palate-Craniofacial Journal, the International Journal of Language and Communication Disorders, and Folia Phoniatrica et Logopaedica. RESULTS AND CONCLUSIONS: The majority of articles (76) were published in the Cleft Palate-Craniofacial Journal, with an increase in articles during the 1990s and 2000. Information about measures or variables was clearly given in all articles. However, the review raises several major concerns regarding method for collection and documentation of data and method for measurement. The most distressing findings were the use of a cross-sectional design in studies of few patients with large age ranges and different types of clefts, the use of highly variable speech samples, and the lack of information about listeners and on reliability. It is hoped that ongoing national and international collaborative efforts to standardize procedures for collection and analysis of perceptual data will help to eliminate such concerns and thus make comparison of published results possible in the future.
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| 10. |
- Persson, Christina, 1959, et al.
(author)
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Speech outcomes in isolated cleft palate: impact of cleft extent and additional malformations.
- 2002
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In: The Cleft palate-craniofacial journal : official publication of the American Cleft Palate-Craniofacial Association. - 1055-6656. ; 39:4, s. 397-408
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Journal article (peer-reviewed)abstract
- OBJECTIVE: The purpose of the study was to study the speech outcome in a series of 5-year-old children born with an isolated cleft palate and compare the speech with that of noncleft children and to study the impact of cleft extent and additional malformation on the speech outcome. DESIGN: A cross-sectional retrospective study. SETTING: A university hospital serving a population of 1.5 million inhabitants. SUBJECTS: Fifty-one patients with an isolated cleft palate; 22 of these had additional malformations. Thirteen noncleft children served as a reference group. INTERVENTIONS: A primary soft palate repair at a mean of 8 months of age and a hard palate closure at a mean age of 4 years and 2 months if the cleft extended into the hard palate. MAIN OUTCOME MEASURES: Perceptual judgment of seven speech variables assessed on a five-point scale by three experienced speech pathologists. RESULTS: The cleft palate group had significantly higher frequency of speech symptoms related to velopharyngeal function than the reference group. There were, however, no significant differences in speech outcome between the subgroup with a nonsyndromic cleft and the reference group. Cleft extent had a significant impact on the variable retracted oral articulation while the presence of additional malformations had a significant impact on several variables related to velopharyngeal function and articulation errors. CONCLUSION: Children with a cleft in the soft palate only, with no additional malformations, had satisfactory speech, while children with a cleft palate accompanied by additional malformations or as a part of a syndrome should be considered to be at risk for speech problems.
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