Three-dimensional stereophotogrammetric systems have some advantages over direct anthropometry, and therefore the method could be sufficiently precise and accurate on palatal cast digitization with unilateral cleft lip and palate. This would be useful for clinical analyses in maxillofacial, plastic, and aesthetic surgery.
Maxillary segments have the potential for growth during presurgical orthopedic treatment in the early neonatal period. The cleft segment delimitation on digital dental casts and area measurements by the 3D stereophotogrammetric system revealed an accurate (true and precise) method for evaluating the stone casts of newborn patients with UCLP.
To compare the three-dimensional changes occurring in the maxillary arch during the use of modified pre-surgical nasoalveolar moulding (PNAM) and Hotz's plate. A clinical trial including 32 children with unilateral cleft lip and palate (UCLP), 16 treated with Hotz's plate and 16 with PNAM, was performed. Impressions of the maxillary arches were taken: A. prior to pre-surgical orthopaedics, B. before cheiloplasty and C. after cheiloplasty. Models were digitised using a stereophotogrammetric instrument, and geodesic distances were calculated: anterior, canine and posterior widths of the arch, and lengths and cleft depths of the larger and shorter segments. The time and treatment effects were assessed by two-factor anova. A significant effect of treatment was found for cleft depth at the larger segment: children treated with Hotz's plate had significantly deeper cleft than children treated with PNAM. All distances significantly changed during time: the anterior and canine widths decreased, while the posterior width, the lengths and depths of the cleft segments increased. Significant treatment per time interactions was found. The anterior and canine widths reduced more with PNAM between time points A and B while Hotz's treatment was more effective between B and C. The shorter segment depth increased more between B and C with PNAM, and between A and B with Hotz's plate. During pre-surgical orthopaedics, therapy with PNAM obtained the best results in reducing the width at the anterior segment of the cleft. This treatment gave a lower increase in cleft depth than treatment with Hotz's plate.
Background Unilateral cleft lip and / or palate (UCL/P) is one of the most common congenital craniofacial differences. The objective of this study was to describe the maternal perception of breastfeeding in children with unilateral cleft lip and palate and to assess the role of breastfeeding counseling. Methods This study was conducted using an interpretive phenomenological approach to explore the experience from the perspectives of mothers breastfeeding her UCL/P child. Twenty-eight mothers of patients with nonsyndromic UCL/P treated with nasoalveolar molding (NAM) therapy between April 2015 and April 2018 were selected during consultations at the Fundación Clínica Noel in Medellín, Colombia. Thematic analysis was conducted for qualitative data. Results The findings resulted in six main categories: First contact with the CL/P team, access to early diagnosis and timely treatment, perceptions of parents about health personnel on breastfeeding of CL/P patients, perceptions of mothers toward breastfeeding, perception of advantages and disadvantages of the NAM technique regarding breastfeeding and assessment of the CL/P team. The interviewed mothers, both prenatally and postnatally, stated the benefits of initiating the process prenatally. There are still difficulties in reaching a timely diagnosis. Several mothers noted that health professionals and assistants determined the hospitalization, installation of a nasogastric tube or feeding through a baby bottle or syringe, which prevented the first contact between mother and child. Even though the exclusive breastfeeding process is difficult for these mothers, they acknowledge its immense advantages. Interviewed mothers considered using the NAM therapy advantageous as the obturator allowed a better bottle-feeding process. The interdisciplinary team generates satisfaction, motivation, expectations and happiness in the mothers who initiated this therapy with their children. Conclusion The participants related difficulties with exclusive breastfeeding. Mothers acknowledged the clinical results when using the NAM therapy and the support provided by the IBCLC. We encourage health providers in Medellín, Colombia, to seek education to enhance their clinical skills and promote and protect breastfeeding. Also, health professionals in other cities or countries could consider search more breastfeeding education as well.
Background : Unilateral cleft lip and / or palate (UCLP) is one of the most common congenital craniofacial difference. The objective of this study was to describe maternal perception of breastfeeding in children with unilateral cleft lip and palate and to assess the role of breastfeeding counseling. Methods : Qualitative descriptive method and phenomenological analysis were used to analyze the narratives. 28 mothers of patients with nonsyndromic UCLP treated with nasoalveolar molding (NAM) between April 2015 and April 2018 were strategically selected and interviewed after NAM treatment. Framework analysis was conducted for qualitative data. The CES University ethical committee approved the study. Results : The findings resulted in six main categories: First contact with the CLP program, access to early diagnosis and timely treatment, perceptions of parents about health personnel on breastfeeding of CLP patients, perceptions of mothers toward breastfeeding, perception of advantages and disadvantages of the NAM technique regarding breastfeeding and assessment of the CLP program. The interviewed mothers, both prenatally and postnatally, stated the advantages of initiating the process prenatally. There are still difficulties for reaching a timely diagnosis. Several mothers stated that health professionals and assistants determined the hospitalization, installation of a nasogastric tube or feeding through a baby bottle or syringe, which prevented the first contact between mother and child. Even though the breastfeeding process is difficult for these mothers, they acknowledged its immense advantages. Interviewed mothers considered the use of the NAM advantageous as the obturator allowed a better bottle-feeding process. The program generates satisfaction, motivation, expectations and happiness to the mothers who initiated this therapy with their children. Conclusion : The participants related difficulties with breastfeeding. Mothers acknowledged the clinical results when using the NAM obturator, as well as the support provided by the breastfeeding consultant.
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