Complete Bilateral Cleft Lip and Palate

Cleft lip and palate (CLP) patients have various problems with nasal anatomy beyond just oronasal separation. The alar base, concha, and septum are over impressed in these individuals. Additionally, skeletal class III deformity is seen. These conditions may limit nasal function. In our study, 15 unilateral patients with CLP older than 15 years (10 females, 5 males; mean age: 19.13) who had received surgery were included as the study group, and 15 participants with noncleft skeletal class III deformities were included as the control group (10 females, 5 males; mean age: 19.20). The individuals' nasal airway volumes (total/cleft side/noncleft side/control/ nasal passages) were examined and compared statistically. The results showed that the study group had significantly higher values in terms of total airway volume ( P < .05). Additionally, there were significant differences between the cleft side and noncleft side volumes, between the cleft side volumes and the volumes of the control group participants, and between the noncleft side volumes and the volumes of the control group participants ( P < .05). There was no difference between the groups in terms of nasopharyngeal ( P = .39) and nasal passage volumes ( P = .73). The results show there are some problems regarding nasal airway volume in patients with CLP, even when lip, palate, and alveolar cleft operations have been performed. The aim of this study was to evaluate differentiation of nasal airway volumes between unilateral patients with CLP and individuals with noncleft skeletal class III serving as the control group.

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Evaluation of Nasal Airway Volume of Operated Unilateral Cleft Lip and Palate Patients Compared With Skeletal Class III Individuals

Ertaş

Ataol

2018

“…There are many causes for this, but a major factor is the postnatal “environment” broadly defined. Children with clefts experience problems with feeding, respiration, speech, social interactions, and many other physical and psychosocial problems (Berkowitz, 2013; Losee et al, 2015). The permanent teeth mineralize during this debilitating postnatal milieu (Kitamura, 1989), where several environmental stressors slow growth (eg, feeding problems, airway problems, aspiration problems, recurrent surgeries, etc).…”

Section: Introductionmentioning

confidence: 99%

A Retrospective Mixed Longitudinal Study of Tooth Formation in Children With Clefts

Kimbrough

Parris

Williams

et al. 2020

Objective: To test for systematic age changes in cleft children based on dental age. Design: Retrospective case–control longitudinal study. Setting: One orthodontic solo practice. Patients: Nonsyndromic, complete cleft lip and palateCLP cases, either unilateral or bilateral (102 children; 370 radiographs), between 4 and 16 years of age. Interventions: Children were treated with a team approach, but only orthodontic radiographs were studied. Main Outcome Measure: The principal outcome measure was dental age of the cleft cases compared to a sex-specific sample of phenotypically normal children (1107 children), from the same geographical region. Multiple panoramic radiographs taken during the course of orthodontic treatment were examined to track patterns of dental age as children matured. Analysis used linear mixed models primarily testing for sex, cleft type (unilateral, bilateral), and hypodontia differences. Initial expectation was that cleft children would exhibit delayed dental ages from postnatal stressors and would become more deviant with maturity. Results: In childhood (4-6 years), both sexes were significantly delayed ( P < .001), but dental age normalized around 8 to 10 years. Boys experienced faster maturation thereafter than girls ( P < .001). Only trivial differences occurred between unilateral CLP and bilateral CLP samples.Hypodontia further depressed maturation rates ( P < .001). Dental age improved in a decidedly curvilinear fashion ( P < .001), with greater change at earlier ages. Conclusions: This report agrees with other contemporary studies, showing childhood catch-up. Older studies observed that clefting caused significant delays that worsened with growth. This potential “seachange” suggests better recovery and quicker normalization of children with clefts, perhaps due to improved management.

“…Clefts result from errors in the embryonic facial fusion process and can affect the lip, jawbone, and/or palate (Kernahan and Stark, 1958; Arosarena, 2007). In addition to facial growth deficiencies (Chen et al, 2015), Eustachian tube dysfunction (Chang et al, 2013), dentition problems, and reduced quality of life (Berkowitz, 2006) affected patients may also have velopharyngeal insufficiency, which manifests as an alteration of the swallowing process and impaired speech (Henkel et al, 2002). In newborns, an open palate, and particularly an impaired swallowing function, is a major concern.…”

Section: Introductionmentioning

confidence: 99%

Deglutition in Patients With Hypernasality Associated With Unilateral Cleft Lip and Palate Evaluated With High-Resolution Manometry

Kallusky

Zimmerer

Tavassol

et al. 2019

Objective: To evaluate pharyngeal pressure profiles during swallowing in patients with unilateral cleft lip and palate (UCLP) and identify compensation mechanisms. Design: Prospective experimental study. Setting: University Hospital and Medical School. Participants: Ten volunteers and 10 patients with nonsyndromic repaired UCLP with hypernasality (age: 19-27 years, 5 females and 5 males per group) were included. Interventions: All participants swallowed 2 and 10 mL of water and underwent high-resolution manometry (HRM). Main Outcome Measures: Pharyngeal and upper esophageal sphincter (UES) parameters were measured using HRM. Student t test was used for statistical intergroup comparisons. Additionally, the Sydney Swallowing Questionnaire (SSQ) was used as a subjective measure. Results: Patients exhibited reduced velopharyngeal closing pressure and velopharyngeal and tongue base (TB) region contraction times, compared to volunteers ( P < .05). The UES opening and closing functions did not change. The SSQ revealed nasal regurgitation in some patients. Conclusions: In patients with UCLP, velopharyngeal region alterations are caused by impaired muscle force and function. The reduced TB contraction time may be a compensation mechanism allowing bolus transportation without nasal regurgitation. However, deglutition is not completely altered since UES function remains normal. Future studies will need to reveal at which point a decrease in velopharyngeal closing pressure will result in velopharyngeal insufficiency.