Cleft palate repair: art and issues (original) (raw)
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Siriraj Medical Journal, 2022
Cleft lip and/or cleft palate (CL±P) in addition to the cleft palate (CP) are a category of anomalies known as orofacial clefts (OC). These anomalies are accompanied by several aesthetic and functional problems. Information on the prevalence of OC showed different values between studies worldwide. In addition, the presence of cleft lip and/or cleft palate is determined by several changes during the embryonic stage. Besides, cleft repair may lead to a significant impact on the overall aesthetic and function and could negatively affect maxillary growth on certain occasions. Therefore, having the background and knowledge on this phenomenon is essential in designing the overall treatment and obtaining outcomes that are as close to normal as possible. This article reviews the maxillary development, occurrence of cleft lip and/or palate and their prevalence, facial growth in the presence of clefts, effect of cleft repair, an overview of alveolar cleft treatment, as well as the essential information related the prevention of cleft lip and palate.
Cleft Lip and Palate: The Multidisciplinary Management
2012
Patients with cleft lip and palate usually face a multitude of problems, esthetic compromise being the most noticeable, malocclusion, missing teeth, oronasal fistula, speech and hearing pathology are also present in most cleft patients; this necessitates a multidisciplinary treatment across various medical and dental specialties that extends from birth to adulthood but in separate stages. A protocol for the treatment of cleft patients should followed by the healthcare providers, and coordination amongst them is a major contributor to success in cleft treatment.
Current concepts in cleft care: A multicenter analysis
Journal of cranio-maxillo-facial surgery : official publication of the European Association for Cranio-Maxillo-Facial Surgery, 2018
The current surgical techniques used in cleft repair are well established, but different centers use different approaches. To determine the best treatment for patients, a multi-center comparative study is required. In this study, we surveyed all craniofacial departments registered with the German Society of Maxillofacial Surgery to determine which cleft repair techniques are currently in use. Our findings revealed much variation in cleft repair between different centers. Although most centers did use a two-stage approach, the operative techniques and timing of lip and palate closure were different in every center. This shows that a retrospective comparative analysis of patient outcome between the participating centers is not possible and illustrates the need for prospective comparative studies to establish the optimal technique for reconstructive cleft surgery.
Cleft Lip and Palate -A Review Article
https://www.ijrrjournal.com/IJRR\_Vol.9\_Issue.7\_July2022/IJRR-Abstract27.html, 2022
Craniofacial anomalies, and in particular cleft lip and palate, are major human birth defects with a worldwide frequency of 1 in 700 and substantial clinical impact. The cause of clefts is multifactorial with both genetic and environmental input and intensive research efforts have yielded significant advances in recent years facilitated by molecular technologies in the genetic field. In 2008, the World Health Organisation (WHO) has recognised that non-communicable diseases, including birth defects cause significant infant mortality and childhood morbidity and have included cleft lip and palate in their Global Burden of Disease (GBD) initiative. This will further facilitate the birth defects registration and international efforts aimed at improving quality of care and ultimately prevention of nonsyndromic clefts of the lip and palate.
Cleft Lip and Palate Management from Birth to Adulthood: An Overview
Insights into Various Aspects of Oral Health, 2017
Cleft lip and palate (CLP) is the most common congenital deformity of the orofacial. Clefts are thought to be of multifactorial etiology due to genetic and environmental factors. Different dental abnormalities are usually seen in cleft patients, including midface deficiency, collapsed dental arches, malformation of teeth, hypodontia, and supernumerary teeth. Moreover, feeding and speech are major functional dilemmas for those patients. The goal of treatment is to restore esthetics and functional impairments associated with clefts. The nature and the extent of medical and dental problems among CLP patients dictate the need toward multidisciplinary approach where different medical and dental specialists are involved in the treatment. The purpose of this section is to codify and synthesize a literature about management of cleft lip and palate deformity from birth until adulthood so that general concepts, principles, and axioms can be formulated. In this regard, feeding plates, nasoalveolar molding (NAM), lip and palate repair, palatal expansion, alveolar bone grafting, rhinoplasty, orthodontic treatment, and orthognathic surgery will be discussed. Furthermore, the question of proper timing for each therapeutic procedure is scrutinized in this chapter. Suggested clinical tips and changes of treatment modalities are summarized and illustrated as well.
2017
Background Clefts of the lip and palate, occurring with an incidence of about 1 per 500 births, are among the commonest birth anomalies affecting humans. The anatomical location of the defect creates problems in feeding, speech, hearing, dental development and facial growth. Communication disability and the distorted facial appearance represent serious barriers to social integration. The success of primary surgery in the early months of life is crucial in determining outcome for the above functions, and the subsequent cost of secondary surgery and remedial care. The scientific basis of the cleft lip and palate discipline is weak since virtually no elements of treatment have been subjected to the rigours of contemporary clinical trial design (Roberts et al., 1991). Thus highly complex and varied protocols of care and a bewildering diversity of surgical technique, timing, and sequencing is practised by teams. Cleft care generally constitutes only a minor part of the clinical load of the disciplines involved-nursing, plastic surgery, maxillofacial surgery, otolaryngology, speech therapy, audiology, counselling psychology, genetics, orthodontics, dentistry. Cleft surgery is almost completely devoid of a sound evidence base. A review of 25 years of the Cleft Palate-Craniofacial Journal identified only 3 randomised control trials, and none of these involved primary surgery (Roberts et al., 1991).