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Charlotta Gustafsson, Arja Heliövaara, Junnu Leikola, Jorma Rautio
OBJECTIVE: Speech-correcting surgeries (pharyngoplasty) are performed to correct velopharyngeal insufficiency (VPI). This study aimed to analyze the need for speech-correcting surgery in children with isolated cleft palate (ICP) and to determine differences among cleft extent, gender, and primary technique used. In addition, we assessed the timing and number of secondary procedures performed and the incidence of operated fistulas. DESIGN: Retrospective medical chart review study from hospital archives and electronic records...
January 1, 2018: Cleft Palate-craniofacial Journal
Sergey Y Turin, Cathy J Tang, Arun K Gosain
The anatomy of the greater palatine foramen has variation with regard to location, but there have been no reports on the absence of a complete foramen. We present 2 cases of pediatric patients with cleft palates possessing a greater palatine "notch" as opposed to a bony foramen. Awareness of this anomaly is advantageous in preventing injury to the greater palatine vessels during palatoplasty.
January 1, 2018: Cleft Palate-craniofacial Journal
Hsueh-Yu Li, Li-Ang Lee, Eric J Kezirian, Meiho Nakayama
Suspension palatoplasty, a new surgical technique to treat obstructive sleep apnea (OSA), has been developed to correct the retropalatal obstruction in patients with small tonsils (grade I/II) and anterior-posterior palatal (A-P) obstruction. The objecteive of this preliminary study was to investigate the effectiveness and change in retropalatal airway dimensions after suspension palatoplasty. This retrospective case series study included 25 consecutive male adults with OSA. Unique technical features of suspension palatoplasty are exposure of pterygomandibular raphe and suspension of palatopharyngeus muscle to the raphe...
March 9, 2018: Scientific Reports
Anas Imran Arshad, Mohammad Khursheed Alam, Mohammad Fadhli Khamis
OBJECTIVES: The aim of this study is to assess the treatment outcome of complete unilateral cleft lip and palate (CUCLP) patients using modified Huddart/Bodenham scoring system (MHB). To determine whether there is an association of congenital and postnatal factors with the treatment outcome. DESIGN: Retrospective observational study. SETTING: Two regional cleft-referral centers. MAIN OUTCOME MEASURES: In the current study, 101 pairs of dental models of non-syndromic CUCLP patients were retrieved from hospital archives...
January 1, 2018: Cleft Palate-craniofacial Journal
Arun K Gosain, Harvey Chim, Walter M Sweeney
OBJECTIVE: The present study investigates the efficacy of performing a "palate rerepair" utilizing a double-opposing z-palatoplasty (DOZ) following primary Furlow palatoplasty. DESIGN: Retrospective study. SETTING: Tertiary referral academic center for craniofacial surgery. PATIENTS: 15 consecutive patients who presented with velopharyngeal insufficiency (VPI) after primary Furlow palatoplasty. MAIN OUTCOME MEASURES: All subjects were evaluated using the perceptual speech assessment (PSA) scale...
January 1, 2018: Cleft Palate-craniofacial Journal
Grégoire D'Andréa, Claude Maschi, Charles Savoldelli, Hervé Caci, Sonanda Bailleux
OBJECTIVE: To compare otologic outcomes in patients with cleft palate who underwent 2 different surgical protocols. DESIGN: Monocentric retrospective analysis of medical reports. PATIENTS, PARTICIPANTS: All consecutively treated patients affected by a cleft palate, born between January 1998 and December 2002 (group 1) and between January 2007 and December 2010 (group 2). INTERVENTIONS: Patients in group 1 underwent Veau-Wardill-Kilner palatoplasty at 10 months and had ventilation tubes inserted in case of otitis media with effusion (OME) during surgery...
January 1, 2018: Cleft Palate-craniofacial Journal
Jung Woo Nam
Spontaneous palatal perforation can be rarely developed by several causes, such as tumor, trauma, and infection. This article reports a patient with large mid-palatal perforation after suffering from severe oral mucositis, which occurred about a month after taking methotrexate (MTX) for rheumatoid arthritis. Through computed tomography and clinical examination, this patient was diagnosed with perforation in unrecognized submucous cleft palate (SMCP) due to drug-induced mucositis. After MTX discontinuation, the oral mucositis was almost healed completely in a month, and the hole was successfully closed by palatoplasty...
February 23, 2018: Journal of Craniofacial Surgery
Russell E Ettinger, Theodore A Kung, Natalie Wombacher, Mary Berger, M Haskell Newman, Steven R Buchman, Steven J Kasten
BACKGROUND: Submucous cleft palate (SMCP) is the most common form of cleft involving the posterior palate, resulting in variable degrees of velar dysfunction and speech disturbance. Although early surgical intervention is indicated for patients with true cleft palate, the indications for palatoplasty and timing of surgical intervention for patients with SMCP remain controversial. METHODS: Twenty-nine patients with SMCP were retrospectively reviewed. Patients treated with Furlow palatoplasty were dichotomized based on patient age at the time of surgical correction into early speech development and late speech development...
March 2018: Cleft Palate-craniofacial Journal
Kathryn V Isaac, Ingrid M Ganske, Stephen A Rottgers, So Young Lim, John B Mulliken
OBJECTIVE: Infants with syndromic cleft lip and/or cleft palate (CL/P) often require more complex care than their nonsyndromic counterparts. Our purpose was to (1) determine the prevalence of CL/P in patients with CHARGE syndrome and (2) highlight factors that affect management in this subset of children. DESIGN: This is a retrospective review from 1998 to 2016. PATIENTS: Patients with CHARGE syndrome were diagnosed clinically and genetically...
March 2018: Cleft Palate-craniofacial Journal
Mitchell A Pet, Ryan Dodge, Babette Siebold, Sara Kinter, Jonathan Perkins, Raymond W Tse
OBJECTIVE: This study compares speech and surgical outcomes in internationally adopted and nonadopted patients undergoing cleft palate repair, and examines the influence of age at initial palatoplasty. DESIGN: Retrospective cohort study setting: Tertiary Care Children's Hospital. PATIENTS: 70 international adoptees and 211 nonadoptees with Veau type III and IV clefts (without associated syndrome) repaired at our institution. OUTCOME MEASURES: Outcomes included VPI, compensatory misarticulations, intelligibility, nasal air emission, oronasal fistula, and secondary speech surgery...
March 2018: Cleft Palate-craniofacial Journal
Catherine de Blacam, Susan Smith, David Orr
OBJECTIVE: This systematic review sought to evaluate the consensus in the literature regarding the surgical management of VPD and to determine whether a particular procedure results in superior speech outcome or less morbidity Design: A systematic review was carried out according to PRISMA-P guidelines. Systematic review software was used to facilitate 3-stage screening and data extraction by 2 reviewers. SETTING: University teaching hospital. PATIENTS, PARTICIPANTS: Studies that reported perceptual speech assessment or obstructive sleep apnea (OSA) in patients who had undergone surgery for VPD were included in the review...
March 2018: Cleft Palate-craniofacial Journal
Amber D Shaffer, Matthew D Ford, Sukgi S Choi, Noel Jabbour
OBJECTIVES: To determine whether children with cleft palate might benefit from early long-term tympanostomy tubes with the hypothesis that receiving multiple tubes is associated with shorter duration of first tubes. DESIGN: Retrospective cohort study. SETTING: Tertiary care children's hospital. PARTICIPANTS: Records from 401 consecutive children with cleft palate ± cleft lip, born April 2005 to April 2010, were reviewed...
March 2018: Cleft Palate-craniofacial Journal
Ahmed Elsherbiny, Ahmed S Mazeed, Samia Saied, John H Grant
OBJECTIVE: This study aims to examine the importance of the uvula as a part of palatoplasty outcome and to assess the aesthetic results of the conventional versus a new technique for uvuloplasty. DESIGN/PARTICIPANTS: The study included 2 groups of patients undergoing palatoplasty. Group I consisted of 20 cleft palate patients repaired with the conventional uvula repair, combining the 2 hemi-uvulae. Group II consisted of 20 patients repaired with our new technique, sacrificing one hemi-uvula and centralizing the remaining one...
March 2018: Cleft Palate-craniofacial Journal
Ahmed Elsherbiny, Meghan Amerson, Laura Sconyers, John H Grant
OBJECTIVES: Palatal re-repair aims to improve velar function by retro-positioning the levator veli palatini muscles. The surgery includes extensive dissection, leading to tissue edema and scar formation which may need time to remodel. Together with the change of muscle orientation and tension, it is expected that a period of time is needed to reach the final functional performance. This study attempts to determine how much time is required to reach the optimum performance of the palate after re-repair...
February 5, 2018: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
Laura Bruneel, Kim Bettens, Marc De Bodt, Nathalie Roche, Katrien Bonte, Kristiane Van Lierde
OBJECTIVE AND SUBJECTS: Speech outcomes were described for 16 patients with cleft palate (mean age: 5.4 years) following Sommerlad primary palatoplasty performed by a single surgeon of the Ghent University Hospital. These speech outcomes were compared with those of an age and gender matched control group without cleft palate (mean age: 5.3 years). METHODS: Speech intelligibility/distinctiveness, resonance, nasal airflow and articulation, were perceptually evaluated...
January 31, 2018: Journal of Communication Disorders
Mosaad Abdel-Aziz, Ayman Hussien, Ahmed Kamel, Khaled Azooz, Mohamed Fawaz
Velopharyngeal surgical procedures may have adverse effect on the airway of the patients with velopharyngeal insufficiency (VPI). The aim of this study was to evaluate the polysomnographic parameters (PSG) in patients who underwent corrective surgery for treatment of VPI. The study included 39 patients who underwent 1 of 3 velopharyngeal surgical techniques; Furlow palatoplasty (12 patients), pharyngeal flap (18 patients), and sphincter pharyngoplasty (9 patients). The patients were subjected to PSG, and they were considered to have obstructive sleep apnea (OSA) with apnea-hypoapnea index (AHI) >1...
January 29, 2018: Journal of Craniofacial Surgery
Jeff Markey, Rebecca Maine, Kimberly Daniels, Emily Yang Yu, George Gregory, William Hoffman, Jorge Palacios
OBJECTIVE: Study the prevalence of otologic disease in a pediatric post-palatoplasty population with no prior ear tube placement in resource-deprived countries and assess patient characteristics associated with these abnormal results. DESIGN: Retrospective data review. PARTICIPANTS: Ecuadorian and Chinese children identified during humanitarian cleft lip and palate repair trips with cleft palates undergoing palatoplasty from 2007 to 2010. INTERVENTIONS: Tympanometry and otoacoustic emission (OAE) testing performed following palatoplasty...
February 2018: Cleft Palate-craniofacial Journal
Davi Sandes Sobral, Gustavo Juliane Faller, Marcus Vinícius Martins Collares
Cleft lip and palate (CLP) is the most common congenital craniofacial abnormality. Obstructive sleep apnea syndrome (OSAS) is a highly prevalent but underdiagnosed disease and is frequently associated with craniofacial anomalies. There are few studies describing the sleep breathing pattern of children with CLP. This study sought to characterize the respiratory profile of 23 children with unilateral cleft lip and palate, aged 7-12 years, who had undergone cleft lip and nasal repair at age 3-4 months and palatoplasty at 12-15 months, with a particular focus on evaluating the presence of OSAS in children with CLP...
February 2018: Cleft Palate-craniofacial Journal
Rami D Sherif, Paymon Sanati-Mehrizy, Peter J Taub
BACKGROUND: A variety of palatoplasty techniques are used for cleft palate repair, almost all involving a device called the Dingman-Grabb mouth gag ("Dingman") to push the tongue and cheeks out of the way of the operating field. There have been numerous case reports of complications hypothesized to be due to the gag, such as lingual edema and airway obstruction. The purpose of this study is to introduce a technique for monitoring lingual pressure during Dingman-assisted palatoplasty and present preliminary data from a small series...
February 2018: Cleft Palate-craniofacial Journal
Engin Aynacı, Murat Karaman, Burak Kerşin, Mahmut Ozan Fındık
INTRODUCTION: Radiofrequency tissue ablation (RFTA) and transoral robotic surgery (TORS) are the methods used in OSAS surgery. We also aimed to compare the advantages and disadvantages of RF and TORS as treatment methods applied in OSAS patients in terms of many parameters, especially apnea hypopnea index (AHI). MATERIALS AND METHODS: Patients were classified by performing a detailed examination and evaluation before surgery. 20 patients treated with anterior palatoplasty and uvulectomy -/+ tonsillectomy + RFTA (17 males, 3 females) and 20 patients treated with anterior palatoplasty and uvulectomy -/+  tonsillectomy + TORS (16 males, 4 females) were included in the study...
January 3, 2018: Acta Oto-laryngologica
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