Cleft Of Hard Palate Research Articles

"Evaluation of palatal bone regeneration in cleft palate patients following a two-stage palatoplasty using a modified Furlow procedure".

A palatal cleft can be reconstructed using various palatoplasty techniques. Many techniques use local mucoperiosteal flaps to close the hard palate cleft, without closing the underlying bone defect. The purpose of this study was to explore the possibility of spontaneous bone regeneration in the remaining bone defect following a two-stage palatoplasty. Furthermore, the effect of this bone regeneration on transverse maxillary growth was studied. A retrospective study of unilateral cleft lip and palate patients was performed. Cleft size was measured at the hard-soft palate junction on plaster models obtained during palatoplasty. Residual bony cleft was evaluated at the time of alveolar process reconstruction using CBCT images. The presence of crossbites was evaluated through clinical photographs to evaluate transverse maxillary growth. Forty-six patients were included in this study. Thirteen patients (28%) presented with complete ossification of the hard palate at the age of six years. Six patients (13%) had no ossification, while twenty-seven patients (59%) demonstrated partial closure, averaging 75% of the total hard palate length. All patients with complete closure and 89% of patients with partial closure presented without lateral crossbites. Statistical analysis revealed no significant correlation between lateral crossbites and the extent of hard palate ossification (p = 0.4314). 87% of children presented with at least partial ossification of the hard palate after a two-stage palatoplasty, indicating the potential for spontaneous bone regeneration. Importantly, lateral crossbites demonstrated no correlation with palatal ossification (p = 0.1819), suggesting no detrimental impact of regenerated bone on transverse maxillary growth.

A Novel Self-Retentive Obturator to Facilitate Feeding in an Infant with Cleft Palate: A Case Report and Literature Review.

Cleft lip and palate are common congenital defects with multifactorial complex etiology characterized by complete or incomplete cleft of lip, alveolus, and hard and soft palate. In infants, the main problem lies in the difficulty of suckling with frequent nasal regurgitation leading to respiratory and middle ear infections. This article presents a case report of an 8-day-old female with complete cleft of hard and soft palate who was given a novel self-retentive type feeding obturator. This obturator eliminated the need for supplementary aids to help in retention and has a simple design, is cost-effective, and easy to use.

Cleft Treatment: Obturpaedics, Orthopaeddontics, Orthodontics-Important Concepts

Cleft patients present with a wide clinical spectrum. Deciding on the precise techniques is of utmost importance. There are various surgical procedural treatments, what is critical, is the technique used in the course of the application of Obturpaedic, Orthopaeddontic and Orthodontic treatments. The reason for its importance is that it impacts on the lifelong outcome for the cleft patient and the goal is to obtain the optimal result. Deciding on the most suitable treatment plan is often challenging, especially for patients born with unilateral and bilateral cleft lip, cleft alveolus, cleft hard and soft palate (CLAP) (±41%) and those with a hard and soft palate cleft (hPsP) (±17%), including infants born as a Pierre Robin sequence (±6%) for their survival. Additional cleft anomalies, such as isolated Cleft Lip (CL) (6%), Cleft Lip with Cleft Alveolus (CLA) (±14%) and isolated Soft Palate Cleft (sP) (18%), presents less of a challenge with the application of Obturpaedic, Orthopaeddontic and Orthodontic treatments.

Occlusal Outcomes in Non-Robin Sequence Patients with Isolated Cleft Palate.

1. To assess the skeletal class occlusion and lateral cephalometry in children with isolated cleft palates (non-Robin sequence) and 2. to identify associations between these findings and pre-palatoplasty cleft palate measurements. Retrospective cohort study. North American Institutional Tertiary Paediatric Center. Our cleft database was reviewed, and patients were included if they had an isolated cleft palate without a Robin Sequence diagnosis, had a Furlow palatoplasty and had available per operative cleft palate measurements and available lateral cephalogram between 6 and 8 years old. Thirty-two patients matched to inclusion criteria. Furlow's Palatoplasty. Cleft size at palatoplasty, cephalometric measurements and skeletal occlusal classes were analysed. ANOVA was used to test the association between cephalometric measurements and occlusal classes. Results are presented as means with a 95% confidence interval. The association between cleft measurements and cephalometric parameters was tested with Spearman Correlation (rs). The skeletal occlusal outcome at 7 years old for this series of patients was: Class I: 19%; Class II: 59% and Class III: 22%. No single cleft measurement at palatoplasty was predictive of the skeletal occlusal outcome. A larger hard palate cleft was associated with a shorter antero-posterior maxilla. The skeletal occlusal class outcomes were similar to those found in a previous study in the literature. The occlusal prognosis appears to be better than in patients with Robin Sequence or with an associated cleft lip. No preoperative measurement was found to be associated with the occlusal outcome.

Early Results on the Efficacy of Demineralized Bone Matrix, Bone Morphogenic Protein, and Freeze-dried Bone Chips in Alveolar Cleft Repair.

Conventional treatment for alveolar cleft repair is done using autologous iliac crest alveolar bone graft (ABG). However, this method may not be ideal in all patients. Analysis of the efficacy of a mixture of demineralized bone matrix (DBX), bone morphogenic protein (rhBMP-2), and freeze-dried bone chips (FDBC) as an alternative for alveolar cleft repair was performed. Consecutive patients from August 2019 to June 2022 undergoing early alveolar cleft repair, concomitant hard palate and alveolar cleft repair, secondary alveolar cleft repair, and regrafting from a previously failed ABG were analyzed. Computed tomography scans were performed to evaluate graft take at least 6 months postoperatively. Images were reviewed and scored. Alveolar graft height and graft thickness were recorded. A standardized scoring system was developed, with a score of 0 representing no graft take and 3 representing best possible graft take. Fifty-five consecutive alveolar clefts (43 patients) were identified as having undergone ABG and satisfied all the other inclusion criteria. Of these, 29 underwent first time ABG and 26 underwent redo ABG. The mean graft height and graft thickness recorded for all clefts was 2.2 and 2.0, respectively. Early results evaluating the efficacy of ABG using DBX, rhBMP-2, and FDBC show feasibility in regard to both graft height and thickness when using a maxillary computed tomography scan to measure the bone graft take. These results suggest that DBX, rhBMP-2, and FDBC may act as a versatile bone graft material in cleft care, although further studies are needed to determine long-term outcomes.

Using polypropylene mesh or ear cartilage autograft with mini screws for the treatment of induced cleft hard palate in puppies: A comparative study

Using polypropylene mesh or ear cartilage autograft with mini screws for the treatment of induced cleft hard palate in puppies: A comparative study

A comparison of maxillofacial growth in Chinese children with isolated cleft palate treated with two different palatoplasty techniques without relaxing incisions: a preliminary study

ObjectiveTo assess the maxillofacial growth of patients with isolated cleft palate following the Sommerlad-Furlow modified technique and compare it with the effect of the Sommerlad technique.Study designA Retrospective Cohort Study.MethodsA total of 90 participants, 60 patients with non-syndromic isolated soft and hard cleft palate (ISHCP) underwent primary palatoplasty without relaxing incision (30 patients received the Sommerlad-Furlow modified (S-F) technique and 30 received Sommerlad (S) technique). While the other 30 were healthy noncleft participants with skeletal class I pattern (C group). All participants had lateral cephalometric radiographs at least 5 years old age. All the study variables were measured by using stable landmarks, including 11 linear and 9 angular variants.ResultsThe means age at collection of cephalograms were 6.03 ± 0.80 (5–7 yrs) in the S group, 5.96 ± 0.76 (5–7 yrs) in the S-F group, and 5.91 ± 0.87 (5–7 yrs) in the C group. Regarding cranial base, the results showed that there were no statistically significant differences between the three groups in S–N and S–N-Ba. The S group had a significantly shortest S-Ba than the S-F & C groups (P = 0.01), but there was no statistically significant difference between S-F and C groups (P = 0.80). Regarding skeletal maxillary growth, the S group had significantly shorter Co-A, S- PM and significantly less SNA angle than the C group (P = < 0.01). While there was no significant difference between S-F & C groups (P = 0.42). The S group had significantly more MP-SN inclination than the C group (P = < 0.01). Regarding skeletal mandibular growth, there were no statistically significant differences in all linear and angular mandibular measurements between the three groups, except Co-Gn of the S group had a significantly shorter length than the C group (P = 0.05). Regarding intermaxillary relation, the S-F group had no significant differences in Co-Gn—Co-A and ANB as compared with the C group. The S group had significantly less ANB angle than S-F & C groups (P = 0.01 & P = < 0.01). In addition, there were no significant differences in all angular occlusal measurements between the three groups.ConclusionAs a preliminary report, Sommerlad-Furlow modified technique showed that maxillary positioning in the face tended to be better, and the intermaxillary relationship was more satisfactory than that in Sommerlad technique when compared them in healthy noncleft participants.

Impact of relaxing incisions on maxillofacial growth following Sommerlad–Furlow modified technique in patients with isolated cleft palate: a preliminary comparative study

ObjectiveTo estimate the impact of relaxing incisions on maxillofacial growth following Sommerlad-Furlow modified technique in patients with isolated cleft palate.Study designA Retrospective Cohort Study.MethodsA total of 90 participants, 60 patients with non-syndromic isolated soft and hard cleft palate underwent primary palatoplasty (30 patients received the Sommerlad-Furlow modified technique without relaxing incision (S.F−RI group), and 30 received Sommerlad-Furlow modified technique with relaxing (S.F+RI group) with no significant difference found between them regarding the cleft type, cleft width, and age at repair. While the other 30 were healthy noncleft participants with skeletal class I pattern as a Control group. The control group (C group) was matched with the patient groups in number, age, and sex. All participants had lateral cephalometric radiographs at least 5 years old age. The lateral cephalometric radiographs were taken with the same equipment by the same experienced radiologist while the participants were in centric occlusion and a standardized upright position, with the transporionic axis and Frankfort horizontal plane parallel to the surface of the floor. A well-trained assessor (S. Elayah) used DOLPHIN Imaging Software to trace twice to eliminate measurement errors. All the study variables were measured using stable landmarks, including 12 linear and 10 angular variants.ResultsThe mean age at collection of cephalograms was 6.03 ± 0.80 in the S.F+RI group, 5.96 ± 0.76 in the S.F−RI group, and 5.91 ± 0.87 in the C group.Regarding cranial base, the results showed no statistically significant differences between the three groups in S–N and S–N-Ba. While the S.F+R.I group had a significantly shortest S-Ba than the S.F−R.I & C groups (P = 0.01 & P < 0.01), but there was no statistically significant difference between S.F−R.I & C groups (P = 0.71).Regarding the skeletal maxilla, there was no significant difference between the S.F+R.I and S.F−R.I groups in all linear measurements (N-ANS and S-PM) except Co-A, the S.F+R.I group had significantly shorter Co-A than the S.F−R.I & C groups (P = < 0.01). While the angular measurement, S.F+R.I group had significantly less SNA angle than the S.F−R.I & C groups (P = < 0.01).Regarding mandibular bone, there were no statistically significant differences in all linear and angular mandibular measurements between the S.F+R.I and S.F−R.I.groups.Regarding intermaxillary relation, the S.F+R.I group had significant differences in Co-Gn—Co-A and ANB compared to the S.F−R.I & C groups (P = < 0.01). While there was no statistically significant difference in PP-MP between the three groups.ConclusionAs a preliminary report, the Sommerlad-Furlow modified technique without relaxing incisions was found to have a good maxillary positioning in the face and a satisfactory intermaxillary relationship compared to the Sommerlad-Furlow modified technique with relaxing incisions.

A case of deletion 9p syndrome with soft and hard cleft palate

AbstractBackgroundDeletion 9p syndrome is a rare structural chromosomal disorder. Various phenotypes of deletion 9p syndrome have been reported; however, cleft palate has not been reported in many cases.Case presentationWe report the case of a child with deletion 9p syndrome with soft and hard cleft palate, ventricular septal defect, broad and narrow forehead, long philtrum, highly arched eyebrows, binocular dissection, upward‐slanting palpebral fissures, low flat nose, and triangular cranium. Pushback palatoplasty was performed at the age of 1 year and 9 months.ConclusionThis report contributes to the accumulation of reports on the phenotype of deletion 9p syndrome.

Remote Real-Time Training for Sustainable Cleft Operation in Rural Region of West Africa: Effective Webinar in the COVID-19 Pandemic.

The surgical requirement for cleft lip and palate repair remains unmet in many developing areas of the world, including remote regions of Ghana. This article reviews the utilization of Internet education and online consultation for cleft lip and palate surgical training in Sunyani Regional Hospital (SRH), Ghana. The cleft lip and palate treatment was promoted to patients in remote areas of Sunyani, Ghana region, through a charitable outreach program. These basic designs and settings were managed by local participants such as doctors, residents, nurses, and staff in SRH, Ghana. From November 2014 to December 2020, the authors collaborated in surgical treatment for 84 cases that were diagnosed with unilateral cleft lip, bilateral cleft lip, hard and soft palate cleft, and microstomia. The type of surgery has varied and has included cheiloplasty, palatoplasty, and others. The average scores of esthetic outcome evaluation were nasal form=2.4, symmetry of the nose=2.9, and vermillion border=2.9. Through the program, the surgeons and residents became significantly more proficient at cleft lip and palate surgery. The seminar topics have covered essential and sustainable topics based on SRH's current needs and showed the effectiveness in the current coronavirus disease-19 pandemic situation. The shortage of orofacial cleft surgeons working in rural areas like Sunyani, Ghana, remains an obstacle that poses a challenge to any effort to improve health care quality in these rural communities. Sustainable remote education is essential for the training of local cleft surgeons to fill this local need; our collaborative and charitable program could be a recommended education design for cleft surgeons and institutes for their sustainable education.

Case Study in Infants with Cleft Lip and Palate Who Attended the Fundación Operación Sonrisa Consultation in The Period 2015-2019

Cleft lips and palate are considered congenital craniofacial malformations originating in the early stage of embryo development, due to an incomplete fusion of the medial nasal processes and maxillary processes. A multidisciplinary team is required to carry out the ideal treatment for these childhood patients. Aims: The objective of this study was meant to describe the casuistry of patients with cleft lip and palate in infants who attended the Operation Smile Venezuela Foundation in the period from 2015 to 2019. Subjects and Method: This was a non-experimental and descriptive field research. The sample included medical records from patients with cleft lip and palate that were attended since 2015 to 2019, having in account exclusion and inclusion criteria. A questionnaire was used as an instrument through the Google Form application with 34 closed questions of dichotomous answers. The variables studied were epidemiological characteristics such as: age, gender and origin, also we analyzed types of clefts lip and palate and whether they obtained surgical resolution or not, which were collected and evaluated according to our type of research and the objectives. Results: 618 medical records were analyzed, with an average of showing a prevalence in preschool age ( 40%) , followed by minor infants ( 29%) and the age with less prevalence was newborns (1%). In terms of gender there was an almost equal distribution, males (58%) and females (42%). Geographically there was a predominance in the Capital District (20%), Miranda (15%), Aragua (13%) and Monagas (12%) during the period studied. But states such as Amazonas, Barinas, Cojedes, Delta Amacuro, Lara and Nueva Esparta had the lowest percentage (0%). Of the cleft lip the most prevalent was the Complete left Unilateral, followed by the Incomplete Left Unilateral and the Complete Bilateral cleft lip. The Complete Bilateral and the Hard and Soft Posterior Palate Cleft were the most common. Conclusions: It is essential to determine the epidemiological variants, as well as to know the etiology of the cleft lip alveolus palatal and how to prevent them. Likewise, through this work, the activity that Operation Smile Venezuela Foundation carried out day by day is made known.

Trio-based GWAS identifies novel associations and subtype-specific risk factors for cleft palate

Cleft palate (CP) is one of the most common craniofacial birth defects; however, there are relatively few established genetic risk factors associated with its occurrence despite high heritability. Historically, CP has been studied as a single phenotype, although it manifests across a spectrum of defects involving the hard and/or soft palate. We performed a genome-wide association study using transmission disequilibrium tests of 435 case-parent trios to evaluate broad risks for any cleft palate (ACP) (n= 435), and subtype-specific risks for any cleft soft palate (CSP), (n= 259) and any cleft hard palate (CHP) (n= 125). We identified a single genome-wide significant locus at 9q33.3 (lead SNP rs7035976, p= 4.24×10-8) associated with CHP. One gene at this locus, angiopoietin-like 2 (ANGPTL2), plays a role in osteoblast differentiation. It is expressed both in craniofacial tissue of human embryos and developing mouse palatal shelves. We found 19 additional loci reaching suggestive significance (p<5×10-6), of which only one overlapped between groups (chromosome 17q24.2, ACP and CSP). Odds ratios for the 20 loci were most similar across all 3 groups for SNPs associated with the ACP group, but more distinct when comparing SNPs associated with either subtype. We also found nominal evidence of replication (p<0.05) for 22 SNPs previously associated with orofacial clefts. Our study to evaluate CP risks in the context of its subtypes and we provide newly reported associations affecting the broad risk for CP as well as evidence of subtype-specific risks.

Sommerlad–Furlow modified palatoplasty: A retrospective study

The purpose of this study was to introduce the surgical process of Sommerlad–Furlow modified (S–F) palatoplasty and compare its surgical and functional outcomes with conventional Sommerlad (S) palatoplasty.Patients with non-syndromic cleft palate who had undergone either S–F palatoplasty or S palatoplasty were retrospectively reviewed. Data on the outcomes of velopharyngeal function and postsurgical palatal fistula incidence were collected for all patients. Data for preselected factors, including gender, age at palatoplasty, and cleft type, were also collected. Chi-square tests were conducted.1254 patients were included. The postsurgical velopharyngeal competence (VPC) rate after S–F palatoplasty was significantly higher than after S palatoplasty (total, 70.5% vs 57.9%, p < 0.0001; age ≤ 1, 87.0% vs 69.2%, p < 0.0001; 1 < age ≤ 2, 78.3% vs 69.3%, p = 0.0479). With regard to different types of cleft palate, the postsurgical VPC rates after S–F palatoplasty were all significantly higher than for S palatoplasty in all patients younger than 2 years of age (complete cleft palate, 78.7% vs 62.4%, p = 0.0016; hard and soft palate cleft, 84.4% vs 74.8%, p = 0.0172; submucosal cleft and soft palate cleft, 96.6% vs 68.4%, p = 0.0114). The postoperative fistula rate after S–F palatoplasty was 4.3%.This modified palatoplasty technique provided adequate cleft palate closure, with satisfactory speech outcomes and low fistula rates, while older age at palatoplasty may affect the postsurgical outcomes. Within the limitations of the study it seems that the Sommerlad–Furlow modified technique is an option for cleft palate repair.

Surgical closure of cleft palate defects in dogs using a modification of the traditional von Langenbeck technique: 12 cases (2015-2022).

To describe the author's surgical guidelines for the effective use of a modified von Langenbeck technique, utilizing bilateral bipedicle mucoperiosteal flaps in the dog. 12 client-owned dogs with cleft palate defects of the hard and soft palates. 12 dogs with cleft palate were presented to the Angell Animal Medical Center from May 20, 2015, to March 24, 2022. The patient's ages ranged from 5 months to 3 years. All 12 dogs had closure of the hard palate clefts by use of modifications of the original von Langenbeck technique in this prospective study. Successful closure of the cleft (hard and soft) palate defects was achieved in all 12 dogs in a single surgical procedure. A small residual opening was noted at the level of the incisive papilla in each dog; this was of no clinical consequence in this report. The von Langenbeck technique, using the simple closure modifications reported, was effective in closing both narrow and wide defects. Successful execution requires the complete elevation of each flap, which facilitates their tension-free advancement over the palatal cleft. Vertical mattress sutures evert the flap margins, allowing for direct collagen surface contact for proper healing. Placement of sutures in the rugal folds increases the tissue purchase to reduce the risk of suture cut-out. Fine interrupted sutures, placed between the vertical mattress sutures, maintains the proper alignment of the incisional margins. The author waits a minimum of 5 months before closing cleft palate defects, enabling the donor areas time to mature and improving their ability to retain sutures more effectively.

The Utility of the Ultrasound “Superimposed-Line” Sign at the Junction of the Vomer and Maxilla in First-Trimester Screening for Fetal Cleft Palate: A Case-Control Study

Introduction: The current retrospective case-control study evaluates the diagnostic value of screening for a fetal cleft palate by using the ultra-sound-based observation of the “superimposed-line” sign appearing at the junction of the vomer and maxilla in the first trimester of pregnancy. Methods: Retrospective analyses were performed of ultrasonographic images of nuchal translucency obtained during the first trimester of pregnancy (11–13⁺⁶ weeks) from 45 fetuses with a cleft palate later confirmed following parturition or induced labor (cases) and 4,500 normal fetuses confirmed after parturition (controls). Ultrasonographic features of the “superimposed-line” sign were observed and recorded, and between-group comparisons were performed. Results: The “superimposed-line” sign was absent in 39 cases (86.67%), including 4 (8.89%) with simple secondary hard palate cleft and 35 (77.78%) with secondary hard palate cleft complicated by a primary cleft palate. The “superimposed-line” sign was shown in 6 cases (13.33%), including 2 (4.44%) with a simple secondary soft palate cleft, 1 (2.22%) with a simple secondary bifid uvula, and 3 (6.67%) with a simple primary cleft palate. Among the 4,500 controls, 31 fetuses showed an absence of the “superimposed-line” sign (0.69%) and 4,469 showed the “superimposed-line” sign (99.31%). The between-group difference was significant (p < 0.05). The sensitivity, specificity, positive predictive value, and negative predictive values of the “superimposed-line” sign in the first trimester of pregnancy for predicting fetal cleft palate were 86.67% (39/45), 99.31% (4,469/4,500), 55.71% (39/70), and 99.86% (4,469/4,475), respectively. Conclusion: The “superimposed-line” sign did not appear in fetuses with secondary hard palate cleft and primary cleft palate only when a secondary hard palate cleft is present. The sign appeared in normal fetuses and those with a simple primary cleft palate, simple secondary soft palate cleft, or a simple secondary bifid uvula. Based on these results, we propose that the “superimposed-line” sign in the mid-sagittal plane of the fetal face in the first trimester of pregnancy (11–13⁺⁶ weeks) is an important tool in screening for fetal cleft palate, especially secondary hard palate cleft.

Treacher Collins syndrome – a case report

Abstract Objectives Treacher Collins syndrome (TCS), also known as mandibulofacial dysostosis and Franceschetti-Zwahlen- Klein syndrome, is an autosomal dominant disorder of soft tissue and the craniofacial bones. In most cases, TCS is the result of a mutation in the TCOF1 gene. The incidence is estimated to be between 1/10,000 and 1/50,000 live births. Our purpose was to describe a case report of patient with TCS born in the Department of Neonatology at the Pomeranian Medical University in Szczecin (Poland) and his family with short review of literature. Case presentation Clinical abnormalities which were found after birth mainly affect the head – hypoplasia of the cheek bones and the zygomatic bones, micrognation, deformed auricles with undeveloped external auditory canals, retrognathia of the mandible, cleft hard and soft palate and narrow palpebral fissure. Conclusions The treatment of children with TCS is long-term. Patients require a series of reconstructive and plastic surgical procedures. Our patient presented the complete form of TCS. There are multiple surgeries awaiting him, which, eventually, will improve his quality of life.

Maxillary arch dimensions, occlusion assessment and space conditions in patients with cleft palate in the period of deciduous dentition—A retrospective study

PurposeThe aim of this study was to evaluate the maxillary arch dimensions, dentoalveolar relationships and spacing conditions in patients with cleft palate in comparison with the control group. MethodsThe subjects consisted of 31 children with cleft palate only (CP) aged 5.5 ± 0.51 (20 with a cleft of hard and soft palate (SHPC group) and 11 with a cleft of soft palate only (SPC group)). In the control group 30 subjects had a normal occlusion at age 5. Maxillary arch dimensions, dentoalveolar relationship according to the Huddard Bodenham index (HBI) and space conditions were compared with the control group. ResultsIn all variables of maxillary arch dimensions except for total arch height the control group exhibited greater values. Most of the significant differences were on account of differences between the control and the SHPC group, with only three comparisons yielding significant results when comparing the two groups of children with clefts (SHPC vs SPC, IV-IV central: pDunnett T3= 0.0002, 95%CIDifference=-9.9-(-3.18); V-V distopalatal cusps: pDunnett T3= 0.0002, 95%CIDifference=-9.97-(-3.17); Total arch length: pDunnett T3= 0.0014, 95%CIDifference=1.74–7.85). The three groups differed significantly in anterior HBI only (HKruskal-Wallis=15.56, p = 0.0067). The spacing conditions in both jaws were also shown to be significantly dependent on the group of subjects studied (Upper jaw: χ2omnibus= 16.79, p = 0.0018; lower jaw: χ2omnibus= 13.75, p = 0.0102). ConclusionsThe growth of the upper dental arch at the age of five is impeded in participants with CP in comparison to a control group. It is important to assess the effect of cleft subtypes on growth and development to get a better understanding.

Palatoplasty Using Alveolar Ridge Incisions: A Novel Approach for Addressing Cleft Palate Deformities.

Background:Traditionally, plastic surgeons have performed palatoplasties using mucoperiosteal flaps with lateral incisions that are medial to the alveolar ridge. However, narrow flaps can cause limitations in some cases. To construct larger and wider flaps and minimize exposed bone after closure, we propose a novel technique that entails creating the lateral incisions at the top of the alveolar ridge, instead of the base of the alveolar ridge, to capture more tissue when repairing the hard palate.Methods:A retrospective chart review was conducted for patients undergoing cleft palate repair with the aforementioned technique. Information collected included basic demographic and diagnostic factors related to cleft palate deformity and history of previous facial surgeries. Operative report details and postoperative complications were analyzed.Results:Nineteen patients with hard palate clefts were included in the analysis, with the majority being women (68%). There was a balanced representation of patients with Veau classifications of II (47%) and III (42%). The majority of patients had an isolated cleft palate (74%) and incomplete deformity (63%), with no other craniofacial deformities. One (5%) had postoperative self-limited oronasal fistula managed conservatively.Conclusions:We present a novel approach for repairing cleft palate deformities by extending the lateral incision to the top of the alveolar ridge to create larger mucosal flaps. Further longitudinal studies are needed to evaluate how this unique approach compares to traditional methods—with respect to impact on maxillary growth processes, requirement for subsequent surgeries beyond two years of follow-up, and ultimately normalized speech over time.

The Spectrum of External Dysmorphic Features among Newborns

Background: There is a frequent underreporting of minor congenital anomalies. The present study was conducted to identify and record the birth defects (external dysmorphism) among newborns delivered in district hospital attached to Mandya Institute of Medical Sciences, Mandya, for a duration of 1 year. Methodology: After obtaining the parent's written informed consent, newborns were examined for birth defects (visible external dysmorphic features). The details were recorded in the self-designed proforma, and findings/data were statistically studied. Birth defects were analyzed using the WHO International Classification of Diseases 10 reference guide. Results: During the present study, 502 live newborns were examined physically for external dysmorphic features and 17 cases were diagnosed as external congenital dysmorphism. In the present study, the frequency of congenital external dysmorphism was 3.4% and the most common system involved was a musculoskeletal system followed by cutaneous and central nervous system anomalies. We report five cases of talipes equinovarus, two cases of preauricular skin tags, one case each of polydactyly, syndactyly, harlequin ichthyosis, VACTERAL (vertebral defects, anal atresia, cardiac defects, tracheoesophageal fistula, renal anomalies, and limb abnormalities) association, Down syndrome, spina bifida cystica, spina bifida occulta, preauricular tags, preauricular sinus, cleft hard palate, and cleft lip with palate among other congenital anomalies noted. Conclusion: In the present study, the frequency of congenital external dysmorphism was 3.4% and the most common system involved was a musculoskeletal system (41.2%).

Simental Irkı Bir Buzağıda Şilognatopalatoşizi Olgusu: Nadir Bir Olgu

The subject of this study was a 7-day-old female Simmental calf brought to Firat University Veterinary Faculty Animal Hospital Surgery Clinic with the complaint of cleft in the upper lip and palate. In the clinical examination, it was determined that the calf had respiratory difficulties and the nostrils were not formed normally. The calf was diagnosed with cheilognathopalatoschisis. Palatoplasty and reconstructive surgery were performed on the calf for the treatment of the rarely encountered case. The mucosa of the cleft hard palate was freed by dissecting from the os palatinum on both sides. Then, the hard palate was repaired by suturing the mucosal edges mutually. Palatal and alveolar clefts were repaired using Veau's technique. During the post-operative interview with the patient's owner, it was learned that the calf had difficulty in swallowing during feeding. It was determined that the calf died on the 8th postoperative day due to aspiration pneumonia that developed due to the absence of probable swallowing reflex.