Cleft Palate Children Research Articles

Validation of an objective assessment tool for velopharyngeal insufficiency in cleft lip and palate children

The nasalance scores of 42 children aged 8 to 10 years old, born with a cleft lip and palate, were collected and compared with 50 control children. The scores were then analyzed in relation to 31 verbal stimuli from the French corpus created for this study (sentences and syllables). The most relevant threshold values were determined by receiver operating characteristic curves, which exhibited the highest sensitivity and specificity. The results demonstrated statistically significant differences (p < 0.05) in the mean nasalance scores of the control and cleft groups for all verbal stimuli containing oral phonemes. Threshold values with good diagnostic accuracy were defined, and 15 verbal stimuli were selected for use in clinical practice. The nasalance threshold values defined in this study can be utilized for the objective diagnosis of velopharyngeal insufficiency (VPI) and the subsequent monitoring of French children aged 8 to 10 years old, born with a cleft lip and palate.

Franz Alfred (1880-1962) and Georg Frederich (1921-2010) Kantorowicz.

George Kantorowicz was a senior lecturer/consultant in conservative dentistry at the Royal Dental Hospital who provided ground-breaking treatment for cleft palate children at Great Ormond Street Hospital. His father, Alfred, was a Jewish professor, dean at Bonn Dental School and a world-famous advocate of mobile dental surgeries and prevention for children's dental health, until the Nazis put him in a concentration camp. After important interventions, he became director of Istanbul Dental Institute.

Investigation of the effectiveness of articulation therapy through tele-practice on children with cleft palate in Khuzestan Province during COVID-19 pandemic

IntroductionA cleft palate is a common type of facial malformation. Compensatory articulation errors are one of the important causes of unclear speech in children with cleft palate. Tele-practice (TP) helps to connect therapists and clients for assessment and therapy. Our goal is to investigate the effectiveness of articulation therapy through tele-practice on cleft palate children in Khuzestan Province during the COVID-19 pandemic. Materials & methodsBefore starting the treatment, a 20-min speech sample was recorded individually from all the children. Speech intelligibility and the percentage of correct consonants were assessed for each speech sample. The control group received treatment sessions in person at the cleft palate center, and the other group received treatment via tele-practice using the ZOOM platform. Treatment sessions were provided in the form of 45–60-min group sessions, twice a week, for 5 weeks (10 sessions in total). After 10 treatment sessions, the speech sample was recorded again. The level of parental satisfaction was measured using a Likert 5-level survey. ResultsThe mean score of intelligibility of the two groups decreased (−1.4400 and 0.7200). The two groups' mean percentage of correct consonants increased. (26.09 and 17.90). In both groups, the mean score of parents’ satisfaction with the treatment was high (3.44 and 3.84). The mean of difference before and after the speech intelligibility and the percentage of correct consonants variables in both groups was statistically significant (P = 0.001 and P = 0.002, respectively). In both groups, the satisfaction variable was not associated with a statistically significant difference (P = 0.067). ConclusionThe effectiveness of in-person therapy over a certain period of time is higher than tele-practice. Nevertheless, the results demonstrated an increase in the intelligibility of speech and the percentage of correct consonants in both groups, thus proving the effectiveness of articulation therapy in correcting compensatory articulation errors in children with cleft palate through in-person and tele-practice.

Feasibility of using ultrasound visual biofeedback to treat persistent speech sound disorders in children with cleft palate- a case series

ABSTRACT The current study aimed to assess the effectiveness of incorporating ultrasound visual biofeedback (UVB) into a treatment programme addressing persistent speech sound disorders linked to cleft palate in children who have been unresponsive to traditional therapy approaches. Materials and Methods. A single-subject multiple baseline experiment was conducted with five children aged 6:5–13:5 over a period of 16 therapy sessions. Treatment focused on providing cues from real-time ultrasound images to assist children in modifying their tongue movements. Probe data were collected before, mid, and post-treatment to assess target consonant accuracy for 50 untreated words. The results of the statistical analysis suggested participants showed a significant increase in percent target consonant accuracy as a result of intervention using UVB. Although most of the participants exhibited progress in generalising learned phonemes to untreated words, some did not show improvement in gaining generalisation from treated phonemic contexts to those untreated ones. When traditional methods fail to yield significant progress, incorporating ultrasound biofeedback into the treatment programme emerges as a viable option to enhance sound accuracy in children with persistent speech sound disorders resulting from cleft palate.

Evaluation of Quality of Life of Parents and Growth Parameters of their Infants with Cleft Lip and Cleft Palate before and after Primary Surgery: An Observational Study

Introduction: Cleft Lip (CL) and Cleft Palate (CP) are associated with several complications that have a significant negative impact on the Quality of Life (QoL) of affected children and caregivers. Compared to their healthy counterparts, children with these conditions experience feeding difficulties, cosmetic abnormalities, and, most importantly, diminished physical and cognitive growth, especially during the first year of their lives. Aim: To evaluate the growth parameters in CL and/or CP infants and the QoL of parents with a CL and/or CP child before and after primary surgery. Materials and Methods: For this observational study, data was collected longitudinally from the same set of Cleft lip and cleft palate (CL/CP)/CL&amp;CP infants and their parents before and after the primary surgery. The study was conducted at the Department of Paediatric and Preventive Dentistry, Guru Nanak Institute of Dental Sciences and Research, West Bengal, ABMSS Kolkata Comprehensive Cleft Care Centre, West Bengal, and IMA Vaccination Centre Barasat, West Bengal, India, from December 2020 to May 2022. In this study, 66 children and 64 parents were included in each study and control group. Growth parameters {weight, length, Head Circumference (HC)} were measured using a weight analogue machine, infantometer, and HC measuring tape, and compared with those of healthy infants. The QoL of parents with CL and/or CP infants was quantified using a questionnaire form of “Revised Impact on Family Scale (RIOFS)” filled out by parents before and after six months of primary surgery and compared with the QoL of same-age healthy infants. The responses to the RIOFS questionnaire were scored according to recommended guidelines. The Statistical Package for Social Sciences (SPSS) Statistics 23.0 was used for data analysis. Results: Among the study groups, statistically significant differences in mean height, weight, and HC were observed between the groups of all infants with CL, CP, and CL with CP before and after the primary surgery (p&lt;0.001). The QoL of parents from the study group improved post-surgery. The difference in mean RIOFS score between study Group-3 and study Group-4 after the primary surgery was statistically significant (p&lt;0.001). Conclusion: The growth of CL and/or CP infants and the QoL of their caregivers are compromised compared to healthy infants. After primary surgery, the growth of CL and/or CP infants and the QoL of their parents partially improved.

Comparative aspect in the formation of the vocabulary of the terminology of the sublanguage of pediatrics

In recent decades, the study of term formation processes has become more and more relevant both in Ukrainian and foreign linguistics. The study of lexical-semantic and structural-morphological features of terms makes it possible to assess the level of development of the corresponding terminological system and determine the priority directions of its normalization. Replenishment of the terminology of specialized languages takes place on the basis of general principles of word formation, characteristic of the language as a whole. The purpose of the article is to identify the trends of internationalization and autochthony in the process of naming diseases in the modern terminology of pediatrics. Understanding the main models of term formation provides an opportunity to master a professional language when exchanging and integrating data, which will contribute to the timely resolution of urgent medical issues. The object of the study is the terms used to designate children's diseases. Research methods. An etymological and comparative analysis of Latin, German and English terms was carried out in order to establish ways of transforming the names of children's diseases. Scientific novelty. German and English medical terminology was formed over the centuries under the influence of various factors that caused its heterogeneity. As for internal factors, at the turn of the century, a dynamic development of languages is observed, which leads to an increase in the number of borrowings and the restoration and improvement of their national language resources. Terms of ancient Greek and Latin origin deserve special attention. Over the centuries, the classical languages of antiquity played a unique role in the formation of medical terminology, which includes the nomenclature of pediatrics, where Greek-Latin morphemes today occupy leading positions from the point of view of term formation for the designation of its nominative classes. In our study, they function as Greek-Latin terms adapted to the phonetic and morphological features of the recipient language, for example, Latin. hepatitis &gt; German die Hepatitis &gt; Eng. hepatitis or lat. cherubismus &gt; German der Cherubismus &gt; Eng. cherubism. With the development of national terminology, terms of autochthonous origin appear, such as: lat. tussis convulsia &gt; German der Keuchhusten &gt; Eng. whooping cough or lat. metatarsus varus &gt; German der Klumpfuß &gt; Eng. clubfoot. In the era of globalization of society, English gradually became the language of international communication, as a result of which in German we have such terms as der Flap-Op (cleft palate in children undergoing surgery) or die Check-up-Untersuchung (screening examination) . Conclusions. A comparative lexical-etymological analysis of the terms of the specialized language of pediatrics made it possible to establish a certain specificity of the origin of the terms, where the etymological basis of the terminology consists of international and autochthonous elements that are fully or partially borrowed and have national counterparts in the specialized language.

Dental anomalies in cleft lip and/or palate children at age 10 - a retrospective review across three cleft centres: Part 1

Introduction Children with oral clefts often present with dental anomalies which can impact function, aesthetics and complicate the patient's dental treatment and needs. An understanding of potential anomalies, along with early recognition and planning, is thus essential for effective care.Aim This paper is the first in a two-part three-centre series. This paper will assess the dental anomalies identified in 10-year-old patients attending three cleft centres in the UK.Method Retrospective review was undertaken of the clinical notes of 10-year-old patients attending South Wales (SW), Cleft NET East (CNE) and West Midlands (WM) cleft units, for their ten-year audit record appointment in 2016/2017.Results In total, 144 patients were reviewed (SW = 42; CNE = 52; WM = 50). Dental anomalies were recorded for 80.6% of patients (n = 116).Discussion The review gives insight into the dental complexities of UK oral cleft patients. These patients require specialist paediatric dental input and intensive preventive regimes.Conclusion Shared care between cleft team specialists and general dental practitioners is important when providing holistic care for cleft patients.

Nasalance scores of Thai cleft palate children using the Thai Simplified Nasometric Assessment Procedures Test (Thai SNAP Test)

Background: Nasometry in children with cleft lip and/ or palate (CLP) aged 4-6 years is necessary for diagnosis and planning treatments to promote decreasing velopharyngeal insufficiency (VPI) or resonance disorders that affect good speech intelligibility, prevent compensatory errors and other speech and language problems. Most Thai nasometric speech stimuli are passages suitable for literate patients. Using nasometric passages in young children who cannot read takes a long time to complete and gives unreliable nasalance scores. Due to the limitations, The Thai Simplified Nasometric Assessment Procedures Test (the Thai SNAP Test) was developed and assessed for validity and reliability, revealing that the Thai SNAP Test is proper for evaluating the speech resonance of illiterate patients. However, there is no study on nasometry in children with repaired cleft lip and/ or palate (RCLP) using the Thai SNAP Test. Objectives: To study nasalance scores between the control (non-cleft) group and the RCLP group assessed by the Thai SNAP Test and to describe the influential factors that affected nasalance scores. Materials and methods: The subjects were Thai children aged 4-7. The two groups of children were the RCLP and the control groups, and 36 children in each group. Nasalance scores were measured by a Nasometer II (model 6450). The child was asked to repeat 25 speech stimuli from the Thai SNAP Test, and then the scores were computed using a t-test or Mann-Whitney U test, depend on data distribution. The mean difference in nasalance scores between the two groups and the 95% Confident Interval (95% CI) were analyzed by the two-sample t-test with equal variances and the bootstrap confidence interval method, respectively. Results: The nasalance scores of the RCLP group were significantly higher than the control group (p&lt;0.05) when using high-pressure oral speech stimuli. However, using nasal speech stimuli, the RCLP group’s nasalance scores were significantly lower than the control group (p&lt;0.05), except for nasal syllable repetition (/na/ and /ni/), which did not find a significant difference (p≥0.05). This study emphasized that influential factors for the difference in the nasalance scores between the two groups were abnormal structures and functions articulators, especially the velopharyngeal port that was affected by the CLP, which caused resonance disorders, misarticulations, voice disorders, obstruction in the vocal tract, and hearing impairment. However, the phonological features used in the speech stimulus caused the difference in the mean nasalance scores of the same group. Conclusion: The trends in nasalance scores suggested that the Thai SNAP Test could identify speech resonance disorders in Thai children aged 4-7. The speech and language pathologist (SLP) or evaluator should consider factors influencing the nasalance scores. For accurately diagnosing or evaluating the progression of treatments, nasalance scores from Nasometer should be applied together with other information from various methods or instruments.

Assessment arch dimensions in children with unilateral cleft lip and palate treated surgically by Furlow double-opposing Z-plasty protocol

Objectives: The present study aimed to analyze the outcomes of Furlow double-opposing Z-plasty techniques and to know the effect of this technique on arch dimensions and also to compare these outcomes with the ordinary technique (pushback technique) and with the control group. Materials and Methods: There are two treatment groups and one control group. Forty-two (20 males and 22 females) patients as a total number of the sample with unilateral cleft lip and palate (UCLP) children were included in this study, 1st group (10 males and 14 females) those treated with Furlow double-opposing Z-plasty performed at the age of 10 weeks repair of the lip, at 10 months closure of soft palate followed by construction of obturator done by an orthodontist, at 6 years of patient`s age a closure of hard palate, 2nd group (10 males and 8 females) treated with pushback technique. Criteria for selecting patients (two treatment groups), those without systemic diseases, cerebral disabilities, or any syndromes. The 3rd group consists of 20 healthy children (10 males and 10 females) those free from systemic diseases, aged 9–10 years old, free from oral habits and with limited or no crowding of teeth. Impressions of the upper arch of the patients were taken and the study model was poured at ages 9–10 years. Measurements include anterior arch width (ARW) or intercanine distance, posterior arch width (PAW) or intermolar distance, and arch depth (Adp). Statistical analysis; after collecting the data SPSS software program (version no. 21 Chicago, Illinois, USA) used for analysis, P ≤ 0.05 will be considered as statistically significant. The data were analyzed for their normal distribution, and a comparison of dental arch dimensions between genders and between the two techniques of surgical repair was tested by independent t-test of samples. Results: Significant larger mean values for arch measurements ARW and Adp for males and Adp for females than with the pushback technique. This is related to the growth pattern that occurred without surgical intervention. Conclusion: An improvement in surgical outcomes, and the patients with UCLP treated with Z-plasty technique, revealed an increase in the mean values of arch measurements (anterior and PAW and Adp) for both genders when compared to the pushback technique, but less than that of healthy non-cleft children.

Hybrid Palatoplasty: A Simplified DOZ (Double Opposing Z Plasty) with Palatal Myoplasty for Primary Palate Repair.

Introduction Surgical techniques for soft palate repair aiming for zero velopharyngeal insufficiency (VPI) are still not achieved. Straight line closure of the soft palate by various techniques of intravelar veloplasty (IVVP) leads to higher incidence of VPI due to scar contracture. Furlow's Z plasty has long, narrow, thin mucosal flaps and mucomuscular flaps with malaligned muscle closure. We present a technique of "hybrid palatoplasty" which borrows from and adds to the existing methods, is robust, is easy to replicate, and results in normal speech consistently. Aim (1) To design a technique of "hybrid palatoplasty"-combining double opposing Z (DOZ) plasty and IVVP, which is applicable to all types of cleft palate. (2) To evaluate the results of cleft palate children operated using the technique of "hybrid palatoplasty" from 2014 to 2015 in terms of surgical complications (fistulae and dehiscence) and incidence of VPI. Methods Our procedure combines aspects of both DOZ and IVVP. It is simplified with design of smaller Z plasties. On one side, from the oral Z plasty muscle is dissected off and sutured to the nasal mucomuscular flap of the opposite side to complete the palatal sling. Oral Z plasty is purely mucosal and reverse of the nasal side. A total of 123 cases, operated below 5 years of age were followed up. Speech was assessed by direct evaluation and tele-evaluation. Results A total of 123 cases, below 5 years of age, were operated between 2014 and 2016 with at least 5 years of follow-up. Note that 120 had normal speech, and 3 had VPI of which 2 were subsequently corrected and went on to develop normal speech. Conclusion This novel "hybrid palatoplasty" is a simple technique with good speech outcome as it combines the principles of Z plasty and direct muscle repair with palatal sling formation.

Perceptual and Acoustical assessment of voice in children with cleft lip and palate

BACKGROUND: The speech of individuals with cleft lip and palate is primarily characterized by nasality of oral speech because of cleft and or velopharyngeal dysfunction. OBJECTIVES: The aim of the present study is to investigate the acoustical assessment and perceptual rating measurements in cleft lip and palate children. METHODS: The study participants included 30 children with cleft lip and palate in the age range of 4 to 12 years. Prior parental consent was obtained for the inclusion of their children in the study. Speech samples of all the l the participants were recorded. Prerecorded speech samples of the individuals of the CLP groups were mixed and randomized and played,using headphone conditions in a quiet room. The SLPs speech language pathologists rated the nasality of the participant. Samples given for perceptual evaluation are 15 phonation samples of /ă/, /ɪ/ and /ŭ/ vowels vowel, 15 conversation samples and 30 subjects (3 oral sentences each so total 90 sentences). RESULTS: For the Phonation sample, SLP must evaluate the presence of hypernasality by Wilcoksons nasality scale. Acoustic analysis was done using PRAAT software. The spectral and temporal parameters were measured. The Kappa coefficient was 0.88 for inter-rater reliability for nasality rating scale, 0.82 for speech intelligibility,1.02 for speech understandability,1.00 for speech acceptability, which suggests substantial agreement between the raters for four different rating scales. CONCLUSION: Thus, to conclude in children with cleft lip and palate both acoustical and perceptual evaluation plays an important role while assessing the speech domain by using different kinds of speech stimuli.

A systematic review of auditory processing abilities in children with non-syndromic cleft lip and/or palate

Abstract Purpose: The present systematic review aims to understand auditory processing abilities in children with nonsyndromic cleft lip and/or palate (NSCL/P). The review summarizes questionnaire, behavioral, and electrophysiological findings of auditory processing abilities in children with NSCL/P. Method: The study used a literature search of electronic databases (e.g., Pub Med, Google Scholar, J Stage, Research Gate, ScienceDirect) and the AIISH repository from 2000 to 2021. The retrieved articles were assessed in two stages: title and abstract screening, followed by a full-length article review. About 13 articles were selected after the full-length review of 17 shortlisted articles. All selected studies used cohort design. Result: The review showed that speech perception in noise and temporal processing were the majorly affected processing abilities in children with NSCL/P. The review also showed that cleft palate children are more prone to auditory processing deficits than other cleft subgroups. These auditory processing deficits in NSCL/P children may cause delayed speech and language skills, reading, and learning disabilities, which are highly reported in these children. Conclusion: Auditory processing evaluation should be a part of the audiological test battery for these children to promote early diagnosis and management.

Impact of a Modified Restoration of Tensor Veli Palatini on Hearing and Middle Ear Function in Cleft Palate Children-a Retrospective Study.

Many children with cleft palate also exhibit hearing loss and middle ear dysfunction, which could last for years. There are still arguments on how to treat this problem. This study aimed to evaluate the impact of a modified restoration of tensor veli palatine (TVP) on hearing and middle ear function in the cleft palate children. This retrospective study was completed using records of the cleft palate children who received surgery in Peking Union Medical College Hospital from May 2013 to December 2020. They were divided into 2 groups: Group 1: children who received cleft palate surgery without specific restoration of TVP; Group 2: children who received palate surgery with a specific TVP restoration technique. Perioperative information was collected. The conductive auditory brainstem response and the 226-Hz tympanometry before and after the cleft surgery were compared intragroup and intergroup. Totally 42 children were included in this study, 21 children in each group. There were no significant differences considering clinical characteristics between the 2 groups. The modified TVP restoration didn't increase operation time or complication compared with no TVP restoration. Statistically, neither the auditory brainstem response air conduction hearing thresholds nor the 226-Hz tympanometry results had significant differences between the 2 groups after the surgery. This modified restoration of TVP was not time-consuming and did not increase complications. The beneficial effect of the modified TVP restoration on the hearing or the middle ear function of cleft palate children was uncertain around 6 months after surgery compared with no restoration.

How Early Can We Predict the Need for VPI Surgery?

This retrospective study reviewed documentation of children with moderate-to-severe VPI at age 3 years who did not undergo VPI surgery until age 5 years. Based on the national cleft register, 959 patients with syndromic and nonsyndromic CP were treated by the craniofacial team at Helsinki University Hospital, Finland between 2000 and 2014. Eighty-six patients fulfilled the study inclusion criteria. The speech pathologist evaluated velopharyngeal function at age 3, 5, and 8 years. Of the 86 children presenting with moderate-to-severe VPI at age 3 years, 94% still had moderate-to-severe VPI at age 5 years, even though speech therapy was offered to 77%. Of those whose velopharyngeal function improved by age 5 years, function regressed to incompetent over time. Overall, 93% underwent VPI surgery and 82% underwent VPI surgery between ages 5 and 8 years. Only 23% at age 8 years still had moderate-to-severe VPI. Speech therapy alone did not improve VPI speech characteristics. Moderate-to-severe VPI did not improve from 3 to 5 years or improved but subsequently relapsed. This suggests that the decision for VPI surgery can be made for children aged 3 years with moderate-to-severe VPI.

Analyzing Acoustic Characteristics of Voice for Children With Cleft Palate With and Without Compensatory Error Compared to Normal Children

Background and Objectives: Voice assessment is one of the five universal parameters in assessing the speech ability of children with cleft palate. One of the characteristics of cleft palate children is the production of compensatory errors. This study aims to compare the acoustic characteristics of the voice, including fundamental frequency, jitter, shimmer, and average harmonic to noise ratio in cleft palate children compared to their normal peers. Methods: A total of 38 children in the age range of 48 to 60 months (17 children with cleft palate and 21 normal peers) participated in this descriptive-analytical and cross-sectional study. The children were asked to produce sustained vowels /a/ and /i/ while their speech samples were being recorded. The acoustic characteristics of the children’s voices were analyzed via the Praat software. Results: There were no statistically significant differences in acoustic parameters between the cleft palate children with and without compensatory errors. There were significant differences between children with cleft palate compared to their normal peers in the jitter averages of the vowel /a/ (P=0.05). The gender differences were found in the harmonic to noise ratio averages of the vowel /a/ between children with cleft palate (P=0.02). Conclusion: Young children with velopharyngeal insufficiency may be at risk of voice problems.

Effect of Bone-Borne Trans -Sutural Distraction Osteogenesis Therapy on the Cranial Base of Children With Midfacial Hypoplasia Due to Cleft Lip and Palate.

Bone-borne trans -sutural distraction osteogenesis (TSDO) is widely used to treat midfacial hypoplasia in children with cleft lip and palate; however, its effects on the cranial base are still poorly understood. The authors aimed to study morphological changes in the cranial base after TSDO. Pre and postoperative computed tomography (CT) images of cleft lip and palate children with midfacial skeleton dysplasia who underwent TSDO were collected retrospectively, and their corresponding 3-dimensional models were measured. Results showed no significant change in the length of the anterior or posterior cranial fossa, but the length of the middle cranial fossa increased significantly. The anterior cranial base rotated upward with the sella turcica at the center, whereas the cranial base angle increased. The sphenoid bone exhibited morphological changes. Post-TSDO, the lateral plate of the pterygoid process increased in length. The angle of the 2 lateral plates of the pterygoid process, the greater wings of the sphenoid bone, and the smaller wings of the sphenoid bone decreased. Posterior inclination of the pterygoid process increased. Mean volume of the sphenoidal sinus increased postoperatively compared with the preoperative volume. Apparent changes in the cranial base after TSDO are primarily in the middle cranial fossa, manifesting as an increase in the sphenoid bone body length, expansion of the sphenoidal sinus volume, growth of the pterygoid process forward and downward, a decrease in the angle of both the greater and smaller wings of the sphenoid bone, and an increase in the posterior inclination of the pterygoid process.

Clinical Epidemiological Study of Children with Cleft Lip and Palate

Aim: To determine the frequency of different types of cleft lip and palate and to investigate the possible relation of some risk factors to cleft lip and palate. Study design: Descriptive study. Place and duration of study: Peshawar Dental College, Peshawar Pakistan from 1st August 2017 to 31st January 2019. Methodology: One hundred and seven patients with congenital cleft lip and cleft palate deformities, either gender and age ranged from 1 day to 720 days were enrolled. Cleft types were categorized as bilateral cleft lip and palate (BCLP), left cleft lip and palate (LCLP), right cleft lip and palate (RCLP), cleft alveolus (CLA) and bilateral incomplete cleft (BICLP). Results: There were 73(68.2%) males and 34(31.8%) females. The highest number of patients from Peshawar 30(28%) followed by Swat 21(19.8%) and Charssada by 11(10.3%). Forty two (39.3%) patients’ parents had consanguineous marriages. There were 89(83.2%) of mother haven't used folic acid during their pregnancy. Forty 40(37.4%) cases had a positive family history of cleft deformities. Most common systemic disease was anemia 25(23.2). Eighty five (79.4%) of cleft lip and palate patients were belonging to poor class family. Conclusion: The households of cleft lip and palate children demonstrated low socioeconomic status. The incidence of cleft lip and palate should be reduced to enhance the conditions of women during pregnancy by maintaining a balanced diet and giving them folic acid. Keywords: Epidemiology, Children, Cleft lip, Palate, Risk factors

Atypical cortical thickness and folding of language regions in Chinese nonsyndromic cleft lip and palate children after speech rehabilitation.

ObjectiveEven after palatoplasty and speech rehabilitation, patients with cleft lip and palate (CLP) remain to produce pronunciation errors. We hypothesized that nonsyndromic CLP (NSCLP) after speech rehabilitation had structural abnormalities in language-related brain regions. This study investigates structural patterns in NSCLP children after speech rehabilitation using surface-based morphometry (SBM) analysis.MethodsForty-two children with NSCLP and 42 age- and gender-matched healthy controls were scanned for 3D T1-weighted images on a 3T MRI scanner. After reconstructing each brain surface, we computed SBM parameters and assessed between-group differences using two-sample t-tests and permutation tests (5,000 times). Then, we assessed the relationship between the SBM parameters and the Chinese language clear degree scale (CLCDS) using Pearson's correlation analysis.ResultThe speech-rehabilitated children with NSCLP showed lower cortical thickness and higher gyrification index mainly involving left language-related brain regions (permutation tests, p < 0.05). Furthermore, the lower cortical thickness of the left parahippocampal gyrus was positively correlated with CLCDS scores (r = 0.370, p = 0.017) in patients with NSCLP.ConclusionThe SBM analysis showed that the structural abnormalities of speech-rehabilitated children with NSCLP mainly involved language-related brain regions, especially the dominant cerebral hemisphere. The structural abnormalities of the cortical thickness and folding in the language-related brain regions might be the neural mechanisms of speech errors in NSCLP children after speech rehabilitation. The cortical thickness of the parahippocampal gyrus may be a biomarker to evaluate pronunciation function.

The usefulness of cone beam computed tomography according to age in cleft lip and palate.

The current study aimed to evaluate the usefulness of cone beam computed tomography (CBCT) examination in cleft children and adolescents, the age of the first CBCT exposure, and the criteria that justified the first CBCT exposure. A number of 229 non-syndromic cleft subjects aged between 0-22 years receiving treatment in the same specialized surgical center in orofacial cleft treatment were studied. A cleft group of 64 cleft lip and palate (CLP) children with at least one CBCT exposure was identified based on CBCT records. Parameters related to diagnosis and treatment planning in cleft deformity were considered dental anomalies and bone morphology changes. The examiners assessed whether the treatment option was necessary, not necessary, or could not be evaluated at the age of CBCT exposure. A number of thirty-nine unilateral clefts and fifteen bilateral clefts were identified. Posterior palatal cleft was present in six children (mean age: 15.03±5.55 years; male/female ratio: 1/0.8). Alveolar bone morphology changes were found in 90.58% of cases; jaw relationship changes in 71.82%; nasal fossa morphology changes in 74.99%; airway obstruction in 49.98% and maxillary asymmetry in 87.48%. Orthodontic planning was necessary for 85.93% of CLP patients, and orthognathic surgery in 39.05%. The usefulness of CBCT in patients with CLP varied with age, with reduced value for the evaluation of impaction and root resorption under the age of ten.

Oral-Health-Related Quality of Life among Non-Syndromic School-Age Children with Orofacial Clefts: Results from a Cross-Sectional Study in Northern Italy.

The aim of this cross-sectional study was to determine the influence of orofacial clefts on the oral-health-related quality of life (OHRQoL) in a group of Italian children and adolescents and to examine whether gender, age, cleft type, and surgical protocol were associated with patients’ OHRQoL. A total of 71 patients with cleft lip and/or cleft palate (CLP) and 71 age- and gender-matched controls (aged 8 to 18 years) were asked to complete the Child Oral Health Impact Profile (COHIP), a validated and reliable questionnaire to assess self-reported OHRQoL in children and teenagers. Children with orofacial clefts showed statistically significant lower quality of life scores than controls for total OHRQoL and for each of the subscales. Gender, the type of cleft, and the type of surgical protocol had no significant influence on OHRQoL. The negative impact of CLP on the area of self-image was greater in 12–18-year-olds, indicating a higher need for psychosocial counselling. These findings suggest that Italian CLP children and adolescents experience a poorer OHRQoL in comparison to their non-cleft peers.