Form Of Cleft Palate Research Articles

Intelligibility in 3-Year-Olds With Cleft Lip and/or Palate Using the Intelligibility in Context Scale: Findings from the Cleft Collective Cohort Study.

To provide comparison data on the Intelligibility in Context Scale (ICS) for a sample of 3-year-old English-speaking children born with any cleft type. Questionnaire data from the Cleft Collective Cohort Study were used. Descriptive and inferential statistics were carried out to determine difference according to children's cleft type and syndromic status. A total of 412 children born with cleft lip and/or palate whose mothers had completed the ICS when their child was 3 years old. Mothers' rating of their children's intelligibility using the ICS. The average ICS score for the total sample was 3.75 (sometimes-usually intelligible; standard deviation [SD] = 0.76, 95% CIs = 3.68-3.83) of a possible score of 5 (always intelligible). Children's speech was reported to be most intelligible to their mothers (mean = 4.33, SD = 0.61, 95% CIs = 4.27-4.39) and least intelligible to strangers (mean = 3.36, SD = 1.00, 95% CIs = 3.26-3.45). There was strong evidence (P < .001) for a difference in intelligibility between children with cleft lip only (n = 104, mean = 4.13, SD = 0.62, 95% CIs = 4.01-4.25) and children with any form of cleft palate (n = 308, mean = 3.63, SD = 0.76, 95% CIs = 3.52-3.71). Children born with cleft palate with or without cleft lip and an identified syndrome were rated as less intelligible (n = 63, mean = 3.28, SD = 0.85, 95% CIs = 3.06-3.49) compared to children who did not have a syndrome (n = 245, mean = 3.72, SD = 0.71, 95% CIs = 3.63-3.81). These results provide preliminary comparative data for clinical services using the outcome measures recommended by the International Consortium for Health Outcomes Measurement.

АНАЛИЗ РЕЗУЛЬТАТОВ И ОСЛОЖНЕНИЙ УРАНОПЛАСТИКИ У ДЕТЕЙ С ВРОЖДЕННОЙ РАСЩЕЛИНОЙ ГУБЫ И НЕБА

Subject. Study of the results and complications of uranoplasty in children with congenital cleft lip and /or palate in the first year after surgical treatment.&#x0D; The goal is to determine the frequency of surgical and speech complications after uranoplasty in children with congenital cleft lip and/or palate in regions with a petrochemical industry and without industrial ecotoxicants.&#x0D; Methodology. After the uranoplasty, 80 children with various forms of cleft palate were examined at the Republican Children's Clinical Hospital. Comprehensive examination included the use of clinical (examination, palpation, percussion ― assessment of surgical status) and functional (electromyography, rheography, magnetic resonance imaging, nasopharyngoendoscopy, speech therapy speech assessment using a sound identification system) research methods.&#x0D; Results. Children with congenital cleft lip and/or palate born and living in regions with petrochemical ecotoxicants more often (37.5 %) have complications after uranoplasty than children from regions without petrochemical ecotoxicants (18.8 %). They have a higher prevalence of palatopharyngeal insufficiency, the frequency of fistulas of the soft and hard palate, and the need for secondary surgical intervention, more often they experience difficulties in restoring speech functions.&#x0D; Conclusions. Due to the presence of somatic diseases and disorders in blood counts at the preoperative stage, more pronounced postoperative complications are noted in the group of children with congenital cleft lip and/or palate from regions with the petrochemical industry, which indicates a violation of their reparative regeneration after uranoplasty. This is the rationale for the development and application of a method for the prevention of postoperative complications, which will be included in the rehabilitation algorithm to improve the physiological and speech functions of children after uranoplasty in a region with a petrochemical industry.

Speaker and production characteristics of posterior nasal fricatives

Posterior nasal fricatives (PNF) are unusual articulations produced by children both with and without velopharyngeal (VP) anomalies to replace oral fricatives. PNFs are produced by occluding the oral cavity and forcing airflow through a partially closed VP port to create turbulent noise. Often, extra noises occur due to displacement of mucous and/or tissue flutter. The headset of the nasometer was used to record the separate oral and nasal acoustic signals from 18 children who produced PNFs. They ranged in age from 4 to 15 years, 11 were males, and 11 had some form of cleft palate. Examination of the oral acoustic waveforms revealed that all children produced a stop gesture during intended fricative targets—typically a lingual-alveolar or palatal articulation. Sixteen of the children produced a clear flutter (raspberry-like) noise as evidenced by quasi-periodic components in the nasal spectra. All children used PNFs to replace /s/, 13 (72%) to replace /z/, 12 (67%) to replace /tʃ/, and 6 (33%) to replace /ʃ/ and /dʒ/. Most of the children had known histories of conductive hearing loss. Most of the children with cleft palate had adequate VP closure during stop consonant production. Possible causes of PNFs are discussed.

Homeobox family Hoxc localization during murine palate formation.

Homeobox genes play important roles in craniofacial morphogenesis. However, the characteristics of the transcription factor Hoxc during palate formation remain unclear. We examined the immunolocalization patterns of Hoxc5, Hoxc4, and Hoxc6 in palatogenesis of cleft palate (Eh/Eh) mice. On the other hand, mutations in the FGF/FGFR pathway are exclusively associated with syndromic forms of cleft palate. We also examined the immunolocalization of Fgfr1 and Erk1/2 to clarify their relationships with Hoxc in palatogenesis. Some palatal epithelial cells showed Hoxc5 labeling, while almost no labeling of mesenchymal cells was observed in +/+ mice. As palate formation progressed in +/+ mice, Hoxc5, Hoxc4, and Hoxc6 were observed in medial epithelial seam cells. Hoxc5 and Hoxc6 were detected in the oral epithelium. The palatal mesenchyme also showed intense staining for Fgfr1 and Erk1/2 with progression of palate formation. In contrast, the palatal shelves of Eh/Eh mice exhibited impaired horizontal growth and failed to fuse, resulting in a cleft. Hoxc5 was observed in a few epithelial cells and diffusely in the mesenchyme of Eh/Eh palatal shelves. No or little labeling of Fgfr1 and Erk1/2 was detected in the cleft palate of Eh/Eh mice. These findings suggest that Hoxc genes are involved in palatogenesis. Furthermore, there may be the differences in the localization pattern between Hoxc5, Hoxc4, and Hoxc6. Additionally, Hoxc distribution in palatal cells during palate development may be correlated with FGF signaling. (228/250 words) © 2016 Japanese Teratology Society.

National Trends in Feeding Interventions for Cleft Palate

Objective: 1) To determine national trends in the rates of failure to thrive (FTT) and subsequent gastrostomy tube placement in infants with cleft palate. 2) To identify risk factors for developing FTT and/or gastrostomy tube placement in the setting of underlying dysphagia related to cleft palate. Method: Retrospective series. The Kids’ Inpatient Database 2006 was analyzed for children under 1 year of age with any form of cleft palate with and without the diagnosis of FTT. The cohort of children with cleft palate and FTT were analyzed for procedure codes indicating gastrostomy placement during admission. Results: In total, 12,067 children under 1 year of age with cleft palate were identified. Of these, 2,085 (17%) also had the diagnosis of FTT. Children with cleft palate and FTT had a g-tube placement rate of 18%, with the overall rate of g-tube placement for any infant with cleft palate being 3%. Odds of FTT among infants with cleft palate were significantly elevated for those with reflux, musculoskeletal anomalies, atrial or ventricular septal defect, circulatory system anomalies, and respiratory problems. Similar concurrent diagnoses increased the odds ratios for g-tube placement in infants with cleft palate and FTT. Conclusion: Failure to thrive among infants with cleft palate approaches 20%. Children with gastrointestinal, cardiac, and respiratory comorbidies are particularly at risk and gastrostomy tube placement for feeding supplementation may be required. Infants without these comorbidities may benefit from longer trials of conservative feeding interventions prior to surgical intervention.

Tissue Engineering Applications for Cleft Palate Reconstruction

AbstractCleft palate is a common birth defect that carries significant biomedical and psychosocial implications throughout the lives of affected children and their families. To date, numerous etiopathogenetic factors have been identified that can lead to isolated and syndromic forms of cleft palate. The management of patients with cleft palate has improved significantly over the last several decades with important surgical advances and an increasingly multidisciplinary approach to patient care. Technological innovations have become focused on improving functional results, with current research and clinical reports of cleft palate reconstruction promising even greater improvements and further “minimalization” of surgery in the future. As part of this evolution, research in tissue engineering approaches for cleft palate reconstruction promise increased functionality, improved aesthetics, fewer complications, and reduced disease burden. The current review discusses several aspects of tissue engineering research that promise innovation in cleft palate repair including distraction osteogenesis, biologic implants, fetal surgery, in utero medical therapy, and prevention.

Cytophotometrical and immunohistochemical analysis of soft palate muscles of children with isolated cleft palate and combined cleft lip and palate

Palatal muscle biopsies from the cleft margin of children were subjected to cytophotometrical and immunohistochemical analysis. Muscle fiber types were classified according to the enzyme activity of myofibrillic adenosine triphosphatase, glycerol-3-phosphate-dehydrogenase and succinate dehydrogenase assessed cytophotometrically. Fiber type-related immunoreactivity of nitric oxide synthase (NOS) isoforms I, II, III, as a physiological modulator of skeletal muscle function, was related to the oxidative and glycolytic activity of the muscle fibers. Fast oxidative glycolytic fibers with high oxidative activity showed strong NOS I immunoreactivity, whereas fast glycolytic fibers with high glycolytic activity were stronger immunolabelled for NOS III. NOS II expression was similar in all fiber types. No differences in NOS immunoreactivity were found between the two investigated forms of deformity. Additionally to the usual skeletal muscle fiber types, a slow tonic fiber type was for the first time identified in cleft palate muscles. Comparison of two forms of cleft palate, isolated cleft palate and combined cleft lip and palate has shown decreased enzyme activities in muscle fibers of palatal muscles from combined cleft lip and palate. Fast oxidative glycolytic fibers were mainly effected. Cytophotometrical and immunohistochemical analysis indicated a depressed performance of the cleft palatal muscles from combined cleft lip and palate as a stronger deformity compared with isolated cleft palate.

A review of the toxicology of salbutamol (albuterol).

This paper reviews the published toxicology of salbutamol. Salbutamol is a relatively selective beta 2-adrenoreceptor stimulant with rapid, potent bronchodilator activity and only minor inotropic or chronotropic effects. It was not found to be mutagenic. LD50 values and other acute studies indicated low toxicity. Findings published for repeat dose studies were mainly uneventful. Tachycardia and flushing of the skin were observed in dogs. There were several findings peculiar to the rat--growth of the salivary gland, enlargement of the Harderian gland, an increase in colloid in the pituitary, and mesovarian leiomyomas. Increases in heart weights associated with inflammation, hypertrophy of muscle fibres, focal myocardial necrosis and fibrosis were seen in rats. Malformation, in the form of cleft palate, was reported in mice but not in rats or rabbits. These treatment related effects reported for salbutamol are not compound-related but rather are class-related. They are an expression of pharmacological activity brought about by the excessive beta stimulant action of high dosage with the drug.

Significance of cleft palate induced by chemicals in the rat and mouse

Five chemicals administered to pregnant rats and/or mice produced from 0–100% incidence of cleft palate in individual litters. Chlorcyclizine, one of six benzhydrylpiperazines already shown to produce a common syndrome in the rat, was found also to produce most of the responses in the mouse. In further studies on chlorcyclizine in the rat, the form of cleft palate in individual foetuses varied from unrotated palatine processes (vertical (V) type) through several horizontal (H) forms. Thorax enlargement, previously shown to be due to oedema of overlying tissue, subsided, was about constant or increased as the incidence of cleft palate increased. On average, the foetuses with cleft palate in individual litters had slightly larger thoraxes. When chlorcyclizine administration began 2 days later in gestation (on day 15), the thorax enlargement developed later and cleft palate did not result, and both the cleft-palate incidence and the degree of thorax enlargement were less when rats were co-treated with either SKF-525A or triamterene. Growth of the foetus, as determined by length, was only slightly retarded on most days of gestation and at most levels of cleft-palate incidence. In other studies, chlorcyclizine given to mice produced H and V forms of cleft palate and mild growth retardation but no thorax enlargement, β-aminopropionitrile produced in the rat and mouse both H and V forms of cleft palate but no growth retardation, and only transient, mild thorax enlargement was seen in the mouse. Only horizontal forms of cleft palate resulted from cortisone treatment of mice or triamcinolone treatment of rats or mice, and while the foetuses in all these cases showed severe growth retardation, thorax enlargement occurred only in the rats. Treatment of rats with N-nitroso- N-methylurea led to V-type cleft palates, severe growth retardation and a transient reduction in thorax area. Thus the teratological significance of cleft palate occurring in safety tests cannot be determined merely from the level of incidence without consideration of other findings. The multiple techniques used in this study should help in relating altered foetal metabolism and physiology to malformation and various other anomalies.