Cleft Palate-Craniofacial Journal最新文献

{"title":"Family Experiences with Diagnosis of Craniosynostosis: Thematic Analysis of Online Discussion Boards.","authors":"Kaamya Varagur, John Murphy, Gary B Skolnick, Sybill D Naidoo, Sean D McEvoy, Jennifer M Strahle, Kamlesh B Patel","doi":"10.1177/10556656231190043","DOIUrl":"10.1177/10556656231190043","url":null,"abstract":"<p><strong>Objective: </strong>Apply thematic analysis of online discussion boards to characterize families' experiences and concerns regarding craniosynostosis diagnoses to aid physicians in tailoring care to families.</p><p><strong>Design: </strong>Grounded theory-based qualitative analysis.</p><p><strong>Setting: </strong>Discussion boards related to craniosynostosis identified via Google and Yahoo.</p><p><strong>Patients/participants: </strong>Posts about craniosynostosis between 2017-2022.</p><p><strong>Interventions: </strong>Thematic analysis was performed using three rounds of coding. Post features including author type and use of technical language were examined.</p><p><strong>Main outcome measure: </strong>Overarching themes emerging from analysis of posts, with forums analyzed until sufficient thematic repetition was observed.</p><p><strong>Results: </strong>366 posts from 4 websites by 290 unique users were included. Parents of patients with craniosynostosis wrote 59% of posts while patients wrote 4%. Five selective codes were identified: 1) Building Community, 2) Diagnosis/Evaluation, 3) Treatment, 4) Outcomes, and 5) Emotional Concerns. Building Community was the most assigned code (85% of posts). 71% of parents' posts expressing emotional concerns expressed negative emotions, commonly regarding anxiety about diagnosis (71%), frustration about doctors' responses (21%), or negative reactions to online search results (17%). 88% of patients' posts expressed positive emotions, discussing positive long-term outcomes. Concerns that may guide physicians included anxiety about delayed diagnosis, difficulty distinguishing postpartum head shape changes from craniosynostosis, and difficulty finding a care team.</p><p><strong>Conclusions: </strong>Online discussion boards allow families of patients with craniosynostosis to share experiences and find community. Improving communication between surgeons, pediatricians, and families about timing of evaluation and revising online information about this condition may ameliorate some anxiety associated with this diagnosis.</p>","PeriodicalId":55255,"journal":{"name":"Cleft Palate-Craniofacial Journal","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9920037","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Role of Postoperative Nasal Stents in Cleft Rhinoplasty: A Systematic Review.","authors":"David C Nguyen, Janine A Myint, Alexander Y Lin","doi":"10.1177/10556656231190703","DOIUrl":"10.1177/10556656231190703","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the role of postoperative nasal stenting in preserving nasal shape and preventing nostril stenosis in cleft rhinoplasty, and to develop a classification system for postoperative nasal stents.</p><p><strong>Design: </strong>Systematic review.</p><p><strong>Methods: </strong>Electronic and manual searches of scientific literature were conducted from 3 databases (PubMed, SCOPUS, OVID). Primary evidence that described postoperative nasal stenting in cleft rhinoplasty were included. Exclusion criteria included secondary evidence, non-English articles, and studies focusing on preoperative nasal stents.</p><p><strong>Patients and participants: </strong>Patients with cleft lip/nose of any type were included.</p><p><strong>Main outcome measure(s): </strong>Role in preservation of nasal shape & symmetry, role in prevention of nostril stenosis, complications with the use of postoperative nasal stent.</p><p><strong>Results: </strong>Of the 13 articles, 9 papers described the preservation of nasal shape with nasal stents and three studies with a control group showed improved symmetry score. No studies evaluated the prevention of nostril stenosis; however, 2 studies reported improvement of nostril stenosis in secondary cleft rhinoplasty. The results of the included studies had significant heterogeneity. Nasal stents were classified into five types: Type I-spare parts assembled, Type II-prefabricated commercial, Type IIIa-patient specific 3D-printed static, Type IIIb-patient specific dynamic, and Type IV-internal absorbable. Total complications were 6.0%, including irritation (0.9%), infection (0.3%), and stent loss (4.6%).</p><p><strong>Conclusion: </strong>Despite the lack of consensus with postoperative nasal stents, this review suggests its safety and role in preserving shape and improving stenosis. Our classification system highlights variability and the need for better quality studies to determine the efficacy of nasal stents.</p>","PeriodicalId":55255,"journal":{"name":"Cleft Palate-Craniofacial Journal","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9883349","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The <i>IRF6</i> rs2013162 and <i>MTHFR</i> A1298C rs1801131 Gene Polymorphisms Related to non-Syndromic Cleft lip and Palate among Deutero-Malay in Indonesia.","authors":"Saskia L Nasroen, Tichvy Tammama, Rudi S Darwis, Almira Adil, Silvia Rahmutia, Ani Melani Maskoen, Basri A Gani","doi":"10.1177/10556656231191003","DOIUrl":"10.1177/10556656231191003","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to identify risk factors for NSCLP by analyzing polymorphisms in <i>IRF6</i> rs2013162 and <i>MTHFR</i> A1298C rs1801131 in the Deutero Malay Population in Indonesia.</p><p><strong>Setting: </strong>DNA isolation from venous blood samples was done followed by PCR and PCR-RFLPs method.</p><p><strong>Patients/participants: </strong>115 NSCLP subjects and 120 healthy control subjects.</p><p><strong>Main outcome measure(s): </strong>The odds ratio (OR) determined to evaluate the risk factors is the main outcome measure.</p><p><strong>Material and methods: </strong>The study is a case-control design using samples from the venous blood of 115 NSCLP subjects and 120 healthy control subjects. After DNA was extracted, the PCR-RFLPs method was performed using the DdeI restriction enzyme on 100 blood samples of the <i>IRF6</i> rs2013162 group and Mboll restriction enzyme on 135 blood samples of the <i>MTHFR</i> A1298C rs1801131 group. The Chi-Square test was used with the Exact Fisher alternatives, depending on the expected count value.</p><p><strong>Results: </strong>The results showed that the T mutant allele (OR = 4.125, <i>P</i> < .05) and GT genotype (OR = 21.00, <i>P</i> < .05) of <i>IRF6</i> rs2013162 and the C mutant allele (OR = 3.781, <i>P</i> < .05), AC genotype (OR = 5, <i>P</i> < .05) and CC genotype (OR = 9,681, <i>P</i> < .05) of the <i>MTHFR</i> A1298C is associated to a greater risk of NSCLP.</p><p><strong>Conclusions: </strong><i>IRF6</i> rs2013162 and <i>MTHFR</i> A1298C rs1801131 gene polymorphisms are strongly associated with NSCLP among the Deutero Malay population in the Indonesian population.</p>","PeriodicalId":55255,"journal":{"name":"Cleft Palate-Craniofacial Journal","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9927291","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Where is the Care? Identifying the Impact of Rurality on SLP Caseloads and Treatment Decisions for Children with Cleft Palate.","authors":"Kazlin N Mason, Katelyn J Kotlarek","doi":"10.1177/10556656231189940","DOIUrl":"10.1177/10556656231189940","url":null,"abstract":"<p><p>Challenges providing cleft/craniofacial care in rural communities are often reported, leading to disparities in resources available to clinicians. The purpose of this study was to identify the impact of rurality on caseloads and practice patterns of speech-language pathologists (SLPs) regarding speech and velopharyngeal function for children with cleft lip and/or palate (CL/P).</p><p><p>A national, survey of US-based SLPs (N = 359 respondents) investigated resources, comfort level, caseloads, and practice patterns for children with CL/P. Sub-county classifications that delineated levels of rurality were utilized. Descriptive statistics and chi-square analyses were conducted to determine the impact of population density on assessment and referral decisions.</p><p><p>Nearly 83% of SLPs reported providing care for a child with CL/P and 41.4% of these SLPs reported five or more children with CL/P on caseload throughout their career. There were no significant differences in rurality of practice setting and the likelihood of treating a child with CL/P. Significant differences were present between rural, town, suburban, and metropolitan-based SLPs regarding available resources (<i>p</i> = 0.035). SLPs in rural settings reported feeling uncomfortable treating children with CL/P compared to those in metropolitan settings (<i>p</i> = 0.02). Distance to the cleft/craniofacial team and comfort levels impacted referral decisions.</p><p><p>Most SLPs report having children with CL/P on caseload regardless of practice location. Rurality impacted assessment and referral decisions, especially surrounding access to resources and comfort levels engaging in team care. Findings have implications for developing support systems and reducing barriers for rural SLPs working with children born with CL/P.</p>","PeriodicalId":55255,"journal":{"name":"Cleft Palate-Craniofacial Journal","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10805969/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9881704","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anxiety, Depression, Stress, and Self-Esteem in Turkish Parents of Children with Microtia.","authors":"Hale Turhan Damar, Filiz Ogce Aktas","doi":"10.1177/10556656231190046","DOIUrl":"10.1177/10556656231190046","url":null,"abstract":"<p><strong>Objective: </strong>To describe factors affecting anxiety, depression, stress, and self-esteem in parents of children with microtia.</p><p><strong>Design: </strong>Cross-sectional correlational study.</p><p><strong>Participants: </strong>Parents (N = 117) of children with microtia were recruited nationally through a Turkish craniofacial non-governmental organization's social media.</p><p><strong>Main outcome measures: </strong>Demographics, parental report of microtia experiences and concerns, the Depression Anxiety Stress Scale, and the Rosenberg Self-Esteem Scale.</p><p><strong>Results: </strong>The mean parental age was 35.61 ± 5.96 years and 74.4% were female. The mean age of their children was 6.08 ± 4.22 years, 69.2% were male, 93.8% had unilateral microtia, and 14.5% had ear reconstruction. Some parents had low self-esteem (24.8%) and were in the severe range for depression (30.7%), anxiety (25.6%), and stress (21.4%). Depression (M = 7.43, SD = 5.35) was associated with worry about child's future (β = 0.25, <i>P </i>= .013), microtia information given around birth (β = -0.20, <i>P </i>= .024), and child no ear surgery (β = -0.23, <i>P </i>= .008), while stress (M = 8.21, SD = 5.37) was associated with worry about the child's future (β = 0.28, <i>P </i>= .008). Parental self-esteem (M = 29.59, SD = 5.10) was related to child having ear surgery (β = 0.19, <i>P </i>= .047) and information about microtia provided around birth (β = 0.22, <i>P </i>= .018). There were no significant associations with Anxiety (M = 6.04, SD = 4.82) identified by multiple regression.</p><p><strong>Conclusions: </strong>While most parents were in the average to moderate range for clinical concerns, a fifth to a third of participants were in the severe range for depression, anxiety, and stress and a quarter of participants for low self-esteem. Informing families about the microtia treatment process, having the child have surgery, and interventions for reducing their future concerns may provide psychological relief for them.</p>","PeriodicalId":55255,"journal":{"name":"Cleft Palate-Craniofacial Journal","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10223687","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sphenoid Sinus Volumes of Patients with Unilateral Cleft Lip and Palate.","authors":"Ahmet Faruk Erturk, Sevde Goksel, Merve Yelken Kendirci, Ilknur Ozcan","doi":"10.1177/10556656231190736","DOIUrl":"10.1177/10556656231190736","url":null,"abstract":"<p><strong>Objective: </strong>There is only one study in the literature in which 3D evaluation of sphenoid sinus volume in patients with cleft lip and palate was used. This shows that this issue has not been adequately evaluated. The present study aimed to compare the volume of the sphenoid sinuses in patients with cleft lip and palate on cone-beam computed tomography images, and to compare them with healthy controls. The high variability of sphenoid sinus volumes poses a risk for iatrogenic lesions during surgical procedures. Because the degree of pneumatization due to increased volume increases the likelihood of exposure of vital neurovascular structures such as the internal carotid artery, maxillary nerves, and optic nerves.</p><p><strong>Design: </strong>Retrospective cohort study.</p><p><strong>Setting: </strong>University Hospital.</p><p><strong>Patients: </strong>A total of 64 patients (32 cleft palate, 32 controls) over 18 years of age who had sphenoid sinuses in the image area were included in our study.</p><p><strong>Outcomes: </strong>Sphenoid Sinus Volume.</p><p><strong>Results: </strong>When the groups were compared in terms of total sinus volume, there was a statistically significant difference between them. Total sinus volume was significantly mean 2.806,87 mm lower in patients with cleft lip and palate compared to the healthy group (<i>P</i> = .015).</p><p><strong>Conclusion: </strong>To be aware this lower volume of the sphenoid sinus in cleft lip and palate patients will be useful for the surgical approach to sphenoid sinus. However, the literature on the subject is insufficient, more comprehensive clinical and radiological studies are needed on a larger sample.</p>","PeriodicalId":55255,"journal":{"name":"Cleft Palate-Craniofacial Journal","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10242611","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient Factors Influencing Speech Outcomes in Velopharyngeal Function Following Initial Cleft Palate Repair: A Systematic Review and Meta-Analysis.","authors":"David C G Sainsbury, Caroline C Williams, Sophie Butterworth, Catherine de Blacam, Matthew J Fell, Joanne Mullen, William Breakey, Colm Murphy, Peter D Hodgkinson, Yvonne Wren","doi":"10.1177/10556656231191384","DOIUrl":"10.1177/10556656231191384","url":null,"abstract":"<p><strong>Objective: </strong>Identification of patient factors influencing velopharyngeal function for speech following initial cleft palate repair.</p><p><strong>Design: </strong>A literature search of relevant databases from inception until 2018 was performed using medical subject headings and keywords related to cleft palate, palatoplasty and speech assessment. Following three stage screening data extraction was performed.</p><p><strong>Setting: </strong>Systematic review and meta-analysis of relevant literature.</p><p><strong>Patients/participants: </strong>Three hundred and eighty-three studies met the inclusion criteria, comprising data on 47 658 participants.</p><p><strong>Interventions: </strong>Individuals undergoing initial palatoplasty.</p><p><strong>Main outcome measures: </strong>Studies including participants undergoing initial cleft palate repair where the frequency of secondary speech surgery and/or velopharyngeal function for speech was recorded.</p><p><strong>Results: </strong>Patient factors reported included cleft phenotype (95% studies), biological sex (64%), syndrome diagnosis (44%), hearing loss (28%), developmental delay (16%), Robin Sequence (16%) and 22q11.2 microdeletion syndrome (11%). Meta-analysis provided strong evidence that rates of secondary surgery and velopharyngeal dysfunction varied according to cleft phenotype (Veau I best outcomes, Veau IV worst outcomes), Robin Sequence and syndrome diagnosis. There was no evidence that biological sex was associated with worse outcomes. Many studies were poor quality with minimal follow-up.</p><p><strong>Conclusions: </strong>Meta-analysis demonstrated the association of certain patient factors with speech outcome, however the quality of the evidence was low. Uniform, prospective, multi-centre documentation of preoperative characteristics and speech outcomes is required to characterise risk factors for post-palatoplasty velopharyngeal insufficiency for speech.</p><p><strong>Systematic review registration: </strong>Registered with PROSPERO CRD42017051624.</p>","PeriodicalId":55255,"journal":{"name":"Cleft Palate-Craniofacial Journal","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9927290","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cleft Palate in Apert Syndrome: A Descriptive Study of Incidence and Surgical Outcome.","authors":"Alicia Andiné, Peter Tarnow, Patrik Boivie","doi":"10.1177/10556656231194445","DOIUrl":"10.1177/10556656231194445","url":null,"abstract":"<p><strong>Objective: </strong>Apert syndrome (AS) is a rare congenital craniofacial disorder that requires a multidisciplinary approach to treatment and multiple surgeries. Given that cleft palate (CP) is presented in some of these cases, this poses an additional risk of aggravating obstructed airways after closure. The timing and outcome of CP repair in these patients remains disputed and requires additional attention.</p><p><strong>Design: </strong>This retrospective analysis included patients diagnosed with CP and AS, born between 1950 and 2020, and treated at our institution. Data were collected from medical records and evaluated using descriptive statistics.</p><p><strong>Setting: </strong>Data analyses were conducted at Sahlgrenska University Hospital in Gothenburg, Sweden.</p><p><strong>Patients/participants: </strong>A registry of 83 patients with AS resulted in a cohort of 26 patients also presenting with CP.</p><p><strong>Main outcome measures: </strong>Postoperative complications, requirement for intensive care, and reoperations following CP repair.</p><p><strong>Results: </strong>CP incidence among all registered patients was 31%. Patients undergoing CP repair at low age (mean: 22.5 months) tended to experience more frequent postoperative complications and requirements for intensive care. Among the evaluated cohort with medical records describing CP repair (<i>n </i>= 14), 29% experienced postoperative complications, all of which involved aggravation of obstructed airways.</p><p><strong>Conclusions: </strong>This study highlights the importance of airway assessment before and after CP repair in AS. The findings suggest that surgical outcomes might benefit from postponing CP repair, avoiding combined surgeries, and operating in two stages when indicated. However, additional and larger studies are required.</p>","PeriodicalId":55255,"journal":{"name":"Cleft Palate-Craniofacial Journal","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9974667","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk Assessment of Sleep Disordered Breathing in Cleft Lip and/or Palate.","authors":"Alec H Fisher, Luke Stanisce, Zach J Nelson, Marilyn A Cohen, Martha S Matthews","doi":"10.1177/10556656231193552","DOIUrl":"10.1177/10556656231193552","url":null,"abstract":"<p><strong>Objective: </strong>Children with cleft lip and/or palate (CL/P) are at increased risk for Sleep Disordered Breathing (SDB), particularly Obstructive Sleep Apnea (OSA). At our institution, routine screening for SDB is performed using the Chevrin Pediatric Sleep Questionnaire (PSQ). This analysis is a practice audit looking at the outcomes of screening children with CL/P.</p><p><strong>Design/setting/patients/participants: </strong>A single-center, retrospective analysis was done of all non-syndromic patients with CL/P over the age of 36 months over a 4-year period. Children with known OSA were eliminated from analysis.</p><p><strong>Main outcome measures: </strong>Univariate logistic regression was used to assess predictors for SDB (PSQ score > 8) amongst various patient, disease, and treatment characteristics. Outcomes of those screened were tracked.</p><p><strong>Results: </strong>Of the 239 patients in the study cohort, 43 (18%) had positive PSQs. These subjects were more likely to have class III dental occlusion with maxillary retrusion (OR = 2.65, 95% CI: 1.2-5.8, p = 0.02). There were no differences amongst age, type of cleft, Veau classification, BMI, or history of pharyngeal surgery. One third of the group did not complete recommended testing. Twenty-five subjects with positive sleep screening underwent subsequent polysomnography and 21 (84%) had OSA.</p><p><strong>Conclusion: </strong>Routine screening reveals a significant proportion of patients with CL/P with symptoms suggestive of OSA. While several patients did not complete confirmatory testing, those who completed a PSG had a high rate of identification of OSA. After excluding children with known OSA, patients with SDB are also likely to have class III dental occlusion and maxillary retrusion.</p>","PeriodicalId":55255,"journal":{"name":"Cleft Palate-Craniofacial Journal","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10319308","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Change in Lower Lip Position After Le Fort I Advancement in Patients with Bilateral vs. Unilateral Cleft Lip and Palate.","authors":"Jill Schechter, Andre Alcon, Alexandra Verzella, Pradip Shetye, Roberto Flores","doi":"10.1177/10556656231184975","DOIUrl":"10.1177/10556656231184975","url":null,"abstract":"<p><p>To compare lower lip changes after Le Fort I advancement surgery in patients with a cleft.</p><p><p>Single institution, retrospective review.</p><p><p>Academic tertiary referral hospital.</p><p><p>Skeletally mature patients with a cleft who underwent one-piece Le Fort I advancement surgery who had a lateral cephalogram or cone-beam computed tomography (CBCT) scan preoperatively and at least 6 months postoperatively. Patients who underwent concomitant mandibular surgery or genioplasty were excluded. 64 patients were included: 45 male and 19 female, 25 with BCLP and 39 with UCLP. The mean age at surgery was 18.4 years.</p><p><p>Single jaw one-piece Le Fort I advancement surgery.</p><p><p>Standard lateral cephalometric landmarks of the bony skeleton and soft tissue were compared before and after Le Fort I advancement. Pearson correlation coefficients (r) were calculated to measure the correlation between lower lip position and other soft and hard tissue changes.</p><p><p>After comparable maxillary advancements [BCLP: 7.2 mm (95% CI: 6.2-8.3 mm), UCLP: 6.4 mm (95% CI: 5.7-7.0 mm)] the horizontal upper-to-lower lip discrepancy significantly improved in both groups. The lower lip became thinner and more posteriorly positioned. Changes in lower lip position correlated strongly with mandibular bony landmarks and moderately with upper lip position, but poorly with maxillary landmarks.</p><p><p>Le Fort I advancement results in posterior displacement of the lower lip and better lip competence, thereby improving facial harmony. This lower lip change is not predictable by degree of maxillary advancement, and does not differ in patients with BCLP vs. UCLP.</p>","PeriodicalId":55255,"journal":{"name":"Cleft Palate-Craniofacial Journal","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84590411","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}