{"title":"Growth after construction of the temporomandibular joint in children with hemifacial microsomia.","authors":"I R Munro, J H Phillips, G Griffin","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Free costochondral grafts have been used to construct the absent ascending ramus and condylar head of 22 children with hemifacial microsomia (HFM) who were less than 14 years of age. Evidence of continued growth was demonstrated in all patients. Growth was determined by measurement of cephalograms or by inference; if the patient grew extensively in height but his/her face remained symmetric, the graft was inferred to have grown. In two patients, considerable overgrowth occurred, displacing the chin to the opposite side and causing a class III malocclusion. Variations in age or type of adjunctive operations did not affect growth. There appears to be no single explanation for all findings. Because all of the grafts grew, early joint construction and correction of hemifacial microsomia are advocated.</p>","PeriodicalId":76622,"journal":{"name":"The Cleft palate journal","volume":"26 4","pages":"303-11"},"PeriodicalIF":0.0,"publicationDate":"1989-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13943243","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Ethics of physicians and other clinical scientists who have financial interests in their own research.","authors":"L Pell","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":76622,"journal":{"name":"The Cleft palate journal","volume":"26 4","pages":"273-4"},"PeriodicalIF":0.0,"publicationDate":"1989-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13943241","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"A study of cephalometric features in cleft lip-cleft palate families. I: Phenotypic heterogeneity and genetic predisposition in parents of sporadic cases.","authors":"R E Ward, D Bixler, E R Raywood","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Several previous studies have indicated that unaffected parents of children with nonsyndromic cleft lip and palate show unusual craniofacial features. This study reexamines this question by applying multivariate cluster analysis to lateral cephalometric head plates from 82 individuals who are parents of sporadic cases of cleft lip with or without cleft palate (CL/P). Considerable phenotypic heterogeneity was present within the sample. Three major groupings were defined. Two of these groups showed cephalometric similarities to individuals with overt clefts, while the third showed a generalized concordance to published norms. In almost every case only one member of each parental pair showed the cleft related cephalometric phenotype, suggesting the possibility of a substantial genetic component in many cases of sporadic CL/P. However, there were several cases in which neither parent showed the phenotypic traits. Such cases may have a different etiology or a greater environmental component.</p>","PeriodicalId":76622,"journal":{"name":"The Cleft palate journal","volume":"26 4","pages":"318-25; discussion 325-6"},"PeriodicalIF":0.0,"publicationDate":"1989-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13943246","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Oculoauriculovertebral spectrum: an updated critique.","authors":"M M Cohen, B R Rollnick, C I Kaye","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>A comprehensive review and critical analysis of oculoauriculovertebral spectrum are provided. Topics discussed include nosologic problems, epidemiology, etiology (chromosomal, monogenic, teratogenic), and pathogenesis (hematoma formation, other vascular mechanisms, overripeness ovopathy). Clinical manifestations are thoroughly reviewed, updated, and documented for craniofacial features, central nervous system characteristics (including the wide spectrum of CNS malformations that make up the so-called \"expanded Goldenhar complex\"), congenital heart defects, and various other anomalies (kidney, lung, gastrointestinal tract). A number of conditions are discussed that are commonly differentiated from oculoauriculovertebral spectrum but have overlapping relationships, in some instances, with frontonasal dysplasia, branchio-oto-renal (BOR) syndrome, Townes-Brocks syndrome, Wildervanck syndrome, DiGeorge sequence, and several associations (VATER, CHARGE, and MURCS).</p>","PeriodicalId":76622,"journal":{"name":"The Cleft palate journal","volume":"26 4","pages":"276-86"},"PeriodicalIF":0.0,"publicationDate":"1989-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13822273","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"A retrospective analysis of growth of the constructed condyle-ramus in children with hemifacial microsomia.","authors":"J B Mulliken, N F Ferraro, A R Vento","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>A retrospective analysis of changes in costochondral rib grafts used to construct the condyle-ramus in children with hemifacial microsomia (HFM) was made. The mean age at surgical correction was 6.5 years, and the average follow-up was 4.5 years. Direct measurements were made on panoramic radiographs. The condyle-ramus length was expressed as a percentage change comparing the constructed with the normal side. During the first 2 postoperative years, there was either no change or a slight decrease in the length of the rib graft. After 2 years, however, the costochondral graft elongated at a slow, irregular rate. The mode change was 11 percent over the postoperative study period. In four patients who exhibited rapid growth of the normal condyleramus (greater than the mean change of 0.94 cm), the constructed side failed to keep pace. In another group of four patients who exhibited moderate elongation of the normal side, the grafted side grew commensurately or demonstrated greater than normal percentage change in length. There was no correlation between the initial size of the costochondral graft, age at time of operation, or presenting type of mandibular deformity. These findings are discussed in terms of the intrinsic growth and the functional matrix theories of mandibular development.</p>","PeriodicalId":76622,"journal":{"name":"The Cleft palate journal","volume":"26 4","pages":"312-7"},"PeriodicalIF":0.0,"publicationDate":"1989-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13943245","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"A jointed fan-type expander: a newly designed expansion appliance for the upper dental arch of patients with cleft lip and/or palate.","authors":"A Suzuki, Y Takahama","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Most patients with repaired cleft lip and/or palate have malocclusion and show various forms of occlusal discrepancy between the upper and lower dentition. In unilateral clefts, the teeth in the collapsed small segment are usually in lingual crossbite, although in most cases they are in normal buccolingual occlusal relation in the molar region. Expansion appliances should fulfill the following functions: the application of expansion force to the alveolar bone of the maxillary complex without buccal tipping of the teeth (to obtain the differential segmental movement); force to the lateral segments of the maxilla without their distortion; and expansion of the smaller segment without creating posterior crossbite. Unfortunately, many appliances do not satisfy these functions. A new fan-type expansion appliance has been designed by the authors to solve these problems. This appliance consists of three parts, as follow: an expansion screw; four bands (anchorage); and a joint connecting both buccal segments. The expansion screw is set in a direction tangent to the curve drawn by the intended fan-type movement of the collapsed small segment. The joint converts the expansion force from parallel to an arched direction.</p>","PeriodicalId":76622,"journal":{"name":"The Cleft palate journal","volume":"26 3","pages":"239-41; discussion 241"},"PeriodicalIF":0.0,"publicationDate":"1989-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13809731","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Incidence and prevalence of cleft lip and palate: what we think we know.","authors":"R B Sayetta, M C Weinrich, G N Coston","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The descriptive epidemiology of the spectrum of orofacial cleft disorders has many methodologic problems, including (1) casefinding using data sources such as birth certificates, fetal death certificates, and hospital records that often produce ascertainment bias, selection bias, or both and (2) the multiple comparisons problem (i.e., the chance occurrence of statistically significant findings). The resultant incidence and prevalence rates from studies with inadequate designs or inadequate data are limited and may be misleading. A variety of reasons is advanced to explain the wide discrepancies in reported statistics on orofacial clefting from different geographic areas, ethnic groups, and time periods. Specific recommendations are offered for producing better epidemiologic data. An example of how higher quality descriptive statistics can be used for future hypothesis testing is also provided.</p>","PeriodicalId":76622,"journal":{"name":"The Cleft palate journal","volume":"26 3","pages":"242-7; discussion 247-8"},"PeriodicalIF":0.0,"publicationDate":"1989-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13809732","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A W Kummer, J L Strife, W H Grau, N A Creaghead, L Lee
{"title":"The effects of Le Fort I osteotomy with maxillary movement on articulation, resonance, and velopharyngeal function.","authors":"A W Kummer, J L Strife, W H Grau, N A Creaghead, L Lee","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Articulation, resonance, and velopharyngeal function were evaluated before and after Le Fort I maxillary advancement in 16 patients (seven with cleft lip and palate, one with cleft lip only, and eight without clefts). On the postoperative evaluation, seven of 11 patients with preoperative articulation errors showed an improvement in articulation after surgery. Two patients without clefts showed slight changes in nasal resonance, and two patients (one with cleft lip and palate and one with cleft lip only) developed mild nasal emission. Nine patients showed diminished velopharyngeal contact during speech on videofluoroscopic studies. Compensatory changes in velopharyngeal function were also observed, which included velar stretching and lengthening and increased lateral pharyngeal wall movement.</p>","PeriodicalId":76622,"journal":{"name":"The Cleft palate journal","volume":"26 3","pages":"193-9; discussion 199-200"},"PeriodicalIF":0.0,"publicationDate":"1989-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13898767","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
K K Sulik, S J Smiley, T A Turvey, H S Speight, M C Johnston
{"title":"Pathogenesis of cleft palate in Treacher Collins, Nager, and Miller syndromes.","authors":"K K Sulik, S J Smiley, T A Turvey, H S Speight, M C Johnston","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Abnormalities of the secondary palate were studied in an animal model in which features of Treacher Collins syndrome (TCS) and Nager or Miller syndromes (both of which are facially similar to Treacher Collins, but include limb malformations) were induced by acute maternal exposure to 13-cis-retinoic acid (13-cis-RA, isotretinoin, Accutane). Previous work in our laboratory has illustrated that excessive cell death in the proximal aspect of the maxillary and mandibular prominences of the first visceral arch and in the apical ectodermal ridge of the limb bud probably accounts for the characteristic craniofacial and limb abnormalities observed (Sulik et al, 1987; Sulik and Dehart, 1988). The current study shows that maternal treatment with 400 mg per kilogram 13-cis-RA at 8 days 14 hours (8d14hr) or 9d6hr post fertilization results in abnormalities of the secondary palate that vary in incidence and severity. Following the earlier treatment time, 82 percent (68 of 74) of the 18d fetuses were affected, with, severely hypoplastic, unfused palatal shelves present in 34 percent (25 of 74). The less severely affected fetuses had malformations that involved primarily the posterior aspect of the palatal shelves. This malformation (foreshortening of the posterior portion of the palate) constituted the major developmental alteration that resulted from treatment at the later time, at which time a 52 percent (26 of 50) malformation incidence was seen. The change in pattern of malformations with treatment time is consistent with the changing pattern of programmed cell death, which was observed to occur in the first visceral arch.</p>","PeriodicalId":76622,"journal":{"name":"The Cleft palate journal","volume":"26 3","pages":"209-16; discussion 216"},"PeriodicalIF":0.0,"publicationDate":"1989-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13898769","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}