Pub Date : 2023-07-01DOI: 10.4103/jclpca.jclpca_7_23
Danielle DeWitt, Christina V. Nobriga
Purpose: The current pilot study aimed to collect craniofacial surgeon's personal perspectives regarding the timing of cleft palate surgical repair, medical considerations for surgical repair (i.e., age, weight, type of cleft, and potential for surgical complications), and social considerations (i.e., speech–language development, socioeconomic status, and familial support). Materials and Methods: Fifteen plastic surgeons currently practicing cleft palate repair participated in this study. Surveys were distributed electronically to team coordinators of the American Cleft Palate-Craniofacial Association-accredited craniofacial teams and included a combination of Likert scales, closed multiple-choice questions, and open-ended qualitative questions for free-text responses. Results: Preliminary data obtained in this study suggest that the most common age range for palate repair in nonmedically complex infants is 10–11 months of age (n = 10). Notably, 20% of respondents (n = 3) reported a typical surgical repair time of 7–9 months of age. While medical and social priorities differed, all surgeons rated speech–language development as an important factor when determining the timing of surgical intervention. Conclusion: Given the limited consensus on surgical timing and intervention for children with cleft palate, further research is needed to determine the optimal timing of palate repair that considers both medical safety and near age-appropriate speech sound acquisition and production.
{"title":"Cleft palate surgical perspectives: A pilot study","authors":"Danielle DeWitt, Christina V. Nobriga","doi":"10.4103/jclpca.jclpca_7_23","DOIUrl":"https://doi.org/10.4103/jclpca.jclpca_7_23","url":null,"abstract":"Purpose: The current pilot study aimed to collect craniofacial surgeon's personal perspectives regarding the timing of cleft palate surgical repair, medical considerations for surgical repair (i.e., age, weight, type of cleft, and potential for surgical complications), and social considerations (i.e., speech–language development, socioeconomic status, and familial support). Materials and Methods: Fifteen plastic surgeons currently practicing cleft palate repair participated in this study. Surveys were distributed electronically to team coordinators of the American Cleft Palate-Craniofacial Association-accredited craniofacial teams and included a combination of Likert scales, closed multiple-choice questions, and open-ended qualitative questions for free-text responses. Results: Preliminary data obtained in this study suggest that the most common age range for palate repair in nonmedically complex infants is 10–11 months of age (n = 10). Notably, 20% of respondents (n = 3) reported a typical surgical repair time of 7–9 months of age. While medical and social priorities differed, all surgeons rated speech–language development as an important factor when determining the timing of surgical intervention. Conclusion: Given the limited consensus on surgical timing and intervention for children with cleft palate, further research is needed to determine the optimal timing of palate repair that considers both medical safety and near age-appropriate speech sound acquisition and production.","PeriodicalId":34294,"journal":{"name":"Journal of Cleft Lip Palate and Craniofacial Anomalies","volume":"17 1","pages":"63 - 70"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139364671","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}
Pub Date : 2023-07-01DOI: 10.4103/jclpca.jclpca_10_23
Dolly Patel, S. Sinha, Prerna Rupareliya, Diptesh Guha
Aims and Objectives: The purpose of this study was to analyze parameters of tooth in subjects with nonsyndromic cleft lip and palate (CLCP) and to compare the findings with the control groups. Teeth in the cleft-affected and nonaffected side in the same unilateral cleft lip and palate (ULCP) patient were also compared. Materials and Methods: The study included 200 subjects in the age group of 12–37 years who were divided into two groups: nonsyndromic CLCP and control group. The control group was further subdivided into skeletal Class I, II, and III subgroups based on ANB, AO-BO, and overjet, respectively. Crown height, root length, total tooth length, crown root ratio (C/R ratio), and tooth angulations of maxillary permanent central incisors, canines, 1st premolars, and 1st molar were measured on orthopantomograms using both ITK SNAP software and manual tracing. Results: Crown heights significantly increased while root lengths significantly decreased in the CLCP patients when compared to control groups. Total tooth lengths of central incisor, canine, and 1st premolar in CLCP patients were found to be decreased significantly. C/R ratios of all the teeth of nonsyndromic CLCP group irrespective of the cleft affected or nonaffected side was found to be increased as compared to the control groups. There was a significant difference seen in crown height, root length and mesiodistal tooth angulations in the cleft affected side when compared to the non affected side in a UCLCP patient's dentition. However the total tooth length and the C/R ratio were not affected. Conclusion: Common findings of CLCP are aberrant teeth development, altered tooth morphology, and malformed teeth. The severity of cleft has an impact on the tooth development and morphology as it was observed that delayed root development and short roots, decreased total tooth length, increased C/R ratio and variations in teeth angulations in CLCP patients were affected by the presence and severity of cleft.
{"title":"Crown root ratio and angulation of various permanent teeth in patients with and without cleft lip/palate","authors":"Dolly Patel, S. Sinha, Prerna Rupareliya, Diptesh Guha","doi":"10.4103/jclpca.jclpca_10_23","DOIUrl":"https://doi.org/10.4103/jclpca.jclpca_10_23","url":null,"abstract":"Aims and Objectives: The purpose of this study was to analyze parameters of tooth in subjects with nonsyndromic cleft lip and palate (CLCP) and to compare the findings with the control groups. Teeth in the cleft-affected and nonaffected side in the same unilateral cleft lip and palate (ULCP) patient were also compared. Materials and Methods: The study included 200 subjects in the age group of 12–37 years who were divided into two groups: nonsyndromic CLCP and control group. The control group was further subdivided into skeletal Class I, II, and III subgroups based on ANB, AO-BO, and overjet, respectively. Crown height, root length, total tooth length, crown root ratio (C/R ratio), and tooth angulations of maxillary permanent central incisors, canines, 1st premolars, and 1st molar were measured on orthopantomograms using both ITK SNAP software and manual tracing. Results: Crown heights significantly increased while root lengths significantly decreased in the CLCP patients when compared to control groups. Total tooth lengths of central incisor, canine, and 1st premolar in CLCP patients were found to be decreased significantly. C/R ratios of all the teeth of nonsyndromic CLCP group irrespective of the cleft affected or nonaffected side was found to be increased as compared to the control groups. There was a significant difference seen in crown height, root length and mesiodistal tooth angulations in the cleft affected side when compared to the non affected side in a UCLCP patient's dentition. However the total tooth length and the C/R ratio were not affected. Conclusion: Common findings of CLCP are aberrant teeth development, altered tooth morphology, and malformed teeth. The severity of cleft has an impact on the tooth development and morphology as it was observed that delayed root development and short roots, decreased total tooth length, increased C/R ratio and variations in teeth angulations in CLCP patients were affected by the presence and severity of cleft.","PeriodicalId":34294,"journal":{"name":"Journal of Cleft Lip Palate and Craniofacial Anomalies","volume":"29 1","pages":"71 - 79"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139364451","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}
Pub Date : 2023-07-01DOI: 10.4103/jclpca.jclpca_20_23
Neeta Bhargava, Suveer Bhargava, Astha Pandey
The cleft lip and palate affect one in 700 newborn babies worldwide. This occurs due to variations during normal development of the primary and/or secondary palate. These lead to multiple challenges for both parents and caregivers in providing proper nutrition for the growth and development of the baby. Babies with cleft lip and palate have difficulty in taking breastfeeding directly, which can lead to gradual lactation suppression. Parental distress, lack of support, unawareness about the defect, improper feeding, frequent infections, and subsequent multiple surgeries can affect the nutrition and development of a cleft child. This article aims to emphasize the importance and understanding of nutrition during the initial 1000 days of life. The infant's brain undergoes maximal development during this stage, and any nutritional insult can have devastating consequences for their physical and mental development. Mothers and caregivers have to be educated regarding the importance of breastfeeding, benefits of human milk, appropriate feeding positions, methods as well as feeding interventions. This article aims to provide a common understanding of the timeline for providing nutrition to infants before surgery. Therefore, it is important to establish timely and proper feeding to build immunity and adequate weight gain. For the identification of studies for this review, detailed search strategies were developed for each database: PubMed, EMBASE, and OVID. All articles having full-text access were searched electronically. Search included WHO publications, original articles, review articles, and other related articles. This comprehensive understanding of nutrition has to be understood by all stakeholders of the multidisciplinary team to ensure a successful and smooth surgical course and an overall positive outcome.
{"title":"Nutritional care of children with cleft lip and palate: A pragmatic approach","authors":"Neeta Bhargava, Suveer Bhargava, Astha Pandey","doi":"10.4103/jclpca.jclpca_20_23","DOIUrl":"https://doi.org/10.4103/jclpca.jclpca_20_23","url":null,"abstract":"The cleft lip and palate affect one in 700 newborn babies worldwide. This occurs due to variations during normal development of the primary and/or secondary palate. These lead to multiple challenges for both parents and caregivers in providing proper nutrition for the growth and development of the baby. Babies with cleft lip and palate have difficulty in taking breastfeeding directly, which can lead to gradual lactation suppression. Parental distress, lack of support, unawareness about the defect, improper feeding, frequent infections, and subsequent multiple surgeries can affect the nutrition and development of a cleft child. This article aims to emphasize the importance and understanding of nutrition during the initial 1000 days of life. The infant's brain undergoes maximal development during this stage, and any nutritional insult can have devastating consequences for their physical and mental development. Mothers and caregivers have to be educated regarding the importance of breastfeeding, benefits of human milk, appropriate feeding positions, methods as well as feeding interventions. This article aims to provide a common understanding of the timeline for providing nutrition to infants before surgery. Therefore, it is important to establish timely and proper feeding to build immunity and adequate weight gain. For the identification of studies for this review, detailed search strategies were developed for each database: PubMed, EMBASE, and OVID. All articles having full-text access were searched electronically. Search included WHO publications, original articles, review articles, and other related articles. This comprehensive understanding of nutrition has to be understood by all stakeholders of the multidisciplinary team to ensure a successful and smooth surgical course and an overall positive outcome.","PeriodicalId":34294,"journal":{"name":"Journal of Cleft Lip Palate and Craniofacial Anomalies","volume":"6 1","pages":"96 - 102"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139365285","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}
Pub Date : 2023-07-01DOI: 10.4103/jclpca.jclpca_11_23
K. Kumar, S. Sayd, Suresh Vyloppilli, S. Nair, A. Pati, A. Sivadasan
Introduction: Children born with the bilateral cleft lip-cleft palate have a shortened columella and an elevated protruding premaxilla which results in an abnormal appearance of the nose. Materials and Methods: This study was conducted in the Baby MemorialHospital, Calicut, a Smile Train Center in India. After scrutiny, the eligible sample size amounted to30 cases. The patient's age rangedfrom 4 to 7 months. The basic technique employed is “Veau three straight line repair” technique. This study analyses the importance of a geometrical incision, a back cut extending cephalically above the inferior turbinate at the mucocutaneous junction to elevate the nostril floor, to achieve the symmetry of the alar bases. Result: Preoperative and postoperative anthropometric studies were conducted on the asymmetry and symmetry of the alar bases. The p values for the right side preoperative and postoperative measurement is 0.007 which is highly significant and for the left side, it is <0.001 which also denotes statistical significance of this technique. Conclusion: Further high volume multicentric studies may be suggested since bilateral cases amount for only 10% of the overall incidence of cleft lip cases and even high volume surgeons are privileged to treat only a few. Therefore, it is the obligation of every surgeon who undertakes the care of these children to learn from the past and to analyse results periodically, including comparison with other centres.
简介先天性双侧唇腭裂患儿的颌骨缩短，前颌骨隆起突出，导致鼻子外观异常。材料和方法：本研究在印度微笑列车中心卡利卡特婴儿纪念医院进行。经过审查，符合条件的样本量为 30 例。患者年龄从 4 个月到 7 个月不等。采用的基本技术是 "Veau 三直线修复 "技术。本研究分析了几何切口的重要性，即在下鼻甲粘膜交界处向头上方延伸的后切口，以抬高鼻孔底，从而实现耳廓基底的对称。手术结果术前和术后对鼻翼基底的不对称性和对称性进行了人体测量学研究。右侧术前和术后测量的 P 值为 0.007，具有高度显著性，左侧的 P 值小于 0.001，也表明该技术具有统计学意义。结论：由于双侧唇裂病例仅占唇裂病例总发病率的 10%，即使是高产量的外科医生也只能治疗少数病例，因此建议进一步开展高产量的多中心研究。因此，每一位负责治疗这些儿童的外科医生都有义务从过去的经验中吸取教训，并定期分析结果，包括与其他中心进行比较。
{"title":"Surgical technique to achieve postoperative alar base symmetry in complete bilateral cleft lip and alveolus repair – A prospective study","authors":"K. Kumar, S. Sayd, Suresh Vyloppilli, S. Nair, A. Pati, A. Sivadasan","doi":"10.4103/jclpca.jclpca_11_23","DOIUrl":"https://doi.org/10.4103/jclpca.jclpca_11_23","url":null,"abstract":"Introduction: Children born with the bilateral cleft lip-cleft palate have a shortened columella and an elevated protruding premaxilla which results in an abnormal appearance of the nose. Materials and Methods: This study was conducted in the Baby MemorialHospital, Calicut, a Smile Train Center in India. After scrutiny, the eligible sample size amounted to30 cases. The patient's age rangedfrom 4 to 7 months. The basic technique employed is “Veau three straight line repair” technique. This study analyses the importance of a geometrical incision, a back cut extending cephalically above the inferior turbinate at the mucocutaneous junction to elevate the nostril floor, to achieve the symmetry of the alar bases. Result: Preoperative and postoperative anthropometric studies were conducted on the asymmetry and symmetry of the alar bases. The p values for the right side preoperative and postoperative measurement is 0.007 which is highly significant and for the left side, it is <0.001 which also denotes statistical significance of this technique. Conclusion: Further high volume multicentric studies may be suggested since bilateral cases amount for only 10% of the overall incidence of cleft lip cases and even high volume surgeons are privileged to treat only a few. Therefore, it is the obligation of every surgeon who undertakes the care of these children to learn from the past and to analyse results periodically, including comparison with other centres.","PeriodicalId":34294,"journal":{"name":"Journal of Cleft Lip Palate and Craniofacial Anomalies","volume":"34-35 1","pages":"80 - 85"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139364811","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}
Pub Date : 2023-07-01DOI: 10.4103/jclpca.jclpca_14_23
Yash Salkar, Shubhaani Singh, Anu Singla, Suruchi Sindwani
This case report presents the treatment of an 18-year-old girl with a unilateral alveolar cleft and impacted deciduous teeth. The patient had a gap in her upper front teeth and sought treatment for the alveolar defect. The initial treatment plan included alveolar bone grafting, fixed mechanotherapy, and prosthetic rehabilitation. However, the patient declined the bone grafting surgery. To address the issue, orthodontic treatment began with the extraction of a lower incisor to correct the overjet and the removal of over-retained deciduous teeth and a resorbed lateral incisor. The impacted lateral incisor was brought into the arch to stimulate bone formation. The treatment lasted 21 months, and an interim prosthetic rehabilitation with a natural tooth pontic was placed before the final rehabilitation using a Maryland bridge. The outcome of the treatment showed improved dental esthetics, harmonious soft-tissue profile, and parallel roots. This case highlights the importance of early intervention for alveolar clefts and the collaborative effort required for comprehensive oral rehabilitation in cleft lip and palate patients.
{"title":"Orthodontic-prosthetic rehabilitation of alveolar cleft","authors":"Yash Salkar, Shubhaani Singh, Anu Singla, Suruchi Sindwani","doi":"10.4103/jclpca.jclpca_14_23","DOIUrl":"https://doi.org/10.4103/jclpca.jclpca_14_23","url":null,"abstract":"This case report presents the treatment of an 18-year-old girl with a unilateral alveolar cleft and impacted deciduous teeth. The patient had a gap in her upper front teeth and sought treatment for the alveolar defect. The initial treatment plan included alveolar bone grafting, fixed mechanotherapy, and prosthetic rehabilitation. However, the patient declined the bone grafting surgery. To address the issue, orthodontic treatment began with the extraction of a lower incisor to correct the overjet and the removal of over-retained deciduous teeth and a resorbed lateral incisor. The impacted lateral incisor was brought into the arch to stimulate bone formation. The treatment lasted 21 months, and an interim prosthetic rehabilitation with a natural tooth pontic was placed before the final rehabilitation using a Maryland bridge. The outcome of the treatment showed improved dental esthetics, harmonious soft-tissue profile, and parallel roots. This case highlights the importance of early intervention for alveolar clefts and the collaborative effort required for comprehensive oral rehabilitation in cleft lip and palate patients.","PeriodicalId":34294,"journal":{"name":"Journal of Cleft Lip Palate and Craniofacial Anomalies","volume":"6 1","pages":"107 - 111"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139364620","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}
Introduction: The poor nutritional status and lower socioeconomic conditions among the Indian population have influenced the decisions on elective cleft lip surgeries. These factors may delay the treatment, as well as affect the overall development of the child. This study aims to identify the prevalence of microcytic hypochromic anemia in the Indian population to formulate the protocol in need for iron and nutritional supplementation in elective surgical planning of cleft lip and palate, thereby providing a comprehensive care in clefts. Methodology: A cohort study was designed comparing 100 children with nonsyndromic cleft lip or palate, who were undergoing surgical repair in our institution cleft deformity and without congenital anomalies under the age of 2 years. The blood parameters (hemoglobin [Hb], mean corpuscular volume, mean corpuscular Hb concentration [MCHC], MCHC, and red cell distribution width cell volume) for identifying the microcytic hypochromic anemia were assessed before the surgical repair and compared with the normal population. Descriptive analysis was performed to extract results. Results: The study population had a mean age of 10.56 ± 7.02 months (55 boys and 45 girls). We identified 61% of the population having anemia, with 2% having severe anemia (Hb <7 g/dL). It was observed that higher levels of Hb were in the age group of 4–6 months, and the lowest was documented in the older children. Conclusion: The study helps in identifying the prevalence of iron-deficiency anemia in children who are undergoing surgical repair for nonsyndromic cleft lip or palate. Therefore, the comprehensive cleft care should be the focus, addressing the feeding difficulties, malnutrition, and failure to thrive, before surgical intervention.
{"title":"Prevalence of anemia in children with cleft lip and palate in Karnataka: A cohort study","authors":"Chetana Kumar, Centina John, Krishna Rao, Rolson Amanna, Tarun Jain, K. Lohitha","doi":"10.4103/jclpca.jclpca_19_23","DOIUrl":"https://doi.org/10.4103/jclpca.jclpca_19_23","url":null,"abstract":"Introduction: The poor nutritional status and lower socioeconomic conditions among the Indian population have influenced the decisions on elective cleft lip surgeries. These factors may delay the treatment, as well as affect the overall development of the child. This study aims to identify the prevalence of microcytic hypochromic anemia in the Indian population to formulate the protocol in need for iron and nutritional supplementation in elective surgical planning of cleft lip and palate, thereby providing a comprehensive care in clefts. Methodology: A cohort study was designed comparing 100 children with nonsyndromic cleft lip or palate, who were undergoing surgical repair in our institution cleft deformity and without congenital anomalies under the age of 2 years. The blood parameters (hemoglobin [Hb], mean corpuscular volume, mean corpuscular Hb concentration [MCHC], MCHC, and red cell distribution width cell volume) for identifying the microcytic hypochromic anemia were assessed before the surgical repair and compared with the normal population. Descriptive analysis was performed to extract results. Results: The study population had a mean age of 10.56 ± 7.02 months (55 boys and 45 girls). We identified 61% of the population having anemia, with 2% having severe anemia (Hb <7 g/dL). It was observed that higher levels of Hb were in the age group of 4–6 months, and the lowest was documented in the older children. Conclusion: The study helps in identifying the prevalence of iron-deficiency anemia in children who are undergoing surgical repair for nonsyndromic cleft lip or palate. Therefore, the comprehensive cleft care should be the focus, addressing the feeding difficulties, malnutrition, and failure to thrive, before surgical intervention.","PeriodicalId":34294,"journal":{"name":"Journal of Cleft Lip Palate and Craniofacial Anomalies","volume":"21 1","pages":"86 - 89"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139364883","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}
Pub Date : 2023-07-01DOI: 10.4103/jclpca.jclpca_21_23
Prachi Varshney, D. Upadhyaya, Vijay Kumar, B. Mishra, Sandhya Pandey
Introduction: Lip–nose complex anthropometry is an important component of cleft lip and palate repair. There are limited studies in the Indian population which measure the anthropometry of facial structures. Various anthropometric and cephalometric techniques have been evolved and applied to measure facial features of cleft lip/palate patients. Objective: The main objective of this study was to measure the anthropometry of lip–nose complex of unilateral cleft lip children and compare it with noncleft children as age-matched controls by VECTRA three-dimensional (3D) digital photogrammetry. Materials and Methods: This was an observational cross-sectional study conducted on 25 children with unilateral cleft lip (complete/incomplete) of 3 months–2 years of age as cases and 25 noncleft children as age-matched controls, admitted to our institute. Philtral height, lip length, lip height, nostril height, nostril width, nasal sill width, and columella height were measured using VECTRA 3D digital photogrammetry. Results: The mean age of cleft and noncleft patients was 7.80 ± 3.76 months and 10.60 ± 4.38 months, respectively. Philtral height, lip height, lip length, and columella height of the cleft side were found to be significantly lower than that of noncleft patients (P < 0.001). The rest of the parameters, nostril height, nostril width, and nasal sill width of cleft patients were found to be significantly higher than that of noncleft patients (P < 0.001). Conclusion: This study provided an anthropometrical analysis of the lip–nose complex which can be a fundamental basis for presurgical consultation, surgical planning, postoperative assessment, and a predictor for treatment outcome.
{"title":"An observational pilot study on anthropometric analysis of lip–nose complex of unilateral cleft lip children and age-matched controls by three-dimensional digital photogrammetry","authors":"Prachi Varshney, D. Upadhyaya, Vijay Kumar, B. Mishra, Sandhya Pandey","doi":"10.4103/jclpca.jclpca_21_23","DOIUrl":"https://doi.org/10.4103/jclpca.jclpca_21_23","url":null,"abstract":"Introduction: Lip–nose complex anthropometry is an important component of cleft lip and palate repair. There are limited studies in the Indian population which measure the anthropometry of facial structures. Various anthropometric and cephalometric techniques have been evolved and applied to measure facial features of cleft lip/palate patients. Objective: The main objective of this study was to measure the anthropometry of lip–nose complex of unilateral cleft lip children and compare it with noncleft children as age-matched controls by VECTRA three-dimensional (3D) digital photogrammetry. Materials and Methods: This was an observational cross-sectional study conducted on 25 children with unilateral cleft lip (complete/incomplete) of 3 months–2 years of age as cases and 25 noncleft children as age-matched controls, admitted to our institute. Philtral height, lip length, lip height, nostril height, nostril width, nasal sill width, and columella height were measured using VECTRA 3D digital photogrammetry. Results: The mean age of cleft and noncleft patients was 7.80 ± 3.76 months and 10.60 ± 4.38 months, respectively. Philtral height, lip height, lip length, and columella height of the cleft side were found to be significantly lower than that of noncleft patients (P < 0.001). The rest of the parameters, nostril height, nostril width, and nasal sill width of cleft patients were found to be significantly higher than that of noncleft patients (P < 0.001). Conclusion: This study provided an anthropometrical analysis of the lip–nose complex which can be a fundamental basis for presurgical consultation, surgical planning, postoperative assessment, and a predictor for treatment outcome.","PeriodicalId":34294,"journal":{"name":"Journal of Cleft Lip Palate and Craniofacial Anomalies","volume":"41 1","pages":"90 - 95"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139364664","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}
Pub Date : 2023-07-01DOI: 10.4103/jclpca.jclpca_4_23
I. Adnyana, G. Samsarga, Rachel Vania
Frontonasal dysplasia (FND) is a rare craniofacial deformity, including severe hypertelorism. We herein presented the case of a 6-year-old female patient with FND and Grade III hypertelorism who underwent a four-wall-orbital box osteotomy with a bicoronal approach. Orbital wall osteotomy was performed behind the lacrimal fossa. Central resection was done to allow for medial translocation of the orbits. At the last, the newly positioned orbitals were fixated using wire, absorbable plates, and screws. Neurosurgical assistance with the frontal bone flap before orbital osteotomy helps to leave the cribriform plate intact to preserve the olfactory. Finally, excessive median soft tissue was excised. The patient's hypertelorism improved after surgery. Careful surgical procedures to correct the soft and bony tissue are beneficial treatments for improving the quality of life and general condition of patients with hypertelorism.
前鼻骨发育不良（FND）是一种罕见的颅面畸形，包括严重的畸形肥大。我们在本文中介绍了一例患有 FND 和 III 度畸形的 6 岁女性患者，她接受了双冠法四壁眶盒截骨术。眼眶壁截骨手术在泪窝后方进行。进行了中央切除，以便眼眶向内侧移位。最后，使用钢丝、可吸收钢板和螺钉固定新定位的眼眶。在进行眼眶截骨术之前，神经外科医生会在额骨瓣上进行辅助，这有助于完整保留楔形骨板，从而保留嗅觉。最后，切除了过多的正中软组织。术后，患者的肥大视力得到了改善。对软组织和骨组织进行仔细的手术矫正，是改善眼球后凸患者生活质量和全身状况的有效治疗方法。
{"title":"Orbital box osteotomy in frontonasal dysplasia with severe hypertelorism: Our first experience","authors":"I. Adnyana, G. Samsarga, Rachel Vania","doi":"10.4103/jclpca.jclpca_4_23","DOIUrl":"https://doi.org/10.4103/jclpca.jclpca_4_23","url":null,"abstract":"Frontonasal dysplasia (FND) is a rare craniofacial deformity, including severe hypertelorism. We herein presented the case of a 6-year-old female patient with FND and Grade III hypertelorism who underwent a four-wall-orbital box osteotomy with a bicoronal approach. Orbital wall osteotomy was performed behind the lacrimal fossa. Central resection was done to allow for medial translocation of the orbits. At the last, the newly positioned orbitals were fixated using wire, absorbable plates, and screws. Neurosurgical assistance with the frontal bone flap before orbital osteotomy helps to leave the cribriform plate intact to preserve the olfactory. Finally, excessive median soft tissue was excised. The patient's hypertelorism improved after surgery. Careful surgical procedures to correct the soft and bony tissue are beneficial treatments for improving the quality of life and general condition of patients with hypertelorism.","PeriodicalId":34294,"journal":{"name":"Journal of Cleft Lip Palate and Craniofacial Anomalies","volume":"161 1","pages":"103 - 106"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139365950","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}
Pub Date : 2023-07-01DOI: 10.4103/jclpca.jclpca_18_23
A. Choudhary, Sanjeev Kumar
{"title":"The transformative role of artificial intelligence in cleft surgery","authors":"A. Choudhary, Sanjeev Kumar","doi":"10.4103/jclpca.jclpca_18_23","DOIUrl":"https://doi.org/10.4103/jclpca.jclpca_18_23","url":null,"abstract":"","PeriodicalId":34294,"journal":{"name":"Journal of Cleft Lip Palate and Craniofacial Anomalies","volume":"57 1","pages":"118 - 120"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139365020","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}
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