Ali Sundoro;Dany Hilmanto;Hardisiswo Soedjana;Ronny Lesmana;Kevin Leonard Suryadinata
Archives of Craniofacial Surgery
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v.24
no.3
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pp.111-116
/
2023
Background: In Indonesia, the prevalence of cleft lip and palate increased from 0.08% to 0.12% between 2013 and 2018. Children with cleft deformities typically undergo staged surgery. However, the coronavirus disease 2019 (COVID-19) pandemic has had negative impacts on the healthcare sector, including the suspension of elective procedures; this has raised concerns about the safety of performing surgery and the functional consequences of delaying treatment, the latter of which is associated with poor prognosis. The purpose of this study was to report the characteristics of clefts treated by the Bandung Cleft Lip and Palate Center team during the pandemic period. Methods: This brief comparative study based on a chart review was conducted at the Bandung Cleft Lip and Palate Center. We statistically evaluated data from all patients treated between September 2018 and August 2021. Frequency analysis was performed to analyze the average number of each procedure by age before and during the COVID-19 pandemic. Results: Data from 18-month periods before (n= 460) and during (n= 423) the pandemic were compared. Cheiloplasty procedures were examined (pre-pandemic, n= 230; pandemic, n= 248); before the pandemic, 86.1% were performed according to the treatment protocol (patient < 1 year old), and this proportion non-significantly dropped to 80.6% during the pandemic (p= 0.904). Palatoplasty procedures were also compared (pre-pandemic, n= 160; pandemic, n= 139); the treatment protocol (patient 0.5-2 years old) was followed for 65.5% of procedures before the pandemic and 75.5% during the pandemic (p= 0.509). Additionally, 70 (mean age, 7.94 years) revision and other procedures were performed before the pandemic and 36 (mean age, 8.52 years) during the pandemic. Conclusion: The cleft procedures performed at the Bandung Cleft Lip and Palate Center did not significantly change during the COVID-19 pandemic.
The frequency of abnormality at birth is average 1-1.5%, and of these, cleft lip & palate is known to be the most frequent congenital abnormality, Cleft is considered to be due to multi-factorial heredity correlated with genetic and environmental factors, Cleft patients require the collaborative treatment with several medical departments, Clinics for Maxillo-Oral Disorders of Tohoku University Dental Hospital performs the total managements related to such as occlusion and language for the patients with congenital maxilla-facial abnormality, This study examined the patients with cleft lip and/or palate who came to the Clinics for Maxilla-Oral Disorders of Tohoku University Dental Hospital for the past 17 years from Jan. 1987 to Dec, 2002, and had the results as follows, 1. Annual mean number of patients The annual mean number of the patients for 17 years from Jan, 1987 to Dec, 2002 was 91 patients, ranging from 63 minimum to 116 maximum, 2, Gender and types of cleft There were 747(51%) males and 709(49%) females, with a male to female ratio 1,05:1. CLP was the most frequent cleft type as shown in 616 patients, and other patients manifested different complaints such as CL, CP, SMCP and MC in order. 3. The laterality in cleft type The lip cleft was frequently expressed orderly on left, right and both sides of CL patients while orderly being shown on left, both and right sides of CLP patients. Accordingly, lip cleft was most commonly found on the left side. 4. Address at first visit Of 1,456 subjects, 850(58.4%) patients were residing in Miyagi Prefecture, where this hospital is located. 5. Age at first visit 615(42.2%) patients came to the hospital at their age younger than 1 year old, comprising 282(19.4%) patients age younger than 2 months old and 333(22.9%) patients age between 2 month old and 1 year old. 6. Mother's age at birth For the mother's age at birth, 526(39.9%) patients were at the age of 25 to 30 years old, and 17(1.3%) patients were over 40 years old. 7. Birth weight 34.3%(443 patients) had a birth weight of 2500-3000gm and 56.0%(724 patients) had a 3000-4000gm. It was also found that 7.9%(102 patients) had a birth weight of less than 2500gm. 8. Familial expression The frequency of familial expression was 6.5%(94 patients).
Lee Jeong-Eun;Baek Seung-Hak;Kim Myung-Jin;Chang Young-Il
Korean Journal of Cleft Lip And Palate
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v.7
no.1
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pp.63-76
/
2004
Cleft lip and palate(CLP) patients usually have midface deficiency and Class III malocclusion. Distraction osteogenesis (DO) has been used recently to correct the maxillary hypoplasia with stable and predictable result. Both external and internal devices that permit midface distraction are available, This case report describes intraoral DO for correction of the midface deficiency in a adult CLP patient with relapse following orthognathic surgery. The purpose of this report is to present advantages of the intraoral DO for the treatment of CLP, The relative and potential clinical indications, treatment planning, patient preparation, and possible vector control for DO are discussed.
Purpose: The purpose of this study is to evaluate the results of alveolar bone grafting in patients with various types of cleft lip and to compare the success rates according to the lateral incisors and canines. Methods: The postoperative radiographs of 20 patient with a cleft lip and alveolar process alone (CLAP), complete unilateral cleft lip and palate (UCLP) and complete bilateral cleft lip and palate (BCLP) were retrospectively analyzed. The alveolar bone height was classified according to ${\AA}$byholm (1981) and Bergland (1986) and we evaluated the dentition at the time of surgery and the existence of a lateral incisor and impacted canines. Results: 16 (80%) of the 20 patients were assigned to Type I & II and they were considered successful. In the UCLP group, the success rate was significantly better than that of the UCLP and BCLP groups. The success rate was significantly better than when the cleft was grafted with the existence of a lateral incisor and before the eruption of the canines. Conclusion: The severity of the deformity influenced the success rate. The timing of the operation was a critical variable that affected the outcome in patients with cleft lip and palate.
The purpose of this study was to examine and analyze the basic conditions of dental health of cleft lip and palate patients at early mixed dentition (7-year-old, experimental group A) and early permanent dentition period (12,13-year old, experimental group B) and compare them with those of normal children. The sample was consisted of 25 patients at the age of 7 years, 15 at the age of 12 years and 5 at the age of 13 years. Two trained dentists examined orthopantomographs and clinical photos at the first visit of each patient and distinguished the states by teeth and dental surface and filled them on the prescribed forms. DMF rate, DMF index, FT rate, mean number of permanent teeth with fissure sealants, DMFS index and mean percentage of caries experienced maxillary anterior 6 teeth by tooth type are calculated and compared to those of other studies examined normal children. Oral hygiene of experimental groups is poorer than control groups'. Preventive and treatment rate of experimental groups' are lower than control groups'. More concem and effort are needed about prevention and treatment of dental caries of cleft lip and palate patients.
Kim, Soung-Min;Park, Jung-Min;Myoung, Hoon;Choi, Jin-Young;Lee, Jong-Ho;Choung, Pill-Hoon;Kim, Myung-Jin
Korean Journal of Cleft Lip And Palate
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v.11
no.2
/
pp.49-58
/
2008
The development of fetal surgery has led to promising options for many congenital malformations, such as congenital diaphragmatic hernia (CDH), obstructive uropathy, twin-to-twin transfusion syndrome (TTTS), and sacrococcygeal teratoma. However, preterm labor (PTL) and premature rupture of membranes continue to be uniquitous risks for both mother and fetus. To reduce maternal morbidity and the risk of prematurity, minimal access techniques were developed and are increasingly employed recently. Lift-threatening diseases as well as severely disabling but not life-threatening conditions are potentially amenable to treatment. Recently, improvement of video-endoscopic technology has boosted the development of operative techniques for feto-endoscopic surgery, which has been demonstrated to be less invasive than the open approach. Fetal surgery for repair of cleft lip and palate, a congenital anomaly which is not life threatening, is inappropriate until such time that the benefits are shown to outweigh the risks of both the procedure itself and preterm delivery. Further animal studies will be needed before intrauterine surgery for humans should be considered. For the better understanding of recent techniques and complications associated with fetal intervention of congenital facial defect patients, we reviewed recent related articles about the current knowledge and new perspectives of experimental fetal fetal surgery in the cleft lip and palate defects.
Kim, Young-Bin;Yang, Jae-Young;Leem, Dae-Ho;Baek, Jin-A;Ko, Seung-O;Shin, Hyo-Keun
Maxillofacial Plastic and Reconstructive Surgery
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v.36
no.1
/
pp.13-15
/
2014
Epithelial cysts are benign epithelium-lined lesions that contain fluid or semisolid material. Most epithelial cysts in the oral cavity occur in the anterior part of the mouth floor. Cysts arising on the uvula in a cleft palate patient are rare. Intraoral examination in a 14-month-old boy with a complete cleft lip and palate revealed a cystic lesion on the right uvula. The lesion was excised and push-back palatorrhaphy with Z-plasty on the uvula was performed. Histopathological examination diagnosed an epithelial cyst. We report a case of an epithelial cyst of uvula in a patient with a unilateral complete cleft lip and palate.
Purpose: Cleft lip and palate is one of the most frequent hereditary deformities of the maxillofacial region which can arise in facial and jaw abnormalities as well as malocclusion and speech problems. In particular, unilateral cleft lip and palate is characterized by midface deformity resulting in maxillary anterior nasal septal deviation and nasal deformity. The aim of this study is to analyze the facial deformity of untreated unilateral cleft lip patients for contribution to primary cheiloplasty. Methods: Thirty-three patients with unilateral cleft lip and palate were impressioned before operation and facial casts were made. The casts were classified into complete cleft lip and incomplete cleft lip groups and each group were classified into affected side and normal side. Anthropometric reference points and lines were setted up and analysis between points and lines were made. Results and Conclusion: The obtained results were as follows: 1. The intercanthal width had no significant difference between the incomplete and complete cleft lip groups. 2. Cleft width and alar base width were greater in the complete group, and nasal tip protrusion was greater in the incomplete group. 3. Involved alar width and nostril width were greater in the complete group and in both complete and incomplete groups, involved alar width and nostril width were greater than the non-involved side. 4. The lateral deviation of the subnasale was greater in the complete group in both involved and non-involved sides. 5. The nasal laterale was placed inferiorly in both cleft groups. 6. The subnasale was deviated to the non-involved side in both cleft groups. 7. The nose tip was deviated to the non-involved side in both cleft groups and had greater lateral deviation in the complete cleft group. 8. The midpoint of cupid's bow had no vertical difference between complete and incomplete groups, but had a greater lateral deviation in the complete group. 9. In the complete cleft group, correlation between differences in cleft width and nostril width and columella height difference were obtained.
Park, In-Soon;Yeo, Hwan-Ho;Kim, Young-Kyun;Kim, Su-Gwan;Gi, Jae-Hyu;Lim, Seok-Gyun
Maxillofacial Plastic and Reconstructive Surgery
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v.19
no.2
/
pp.135-142
/
1997
Despite the current accomplishments with the repair of cleft lips, the surgical management of the nasal deformity remains a functional and aesthetic dilemma for patients, their families, and reconstructive surgeons. Recent improvements in the understanding and technical execution of te primary cleft lip repair have significantly reduced secondary sequelae and the consequent need for secondary surgical correction. But, secondary surgical corrections are necessary according to numerous factors. Such factors include the secondary surgical corrections are necessary according to numerous factors. Such factors include the severity of the initial deformity, the surgical plan, precision of execution of the primary repair, and success of the postoperative management. We preformed the secondary correction of cleft lip and palate in 11 patients via various methods. In conclusion, primary repair of cleft lip and palate patients is the most important to prevent the secondary deformities, and most of cleft lip and palate with secondary deformities must be treated with combined cheiloplasty and rhinoplasty.
Kim, Soung-Min;Kim, Jung-Hwan;Kim, Ji-Hyuck;Park, Young-Wook;Lee, Jong-Ho;Lee, Suk-Keun
Journal of the Korean Association of Oral and Maxillofacial Surgeons
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v.33
no.3
/
pp.238-246
/
2007
This study is aimed to elucidate the abnormal growth pattern of human fetal maxilla with cleft lip and palate (CLP). Total 71 fetal maxillae with CLP were obtained from aborted human fetuses. They were examined radiologically for the dimensional changes of maxillary trapezoid (MT) formed by maxillary primary growth centers (MxPGC)(Lee et al., 1992). In palatal radiogram of the CLP maxilla, the MT was traced by the anterior and posterior MxPGCs, and the dimensions of anterior and posterior maxillary widths, maxillary length, and MT length (MTL), and MT area were measured for evaluation of the basic growth pattern of the developing maxilla. The growth of anterior and posterior MxPGCs was severely retarded in the prenatal maxillae with CLPs, showing abnormal shape of MT. Cleft lip subjects without cleft palate also showed arrested growth of MT. Unilateral cleft lipalveolar cleft or cleft palate (UCL-AC/CP) and bilateral cleft lip-alveolar cleft or cleft palate (BCL-AC/CP) showed enhanced abnormal MT pattern. The abnormality of MT was most marked in BCL-AC/CP. It was also observed that the craniofacial malformations other than CLPs produced abnormal MT. In conclusion, the MT growth of prenatal CLP maxilla was severely arrested and resulting in abnormal MT shape on the palatal radiogram. BCL-AC/CP showed more protruded nasal septum than other types of CLPs, while UCL-AC/CP showed severe deviation of the protruded nasal septum towards the non-cleft side. Cleft lip only subjects also showed the abnormal growth of MT. These data suggest that the MT is primarily involved in CLPs, and MT shape could be utilized as a sensitive indicator for the analysis of maxillary malformation in different types of CLPs.
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