Articulation Disorders ; Cleft Palate ; complications ; Humans

cleft palate.TECHNIQUES AND APPROACHES: Four-hundred-sixity patients operated between 1993 and 2008 were included in this study. The collected data were age, sex, operating time, admission days, and complications. The comparison between techniques were done by independent t-test.RESULTS: The majority (86.9 %) of patients were received the operation later than 1.5 years old. The distribution of each surgical technique was 43.8 % by Bardach palatoplasty, 11.9 % by Furlow palatoplasty, 1.8 % by Veau palatoplasty, and 42.4 % by the new technique developed by us. Postoperative complication such as wound dehiscence, formation of oro-nasal fistulas in the soft and hard palates were shown in 23.0 % of Bardach technique, 44.2 % of Furlow technique, and 37.5 % of Veau technique. However, only 5.4 % of patients were shown complications in our technique (P<0.001). The operation time was recorded 70 minutes under new technique while the others were 110 minutes (P<0.001). The clinical treatment at hospital was required 7.4 days for our technique and 11.3-15.5 days for the other methods.CONCLUSION: The surgical treatment of congenital cleft palate in Mongolia was conducted later than proper timing for surgery. As the results were indicated, our new technique should be considered for the correction of cleft palate in old aged patients.]]>
Aged ; Cleft Palate ; Fistula ; Humans ; Mongolia ; Palate, Hard ; Postoperative Complications

Choristoma ; complications ; Cleft Palate ; complications ; Humans ; Salivary Glands ; Tongue ; abnormalities

INTRODUCTIONThis study aims to review the results of hearing screens in newborns with cleft deformities.

MATERIALS AND METHODSA retrospective audit of 123 newborns with cleft deformities, born between 1 April 2002 and 1 December 2008, was conducted. Data on the results of universal newborn hearing screens (UNHS) and high-risk hearing screens, age at diagnosis, severity/type of hearing loss and mode of intervention were obtained from a prospectively maintained hearing database.

RESULTSThirty-one of 123 newborns (25.2%) failed the first automated auditory brainstem response (AABR). Seventy percent of infants (56 out of 80) who passed the UNHS failed the high-risk hearing screens which was conducted at 3 to 6 months of age. Otolaryngology referral rate was 67.5% (83/123); 90.3% of 31 newborns who failed the first AABR eventually required otolaryngology referrals. Incidence of hearing loss was 24.4% (30/123; 25 conductive, 2 mixed and 3 sensorineural), significantly higher than the hospital incidence of 0.3% (OR: 124.9, 95% CI, 81.1 to 192.4, P <0.01). In terms of severity, 8 were mild, 15 moderate, 5 severe, 2 profound. Eighteen out of 30 infants (60%) were detected from the high-risk hearing screens after passing the first AABR.

CONCLUSIONThese newborns had a higher risk of failing the UNHS and high-risk hearing screen. There was a higher incidence of hearing loss which was mainly conductive. Failure of the first AABR was an accurate predictor of an eventual otolaryngology referral, suggesting that a second AABR may be unnecessary. High-risk hearing screens helped to identify hearing loss which might have been missed out early on in life or which might have evolved later in infancy.

Cleft Lip ; complications ; Cleft Palate ; complications ; Hearing Loss ; complications ; Humans ; Infant, Newborn ; Neonatal Screening ; Retrospective Studies

Cleft Lip ; complications ; Cleft Palate ; complications ; Humans ; Maxillofacial Abnormalities ; pathology ; Orthodontics, Corrective

Objectives of this study is to determine the effect of a critical pathway on hospital stays and outcomes after cleft lip and palate repair. During a period of eleven months from March 2000 to January 2001, twenty six cases to applied by critical pathway for cleft lip and palate were followed up. Comparisions were made between the precritical pathway and postcritical pathway groups. The results of this study showed that expenses of treatment for cleft lip and palate was reduced to 20%, 30% respectively, after critical pathway. After critical pathway, hospital stays for cleft lip and palate was reduced to from 7 days to 4 days, from 9 days to 6 days, respectively. Postoperative complications was not increased. Patient satisfactions was increased because of the detailed explanations and reduced hospital stays. Conclusively, significant decreases in length of hospital stay are seen, and cost reductions can be realized after critical pathway.
Cleft Lip* ; Critical Pathways* ; Humans ; Length of Stay ; Palate* ; Postoperative Complications

The objectives of palatoplasty are to close the palatal defect completely and create and adequately functioning velopharyngeal mechanism for normal speech production. The goal is to minimize adverse effects on maxillofacial growth. The are various surgical techniques in cleft palate repair procedure. According to the report of Bardach and Salyer, two-flap palatoplasty allows closure of the palatal cleft with minimal or no exposure of the bare bone by downward rotation of the mucoperiosteal flap instead of posterior transposition. Thus, two-flap palatoplasty is totally different from the concepts and techniques of other palatoplasties and it results in minimal or no adverse effects on maxillofacial growth. But, there have been no reports about two-flap palatoplasty in Korea. We retrospectively reviewed postoperative complications of 172 consecutive nonsyndromic patients with cleft palate repaired by single operator(two-flap palatoplasty 120 cases, pushback palatoplasty 52 cases). Submucous cleft palate patients were excluded from the study group. Age at cleft repair was from 3 months to 51 years and mean follow-up period was 29 months. Cleft palate fistulas occurred in 20 of 172 patients(11.6%), and fistula rate was similar in patients with two-flap palatoplasty (10.8%) and in patients with pushback palatoplasty (13.5%). Type of palatoplasty, extent of clefting, and age at palate repair did not significantly affect the fistula formation. Of the 52 cleft palates repaired with pushback palatoplasty, there has been one postoperative bleeding that resulted in reoperation. But, of the 120 cleft palates repaired with two-flap palatoplasty, there has been no incidence of postoperative bleeding. Two-flap palatoplasty is considered to be another choice of operative method of palatoplasty. However, more in-depth study is needed to clarify the relationship between two-flap palatoplasty and speech pattern, maxillofacial growth.
Cleft Palate ; Fistula ; Follow-Up Studies ; Hemorrhage ; Humans ; Incidence ; Korea ; Palate ; Postoperative Complications ; Reoperation ; Retrospective Studies

Child, Preschool ; Cleft Lip ; complications ; surgery ; Cleft Palate ; complications ; surgery ; Hernia, Diaphragmatic ; complications ; surgery ; Hernias, Diaphragmatic, Congenital ; Humans ; Male

OBJECTIVETo classify the patients with cleft lip and palate who need orthognathic surgery and to propose the corresponding operations.

METHODSFrom January 2005 to May 2015, 121 patients with cleft lip and palate diagnosed as maxillary retrusion were treated by orthognathic surgery. Inclusion criteriar: (1) male aged over 16, female aged over 14; (2) diagnosed as non-syndromic cleft lip and palate without systemic disease and other genetic diseases; (3) without previous orthodontic and orthognathic treatment; (4) having no other craniofacial malformation. Maxillary features and repaired types were recorded.

RESULTS93 patients were included and divided into two categories depended on the dental crowding. Class I: the teeth quantity and bone quantity is coordinated, space analysis ≤ 4 mm (mild dental crowding). The forward distance of maxillary less than 6 mm was defined as Class I a (36 cases) more than 6 mm as Class I b (28 cases). Class II: the teeth quantity and bone quantity is not coordinated, space analysis > 4 mm ( moderate or severe dental crowding). After the simulation of distraction osteogenesis, the anterior crossbite was corrected defined as Class II a (23 cases), not corrected defined as Class II b (6 cases). Class I a were corrected by conventional orthognathic surgery. While Class I b were corrected by Le Fort I maxillary advancement using distraction osteogenesis. Class II a were repaired just by anterior maxillary distraction. While Class II b need to combine conventional orthognathic surgery with anterior maxillary distraction. All the patients were satisfied with the treatment effect.

CONCLUSIONSThe patients of cleft lip and palate with maxillary retrusion who need orthognathic surgery can be classified as the method mentioned above, and then choose the appropriate operations.

Adolescent ; Adult ; Cleft Lip ; complications ; Cleft Palate ; complications ; Female ; Humans ; Male ; Maxilla ; Osteogenesis, Distraction ; Osteotomy, Le Fort ; Retrognathia ; classification ; surgery

Objective To investigate the multiple correspondence of genetic and environmental risk factors with abnormal birth history and provide a scientific basis for improving the birth defects surveillance system and reducing the incidence of birth defects. Methods Data were collected from all the perinatal infants from 28-week-old fetuses to 7-day-old infants born in all the hospitals with obstetrical department in Xi'an from 2003 to 2015. Results A total of 1 236 937 perinatal infants were surveyed,including 10 619 with birth defects.The average incidence rate of birth defects was 0.86% (0.70%-1.15%).Multiple correspondence analysis showed that the women who had had 1 or 2 children with birth defects were associated with the history of spontaneous abortion,family history of birth defects,and history of exposure to toxic and harmful substances.The women who had had 3 or more children with birth defects showed stronger association with family history of birth defects.The birth defects in women with history of spontaneous abortion (257/10 619) was ranked in the order of congenital heart disease,polydactyly,neural tube defects,congenital hydrocephalus,cleft lip with cleft palate,and simple cleft lip.The birth defects in women who had given birth to children with birth defects (135/10 619) followed the order of cleft lip with cleft palate,anencephaly,hydrocephalus,neural tube defects,cleft lip,and talipes equinovarus. Conclusions Abnormal birth history is associated with family history of birth defects and history of exposure to environmental risk factors.Giving birth to three or more children with birth defects is highly correlated with the family history of birth defects.
Child ; Pregnancy ; Female ; Humans ; Cleft Lip/etiology* ; Cleft Palate/complications* ; Reproductive History ; Abortion, Spontaneous ; Neural Tube Defects/epidemiology* ; Risk Factors