Birth prevalence of cleft lip and palate based on hospital records in Dar es Salaam, Tanzania

Aim: The aim of the study was to determine the prevalence of cleft lip, cleft palate and cleft lip and palate in hospital live births in Dar es salaam, Tanzania. Study design: this was a retrospective study using hospital data. Materials and methods: The records of 75336 live births delivered at three public hospitals in Dar es Salaam were examined. Results: Thirteen cases of cleft lip and cleft palate were recorded giving a prevalence of 17 per 100,000. Boys were more affected than girls with a male to female ratio of 2.25:1. However, 6 (46.2%) out of all the cases had both cleft lip and palate, 4 (30.8%) had cleft lip only and 3 (23.0%) had cleft palate alone. Conclusions: In this study the birth prevalence of cleft lip, cleft palate and cleft lip and palate in Dar es Salaam, was low (17 per 100,000 births). There were more boys than girls who were recorded to be born either with a cleft lip, cleft palate and cleft lip and palate. Tanzania Dental Journal Vol. 14 (1) 2007: pp. 30-3

An update on the aetiology of orofacial clefts

Objective. To review recent data on the aetiology of cleft lip and palate. Data sources. MEDLINE literature search (1986-2003). Study selection. Literature and data on aetiology of cleft lip and palate using the following key words: 'cleft lip', 'cleft palate', 'aetiology', and 'genetics'. Data extraction. Relevant information and data were reviewed by the authors. Data synthesis. Cleft lip and palate is one of the most common types of congenital malformation. The aetiology seems complex, but genetics plays a major role. Recently several genes causing syndromic cleft lip and palate have been discovered. Three of them-namely T-box transcription factor-22 (TBX22), poliovirus receptor like-1 (PVRL1), and interferon regulatory factor-6 (IRF6)-are responsible for causing X-linked cleft palate, cleft lip/palate-ectodermal dysplasia syndrome, and Van der Woude's and popliteal pterygium syndromes, respectively; they are also implied in non-syndromic cleft lip and palate. The nature and function of these genes vary widely, illustrating high vulnerability within the craniofacial developmental pathways. The aetiological complexity of non-syndromic cleft lip and palate is also exemplified by the large number of candidate genes and loci. Conclusions. The aetiology of non-syndromic cleft lip and palate is still largely unknown, but mutations in candidate genes have already been identified in a small proportion of cases of non-syndromic cleft lip and palate. Determining the relative risk of cleft lip and palate, on the basis of genetic background and environmental influence, including smoking, alcohol use, and dietary factors, will aid in genetic counselling and the development of future preventive measures.published_or_final_versio

Oral Clefts with Associated Anomalies: Findings in the Hungarian Congenital Abnormality Registry

BACKGROUND: Over the years, great efforts have been made to record the frequency of orofacial clefts in different populations. However, very few studies were able to account for the etiological and phenotypic heterogeneity of these conditions. Thus, data of cases with syndromic orofacial clefts from large population-based studies are infrequent. METHODS: Clinically recognized and notified syndromes and associations including cleft lip with or without cleft palate and other congenital anomalies were selected from the Hungarian Congenital Abnormality Registry (HCAR) between 1973 and 1982 and prevalence rates were calculated. RESULTS: Of 3,110 cases reported as having orofacial clefts, 653 had multiple congenital abnormalities. Of these, 60 (9.2%) had a known etiology (monogenic: 25 or 3.8%, chromosomal: 31 or 4.7%, teratogenic: 4 or 0.6%). Seventy-three subjects (11.2%) had schisis in addition to the oral cleft. Skeletal anomalies were the most common malformations among cases with cleft lip with/without cleft palate (CL/P) and cleft palate (CP). Disorders of the central nervous system and cardiovascular malformations were also frequently associated. CONCLUSION: Surveillance systems, such as the HCAR, provide useful information about prevalence rates of congenital anomalies in a population. However, in a field where new syndromes are being discovered and classifications regularly updated, these rates should only be accepted as provisional.Massachusetts Center for Birth Defects Research and Prevention of the Massachusetts Department of Public Health; Peer Foundation/Cleft Palate Foundation Etiology Gran

PREVALENSI PASIEN CLEFT LIP DAN PALATE PENGUNJUNG SMF ILMU KESEHATAN ANAK DIVISI NEONATAL DI RSUD DR. SOETOMO SURABAYA TAHUN 2010–2016

Cleft lip dan palate merupakan kelainan kongenital paling umum pada area wajah. Cleft lip bisa diartikan sebagai celah pada bibir sedangkan kombinasi cleft lip dan palate apabila melibatkan bibir dan palatum. Dokter gigi Anak memiliki peran penting dari periode neonatal sampai gigi permanen tumbuh. Tujuan: untuk mengetahui prevalnesi cleft lip dan cleft palate. Metode: Metode penelitian yang digunakan adalah deskriptif dengan mengumpulkan data rekam medis pasien yang datang ke divisi neonatal RSUD Dr. Soetomo berdasarkan jenis cletf, klasifikasi, asal daerah dan kelainan lain yang menyertai dari 2010-2016. Hasil: Prevalensi cleft lip 9%, cleft palate 40%, cleft lip dan palate 51%, distribusi laki-laki dan perempuan di cleft lip adalah perempuan 4% dan laki-laki 6%, cleft palate adalah perempuan 28% dan laki-laki 12%,kombinasi cleft lip dan palate adalah perempuan 19% dan laki-laki 32%. Distribusi berdasarkan wilayah adalah kota 56,5% dan kabupaten 43,5%. Kesimpulan: Jenis cleft yang paling umum terjadi ialah kombinasi cleft lip dan palate. Untuk disribusi berdasarkan jenis kelamin ialah laki-laki lebih sering terjadi pada cleft lip dan kombinasi cleft lip palate sedangkan cleft palate lebih sering pada perempuan, distribusi berdasarkan kelainan lain yang menyertai cleft paling sering ialah kelainan pada pernafasan

Retrospective longitudinal analysis of phonetic and phonological cleft palate speech characteristics

In this study, we analysed phonetic and phonological consonant characteristics of cleft palate speech (CPS) at ages 5 and 10 in cleft palate with/without cleft lip (CP±CL) based on Cleft Audit Protocol for Speech – Augmented (CAPS-A) data collected in the Dental Hospital in Glasgow. The nature and extent of CPS characteristics at different ages were investigated. Video-recordings of 42 cleft palate (CP), unilateral cleft lip and palate (UCLP) and bilateral cleft lip and palate (BCLP) boys and girls were analysed based on narrow transcription and automatic PROPH (profile of phonology) of types of articulation features. Results of this study showed that CP±CL children produce a significantly higher number of phonetic CPS characteristics than phonological processes at both ages

Surgical Strategy of Cleft Palate Repair and Nasometric Results

The goal of cleft palate (CP) repair is to achieve normal speech. Despite the recent development of surgical repair of cleft palate, there is no standard procedure that ensures patients\u27 speech to the same level as that in noncleft children. In this chapter, we describe our surgical strategy of cleft palate repair that approaches each anatomical and pathological abnormality of cleft palate and the postoperative speech outcomes using the subjective and objective manners. After palate repair based on our surgical strategy, patients\u27 speech was significantly improved, and the nasalance scores were recovered to almost the same levels as those of Japanese children without cleft palate

Abnormal patterns of tongue-palate contact in the speech of individuals with cleft palate

Individuals with cleft palate, even those with adequate velopharyngeal function, are at high risk for disordered lingual articulation. This article attempts to summarize current knowledge of abnormal tongue-palate contact patterns derived from electropalatographic (EPG) data in speakers with cleft palate. These data, which have been reported in 23 articles published over the past 20 years, have added significantly to our knowledge about cleft palate speech. Eight abnormal patterns of tongue-palate contact are described and illustrated with data from children and adults with repaired cleft palate. The paper also discusses some of the problems in interpreting EPG data from speakers with abnormal craniofacial anatomy and emphasizes the importance of quantifying relevant aspects of tongue-palate contact data. Areas of research requiring further investigation are outlined

CLEFT LIP AND PALATE IN ADOLESCENCE IDENTIFYING VARIABLES RELATING TO PSYCHOSOCIAL CONCERNS

In study I, 55 adolescents with cleft lip and palate and 31 adolescents without cleft filled out two questionnaires: the Tennessee Self-Concept Scale to assess self-concept, and the Eysenck Personality Questionnaire Inventory to assess the degree of introversion. In studies II & III, data regarding physical characteristic and general intellectual capacity were obtained from the Swedish National Service Enrolment Register for the years 1991-97. Data concerned 335 men with cleft lip with or without clef palate and 88 with cleft palate. They were compared with a control group of 272 879 men without cleft. In study IV, data regarding academic achievement at the time of leaving compulsory education were obtained by linking the Swedish Medical Birth Register for the years 1973-86 with the Swedish School Grade Register. Data concerned 651 individuals with cleft lip, 830 with cleft lip and palate, and 511 with cleft palate. They were compared with a control group consisting of 1 249 404 individuals without cleft. In summary, we found that adolescents with cleft seem to have a normal to high self-concept without an accentuated degree of introversion (I). A cleft influences body dimensions, particularly in the cleft palate group where weight, statue, and muscle strength (II) showed lowered values, this may be correlated to their reduced achievement in physical education at school (IV). The general intellectual capacity (III) supports other studies that individuals with cleft palate have certain cognitive difficulties while the academic achievement (IV) indicated that adolescents with cleft experience difficulties in their educational achievements

Speech and expressive language in Swedish-speaking children with unilateral cleft lip and palate

Introduction and aims: A cleft palate may hamper development of speech and expressive language. Expressive language, including phonology, has been sparsely explored in children with cleft lip and palate, and extended knowledge is essential in order to improve intervention for this patient group. The aims of the project were to assess the effectiveness of different speech materials used when evaluating cleft palate speech, to assess the development of speech and expressive language in children born with unilateral cleft lip and palate, and to identify variables in early speech production, which may be associated with later expressive language. Material and methods: Thirty children with unilateral cleft lip and palate, treated with three different methods for primary palatal surgery, and 20 children without cleft lip and palate participated. Speech was longitudinally documented at 18 months, 3 years, and 5 years of age. The effectiveness of four different speech materials for assessing cleft palate speech was explored. Articulation/phonology at 3 and 5 years were studied, and the outcomes were correlated with earlier outcomes of consonant production. Speech and phonology in children treated with different methods for primary palatal surgery were assessed. Expressive language in narrative retelling was assessed and the outcomes were compared with outcomes of articulation/phonology. Results: The best speech performance and reliability were achieved in single word naming. The reliability in sentence repetition was good, and speech performance was equally good as in conversational speech. The group with unilateral cleft lip and palate displayed deviant phonology at 3 and 5 years of age, compared with peers without cleft palate. Measures of consonant production at 18 months of age correlated significantly with the outcomes at 3 years of age, and there also was a significant correlation between the outcomes at 3 and 5 years of age. The results indicated a two-stage palatal surgery with hard palate closure as late as 3 years of age to be disadvantageous for the development of speech and phonology. At 5 years of age, a larger proportion of the children with unilateral cleft lip and palate than peers without cleft had problems retelling information and these problems were not related to surgical method, gender, or articulatory/phonological competence. Conclusions: Word naming, in combination with sentence repetition, is recommended for evaluation of cleft palate speech when best performance and performance in coherent speech are assessed. Many children with unilateral cleft lip and palate have phonological problems at up to 5 years of age. It seems possible to identify children at risk for impaired phonology at earlier ages for possible prevention of persistent problems. Two-stage palatal surgery with hard palate closure as late as 3 years of age should be avoided since it may hamper phonological development. In addition, many children with unilateral cleft lip and palate have problems retelling information at 5 years of age, unrelated to articulatory and phonological ability, and may be in need of further language intervention