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

Prevalence of cleft lip and palate in Brazilian children 2011 - 2015

Cleft lip and cleft palate are birth defects of complex etiology. The aim of this study was to evaluate the occurrence of cleft lip and palate in Brazilian children. An ecological and descriptive study, based on data from the Live Birth Information System (SINASC / DATASUS) between years 2011 and 2015 in the cities of João Pessoa, Campina Grande, Patos, Cajazeiras, and Sousa (State of Paraíba) was developed. Information on the presence of congenital anomalies and cleft lip and palate, gender of neonate, birth-weight (<2.5kg and ≥2.5kg) and mother's age were collected. Data were tabulated with Microsoft Excel software and presented through descriptive statistics (absolute and percentage distributions). In the study period, there were 206367 cases of live birth, with 1916 cases of children with congenital anomalies of which 109 (5.7%) had cleft lip and palate, predominantly males (66%). Regarding birth-weight, 27.5% had <2.5kg. The majority of mothers aged 20-29 years (45.9%). The city of Campina Grande concentrated the highest number of cases (50.5%), with prevalence of 7.36 cases per ten thousand live births. The frequency of cleft lip and palate was 5.2 per 10000 live births. Male children with normal birth-weight are the most affected by cleft lip and palate.Key words: Epidemiology; Cleft Lip; Cleft Palate; Congenital Abnormalitie

Knowledge of pregnant women about risk factor of cleft lip and palate at Puskesmas Mutiara, Asahan, Indonesia

Cleft is a congenital abnormal space or gap in the upper lip, alveolus, or palate. This congenital abnormality occurs between the 5th and 10th weeks of pregnancy. Clefts are divided into cleft lip, cleft palate, as well as cleft lip and palate. Cleft lip and palate are caused by the interaction of individual genes with certain environmental factors. Mothers’ knowledge about risk factor of cleft lip and palate may promote better health-related behavior in their pregnancy by increasing the understanding about the risk factor. Unfortunately, until now there is still limited data about this. The purpose of this study was to determine the knowledge of pregnant women about risk factor of cleft lip and palate. This was a descriptive study that used the survey method. This study was conducted using a questionnaire distributed to 67 pregnant women (n = 67). The questionnaire consisted of 13 validated questions. The results of this study found that 10.4% of the respondents had good knowledge, 32.8% of the respondents had moderate knowledge and 56.7% of the respondents had poor knowledge. The overall knowledge of the pregnant women about risk factor of cleft lip and palate at Puskesmas Mutiara Asahan fell in the low category

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

Perturbation In Voice Of Children With Cleft Lip And /Or Palate.

Occurrence of phonatory deviancies is not uncommon in children with congenital cleft lip/palate. However, very few researchers have observed and reported the nature of these deviancies. Present study aimed at analyzing perturbation measures in the voices of children born with cleft lip and/ or palate.  Perturbation related measures of the Voice samples of 40 children with clefts were analyzed using VAGHMI software and compared with the age and number matched group of children without any cleft. Mean jitter and shimmer values were found to be higher in the pre and post-operative cases of cleft lip and/ or palate when compared to the controls, though not statistically significant. Operative measures too did not lead to any significant changes in the Perturbation related voice parameters in children with cleft. Present study highlights the lack of sensitivity possessed by Perturbation measures in correlating the perceptual phonatory deviancies in voice of children with repaired and unrepaired cleft lip/palate. Key words: Cleft lip and palate, jitter, shimmer, perturbatio

Dental Implant Treatment for a Patient with Bilateral Cleft Lip and Palate

Dental reconstruction in the cleft space is difficult in some patients with cleft lip and palate because of oronasal fistulas. Most of these patients receive a particle cancellous bone marrow (PCBM) graft to close the alveolar cleft, and secondary bone grafting is also required. Treatment options for the alveolar cleft including fixed or removable prostheses require the preparation of healthy teeth and are associated with functional or social difficulties. Recently, the effectiveness of dental implant treatment for cleft lip and palate patients has been reported. However, there have been few reports on the use of this treatment in bilateral cleft lip and palate patients. We report the case of a patient who had bilateral cleft lip and palate and was missing both lateral incisors. She received dental implant treatment after a PCBM graft and ramus bone onlay grafting (RBOG). A 34-month postoperative course was uneventful.</p

Perioperative adverse airway events in cleft lip and palate repair

Background: Airway-related problems account for the majority of anaesthetic morbidity in paediatric anaesthesia, but more so for cleft lip and palate repair. The aim of this study was to assess the frequency, pattern, management and outcome of adverse airway events during the perioperative period in cleft lip and palate patients. Method: This was a prospective cohort study conducted in a tertiary hospital in a suburban south-western Nigerian town. One hundred and sixteen patients who had cleft lip and palate repair over a five-year period were included. The demographic data, surgical diagnosis, congenital anomalies, procedures performed, medical problems, perioperative anaesthetic and surgical complications were studied. Results: Adverse airway events were observed in six patients (4.6%). These included postoperative chest infection (n=2), failed intubation (n=1), difficult intubation (n=1), post-extubation bronchospasm (n=1), and laryngeal oedema (n=1). All, except one, who developed complications were patients with combined cleft lip and palate. No mortality was recorded. Conclusion: Adverse perioperative airway events in cleft lip and palate surgery are common and are more likely to be associated with combined cleft lip and palate than with isolated lip or palate defects. These complications usually occur immediately following extubation or in the early postoperative period. The severity may necessitate intensive care unit admission and specialised care.South Afr J Anaesth Analg, 2011;17(6):370-37

Cleft Lip and Palate Patients: Diagnosis and Treatment

Cleft lip or palate is one of the most common types of craniomaxillofacial birth anomalies. Midface deficiency is a common feature of cleft lip and palate patients due to scar tissue of the lip and palate closure. Cleft lip and palate patients should be carefully evaluated by the craniofacial team in order to detect potentially serious deformities. Craniofacial team is involved with diagnosis of facial morphology, feeding problems, guidance of the growth and development of the face, occlusion, dentition, hearing and speech problems, and psychosocial issues and jaw discrepancy of the patients with cleft lip and palate or craniofacial syndromes. Treatment for cleft children requires a multidisciplinary approach including facial surgery in the first months of life, preventive and interceptive treatment in primary dentition, speech therapy, orthodontics in the mixed dentition phase, oromaxillofacial surgery, and implant and prosthetics in adults. Treatment plan from orthodontic perspective can be divided into the following stages based on the dentition stages: (1) presurgical orthopedics, (2) primary dentition, (3) mixed dentition, and (4) permanent dentition. The aim of this chapter is to assess a rational team work approach in the management of the patient with cleft lip and/or palate from birth to adulthood