Bilateral microform cleft lip

Microform cleft lip (MCL), also called congenital healed cleft lip or cleft lip "frustré", is a rare congenital anomaly. MCL has been described as having the characteristic appearance of a typical cleft lip which has been corrected in utero. We present a girl with bilateral microform cleft lip associated with a preauricular sinus and bilateral camptodactyly.peer-reviewe

Mandible Cleft: Report of a Case and Review of the Literature

Median cleft of the lower lip and associated structures is a relatively rare condition. We report the case of a patient with mandibular cleft. Unlike other reported cases of similar disorders, there was no cleft of the lower lip. The literature on median clefts of the lower lip and mandible is reviewed, and the etiology and treatment are discussed

Assessment of facial asymmetry before and after the surgical repair of cleft lip in unilateral cleft lip and palate cases

This study was performed to assess facial asymmetry in patients with unilateral cleft lip and palate (UCLP) before and after primary lip repair. Three-dimensional facial images of 30 UCLP cases (mean age 3.7 ± 0.8 months) captured 1–2 days before surgery and 4 months after surgery using stereophotogrammetry were analysed. A generic mesh – a mathematical facial mask consisting of thousands of points (vertices) – was conformed on the three-dimensional images. Average preoperative and postoperative conformed facial meshes were obtained and mirrored by reflecting on the lateral plane. Facial asymmetry was assessed by measuring the distances between the corresponding vertices of the superimposed facial meshes. Asymmetries were further examined in three directions: horizontal, vertical, and anteroposterior. Preoperatively, the philtrum and bridge of the nose were deviated towards the non-cleft side. The maximum vertical asymmetry was at the upper lip. The greatest anteroposterior asymmetry was at the alar base and in the paranasal area. The overall facial asymmetry improved markedly after surgery. Residual anteroposterior asymmetry was noted at the alar base, upper lip, and cheek on the cleft slide. In conclusion, dense correspondence analysis provided an insight into the anatomical reasons for the residual dysmorphology following the surgical repair of cleft lip for future surgical consideration

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

The role of negative maternal affective states and infant temperament in early interactions between infants with cleft lip and their mothers

OBJECTIVES: The study examined the early interaction between mothers and their infants with cleft lip, assessing the role of maternal affective state and expressiveness and differences in infant temperament. METHODS: Mother-infant interactions were assessed in 25 2-month-old infants with cleft lip and 25 age-matched healthy infants. Self-report and behavioral observations were used to assess maternal depressive symptoms and expressions. Mothers rated infant temperament. RESULTS: Infants with cleft lip were less engaged and their mothers showed more difficulty in interaction than control group dyads. Mothers of infants with cleft lip displayed more negative affectivity, but did not report more self-rated depressive symptoms than control group mothers. No group differences were found in infant temperament. CONCLUSIONS: In order to support the mother's experience and facilitate her ongoing parental role, findings highlight the importance of identifying maternal negative affectivity during early interactions, even when they seem have little awareness of their depressive symptoms

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

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

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

Success and Failure for Children Born with Facial Clefts in Africa: A 15-Year Follow-up

Background: This study reviews the 15year program of our Department of Pediatric Surgery for the treatment and follow-up of children born with a cleft in Benin and Togo. Methods: We analyzed files of children born in Africa with a cleft. They were referred to us through a nongovernmental organization (NGO) between 1993 and 2008 and assessed in Africa by local pediatricians before and after surgery. Operations were performed by our team. Results: Two hundred files were reviewed: 60 cases of unilateral cleft lip, seven of bilateral cleft lip, 44 of unilateral cleft lip palate (UCLP), 29 of bilateral cleft lip palate (BCLP), 53 of cleft palate (CP), three of bilateral oro-ocular cleft, one of unilateral and two of median clefts (Binder), and one of commissural cleft. Sixty-nine (35%) of these cases were not operated in Africa: 25 (12.5%) had not shown up, 28 (15%) were considered unfit for surgery (Down's syndrome, HIV-positive, malnutrition, cardiac malformation), and 16 (7.5%) were transferred to Switzerland. Palatal fistula occurred in 20% of UCLP, 30% of BCLP, and 16% of CP. Evaluation of speech after palate surgery gave less than 50% of socially acceptable speech. Conclusions: Our partnership with a NGO and a local team makes it possible to treat and subsequently follow children born with a cleft in West Africa. Surgery is performed under good conditions. If aesthetic results are a success, functional results after palate surgery need further improvement to promote integration in school and social lif

Cleft Lip

Cleft Lip is a feature film and constitutes practice research located within the field of narrative independent film and world cinema. The film forms part of Knudsen’s ongoing critical and practical exploration of transcendent narrative forms and the impact of technologically inspired independence on the telling of prototypical stories. What happens when fertility becomes a commodity in a fractured society? Oedipus reborn. Sophocles' classic of classics adapted for the 21st Century by Erik Knudsen into a contemporary tragedy about the unravelling of the most fundamental of relationships in society; that between a father, a mother and a child. Cleft Lip is set in the context of a world where donor eggs and sperm are freely traded as increasing numbers of people are having to resort to fertility treatment as a consequence of social changes, individual decisions and biological imperatives