Syndromes with cleft lip and cleft palate.

A series of tables is presented as a diagnostic aid for the clinician when he confronts a patient who has a cleft lip and/or palate, together with associated anomalies. The tables provide a rapid way of sorting through the recognized syndromes with orofacial clefting in search of a possible overall diagnosis. Today, 154 such syndromes are recognized. This is more than twice as many as were known in 1971. Undoubtedly, many new syndromes with orofacial clefting will be delineated in the future.     

Feeding infants with cleft lip, cleft palate, or cleft lip and palate

In assessing 143 infants with cleft lip and palate, we found feeding problems to vary with the patients' anatomic lesion. Effective feeding techniques were identified by first assessing the infant's ability to generate negative intraoral pressure and to move the tongue against the nipple and then by matching these deficits to appropriate feeding devices.     

Approaches to cleft lip and palate repair

Facial clefts remain one of the most common congenital anomalies encountered by plastic surgeons. Over the last few decades, surgical results have continued to improve due to the interdisciplinary approach to this complex clinical problem.     

Birth weight and gestational age of newborns with cleft lip with or without cleft palate and with isolated cleft palate

The birth weight and gestational age of 1368 newborns with isolated cleft lip with or without cleft palate and 582 with isolated cleft palate were compared to those of matched healthy controls. The results indicate that fetuses with oral clefts are at elevated risk of having low and very low birth weight, but not of having a premature birth. Speculations on a relationship between these findings and the presence of oral clefts are presented.     

Obturators for cleft lip and cleft palate

Cleft Lip and palate are most common congenital anomalies of the faces. Infants born with cleft lip and palate always have feeding problem. They were referred to dentists for obturators. Obturators usually have definite retention, lead to easily dislodgement. The author suggested the method of fabricating more retentive obturator.     

Association of Wnt3A gene variants with non-syndromic cleft lip with or without cleft palate in Chinese population

Objective

Non-syndromic cleft lip with or without cleft palate (NSCLP) is one of the most common birth defects all over the world. Both genetic and environmental factors may contribute to NSCLP. Recent studies have demonstrated that Wnt/β-catenin signalling pathway is required for lip and palate formation. WNT family may play an important role in the development of NSCLP. This study aimed to evaluate the association between Wnt3A gene polymorphisms and NSCLP in Chinese population from Northwest China.

Design

216 patients with NSCLP and 233 normal controls were genotyped for two SNPs of Wnt3A by PCR-RFLP. Both SNPs genotype frequencies were analysed between cases group and controls group.

Results

The frequencies of rs752107 TT and rs3121310 AA were significantly higher in NSCLP cases group (7.4%, 15.3%) than that in controls group (2.1%, 9.5%) with p-value = 0.013, 0.014, corrected p value (p-corr) <0.05 and with odds ratio (OR) = 3.49, 95% confidence interval [CI]: 1.244–9.79, OR = 2.27, 95% CI: 1.17–4.38, respectively; the frequency of rs3121310 GA was also higher in NSCLP cases group (57.4%) than in controls group (52.0%) with p-value = 0.042 and OR = 1.56 (95% CI: 1.02–2.39). And the frequency of rs752107 TT of Wnt3A showed higher risk in female patients, while the frequency of A allele of rs3121310 showed stronger association in male patients.

Conclusions

This is the first report that two SNPs of Wnt3A (rs752107 and rs3121310) are significantly associated with NSCLP in Chinese population. These findings provide a context for understanding the genetic aetiology of NSCLP.     

Prenatal diagnosis of cleft lip and palate.

OBJECTIVE: The use of ultrasound for the prenatal diagnosis of cleft lip and palate has aided considerably in the early diagnosis of orofacial clefting. The impact and consequences of this need to be considered as the reliability and validity of ultrasound diagnosis increases. This review article considers a number of these issues as well as up-to-date information on the quality of the technique.     

Incidence of cleft lip, cleft palate, and cleft lip and palate among races: a review

A review of the literature pertaining to the incidence of cleft lip, cleft palate, and cleft lip and palate in different races is presented. The studies have been evaluated according to the method used to record the incidence rate. Half of the studies include in their base population livebirths, stillbirths, and abortions, or livebirths and stillbirths to record the incidence rate. In addition, in most of the studies, clefts with associated malformations and possible syndromes are included in the reported incidence. There is evidence, however, to suggest that the risk of developing clefts in stillbirths and abortions is three times as frequent as in livebirths and that clefts with associated malformations behave differently epidemiologically from clefts without associated malformations. It is suggested, therefore, that the incidence of cleft lip, cleft palate, and cleft lip and palate should be studied separately for each group, namely for livebirths, stillbirths, and abortions and should be reported separately for clefts without associated malformations, clefts with associated malformations, and syndromes. More research is needed to study the risk of developing clefts among the various groups that exhibit different epidemiologic behavior for each race.     

Facial balance in cleft lip and palate. I. Normal development and cleft palate.

A full understanding of balanced facial growth, based on a complete knowledge of the anatomy and physiology of the region, is essential if cleft lip and palate is to be treated successfully. The cleft abnormality is the cause of underdevelopment and subsequent loss of function. Cleft surgery must aim to restore normal anatomy and physiology with emphasis on muscle reconstruction of the lip and soft palate if normal facial development is to be achieved.     

Delayed dental development in children with isolated cleft lip and palate

Although most cases of cleft lip and palate are free of other developmental defects, children with isolated cleft lip/palate are at enhanced risk of delayed growth and reduced final size. Three variables were assessed in the permanent dentition away from the cleft site: congenital absence by tooth type (which ranged from 0 to 7%) asymmetry in developmental staging (3 times more common in cleft lip/palate than in controls), and dental age (with a mean delay of 0.9 yr in cleft lip/palate relative to controls). The pervasive nature of these measures of reduced growth potential and developmental control, which were greatest in teeth forming during infancy, suggests that the cause of the compromised growth is the adverse early postnatal environment rather than conditions intrinsic to the individual.     

Reoperations in cleft lip and cleft palate treatment

The surgical management of cleft lip and palate is a difficult and complex endeavor. Several surgical techniques for the treatment of this deformity have been described around the world; each one, when properly done by expert surgeons, renders good and predictable results most of the times. However, the fact that there are so many techniques means that there is no universal procedure that will always deliver great esthetic and functional results. This article discusses the causes of inadequate results in primary cleft lip and palate surgery and describes the various secondary surgical techniques to correct the same.