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Lateral or Midline Cleft Lip

Lateral Cleft Lip


Presentation

  • Presentation As with the unilateral cleft, a wide range of clinical presentations of the bilateral cleft lip and palate is possible, from the simple microform cleft to the complete cleft bilaterally involving the lip, alveolus, palate, and nose.[emedicine.medscape.com]
  • Presenting a collection of advanced theories and techniques in this field, richly illustrated and with video clips of the respective operations, it is intended for plastic surgeons, oral surgeons and paediatrics surgeons, as well as for medical students[books.google.de]
  • The present report presents an interdisciplinary approach for the care of a cleft patient.[jorthodsci.org]
  • In this report, none of the patients presented salivary discharge during meal time.[amhsjournal.org]
Collapse
  • Presurgical orthopedics may be used to prevent the maxillary segments and premaxilla from collapse.[emedicine.medscape.com]
  • […] present approximately in 1 out of 700 live birth. [1] Clefts are thought to be of multifactorial etiology due to genetic and environmental factors. [2] Different dental abnormalities are usually seen in cleft patients, including mid-face deficiency, collapsed[jorthodsci.org]
  • Thus, it tends to grow outward and away from the lateral segments, which then tend to collapse medially. Attachment of the lip to close the cleft then creates a band of lip tissue which restrains this forward growth of the central portion.[hawaii.edu]
  • Complete DenturesTreatment concepts – Challenges and DifficultiesIn these two patients note:v Scarring in the posterior palatal seal areav Collapsed maxillary arch segments 108.[ffofr.org]
Anemia
  • Contraindications See the list below: Malnutrition, anemia , or other pediatric conditions that result in the patient's inability to tolerate general anesthesia are contraindications to this procedure.[emedicine.medscape.com]
Aspiration
  • Thompson who aspired to reproduce a natural cupid's bow designed his paring procedure in a shape of a diamond excision. He emphasized the need for accurate markings for precise matching of the cleft sides when brought together [ 19 ].[intechopen.com]
  • Ultracain DS forte solution (Articainhydrochlorid Epinephrine) alongside the medial cleft edge from the uvula up to the ventral end of the cleft underneath the palatinal mucosa, into the muscle of the soft palate and dorsal of the tuber maxillae under aspiration[esprasshare.org]
  • Given an adequate mouthful of fluid, some cleft palate infants are prone to aspiration because of the mixing of the air and food streams.[familydoctor.co.nz]
Anterior Open Bite
  • Her chief complaint was the unaesthetic appearance of the maxillary anterior teeth and anterior open-bite. She had isolated cleft palate with no other local or systemic illness.[rroij.com]
  • Anterior open bite with temporomandibular disorder treated with titanium screw anchorage: Evaluation of morphological and functional improvement. Am J Orthod Dentofacial Orthop 2007;131:550-60. [ PUBMED ] 36.[jorthodsci.org]
  • Overlay Removable Partial Dentures Note: l Anterior open bite l Fistulas l Soft palate defect 133.[ffofr.org]
Excoriation
  • In 1570 Gaspar Tagliacozzi of Bologna described excoriating the cleft edges and using interrupted sutures to close the cleft. 6.1.2.[intechopen.com]
Fear
  • Surgical techniques of unilateral cleft lip repair “Things done well, and with a care, exempt themselves from fear.”[intechopen.com]
  • Or the surgeon with limited experience in this field of plastic surgery might fear the complexity of the procedure and consider the possible risks of palate surgery with severe postoperative bleeding, wound dehiscence and obstruction of the airway as[esprasshare.org]

Workup

  • MRI is emerging as a technology for evaluating VPI, but it would not be the first choice for diagnostic workup.[brainscape.com]

Treatment

  • Total treatment time was about 31 months with satisfactory results. Post-treatment evaluation after 8 months showed stable results.[jorthodsci.org]
  • This issue of The Clinic’s brings the current state of the art in cleft treatment to the practicing plastic surgeon, highlighting the changes and ongoing developments in the field.[books.google.de]
  • Further treatment planning Orthodontic treatment can be initiated a few weeks following birth, prior to surgical intervention.[emedicine.medscape.com]
  • treatment [ 4 , 5 ].[rroij.com]
  • Treatment of mouth anomalies [ edit ] There are several options for treatment of mouth anomalies like Tessier cleft number 2-3-7 .[en.wikipedia.org]

Prognosis

  • Type-specific sonographic features include: type III: may be seen as a premaxillary echogenic mass 8 Ancillary sonographic features there can be polyhydramnios if the defect is severe and impairs swallowing Treatment and prognosis The overall prognosis[radiopaedia.org]
  • The prognosis for a child with unilateral cleft lip and palate is generally good. They usually learn to take bottle feedings easily with a cleft palate nipple, and learn to control the escape of fluids through the nose.[hawaii.edu]
  • They further suggest that type 1 clefts are associated with a low rate of anomalies and type 2 and 3 clefts with intermediate prognosis. Type 4 and 5 clefts are universally associated with concurrent anomalies and with fatal outcome[ 26 ].[wjgnet.com]

Etiology

  • Etiology Clefting is a multifactorial issue, with both genetic and environmental causes cited. The observation of clustered cases of facial clefts in a particular family indicates a genetic basis.[emedicine.medscape.com]
  • Available from: Introduction Cleft lip and palate (CLP) is the most common congenital deformity of the orofacial region and is present approximately in 1 out of 700 live birth. [1] Clefts are thought to be of multifactorial etiology due to genetic and[jorthodsci.org]
  • A low-situated sinus floor may be in contact with the root of the teeth, and thus may be one of the etiologic factors of sinusitis in patients with clefts.[jamanetwork.com]
  • Embryology Etiology The development of CLP is dependent on the interaction of environmental factors and genetic predisposition References: [5] [6] [7] [8] Clinical features Subtypes and variants Diagnostics Treatment References: [11] [12] [13] [14] [15[amboss.com]
  • Over the years many different classification systems based on morphological, anatomical or etiological features of OFCs have been proposed. However, postnatal classification may not be applicable to prenatal findings.[wjgnet.com]

Epidemiology

  • Epidemiology References: [1] [2] [3] [4] Epidemiological data refers to the US, unless otherwise specified.[amboss.com]
  • Epidemiology Frequency The overall occurrence of cleft lip with or without cleft palate is approximately 1 in 750 to 1 in 1000 live births, establishing it as one of the most common congenital anomalies. [2, 3] Incidence varies by race, with clefts occurring[emedicine.medscape.com]
  • In the epidemiologic study of Doray et al. [ 8 ] CLs were unilateral in 79% of the cases (60/76), bilateral in 20% of the cases (15/76), and median in 1% (1/76); 55% of the unilateral CLs were right and 45% were left.[thieme-connect.com]
  • Epidemiology The incidence of cleft lip and palate is approximately 1:1000, with a higher incidence in populations with a family history and a racial preponderance toward Hispanic and Asian populations.[facialplastics.info]
  • Cardinal signs, epidemiology, associated features, differential diagnosis, expressivity, genetic counselling and treatment. Eur J Orthod 2004;26:17-24. [ PUBMED ] 3. More CB, Varma S, Tailor M, Bhavsar K.[amhsjournal.org]
Sex distribution
Age distribution

Pathophysiology

  • Some of these genes include interferon regulatory factor ( IRF6 ), transforming growth factor ( TGF ) alpha and beta, bone morphogenetic protein ( BMP4 ), and ventral anterior homeobox ( VAX1 ). [9] Pathophysiology While the normal embryologic development[emedicine.medscape.com]

Prevention

  • Inhalt Surgical orthodontic and prosthetic habilitative efforts for 191 Patient compliance with cleft palate team regimens 200 the philosophy revisited 218 Postsurgical prosthodontics in the management of bilateral 227 Discussion 239 Prevention of neural[books.google.de]
  • WRV flap technique is effective in preventing and correcting many vermilion and white roll deformities with promising aesthetic outcome.[ijps.org]
  • Finally, a Z-plasty was designed above the reconstructed muscle at the oral mucosa to prevent a straight-line scar contracture of the oral mucosa (Fig. 1).[journals.lww.com]
  • Instead these inserted materials prevent the adhesion of the flap onto the underlying bone.[esprasshare.org]
  • Prevention [ edit ] Because the cause of facial clefts still is unclear, it is difficult to say what may prevent children being born with facial clefts.[en.wikipedia.org]

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