Perfil epidemiológico dos pacientes portadores de fissuras labiopalatinas atendidos por equipe cirúrgica de referência no Estado do Amazonas / Epidemiological profile of patients with orofacial cleft treated by a reference surgical team in the State of Amazonas, Brazil

Introdução: As fissuras labiopalatinas são malformações congênitas e, no Brasil, estima-se a ocorrência de 1:650 nascimentos. A classificação adotada é a de Spina. A queiloplastia e a palatoplastia são as principais cirurgias executadas. Métodos: Estudo retrospectivo descritivo com obtenção de dados a partir do sistema Smile Train Express referente a pacientes com fissura labiopalatina atendidos por equipe cirúrgica de referência entre 1 de março de 2014 e 1 de dezembro de 2016. Resultados: Foram identificados 477 pacientes, predominando o sexo masculino e os dois primeiros anos de vida na admissão. A fissura mais prevalente foi transforame e unilateral esquerda. O tratamento cirúrgico mais frequente foi a queiloplastia. Conclusões: O padrão epidemiológico está em consonância com a literatura nacional.

Introduction: Orofacial clefts are congenital malformations with an estimated occurrence of 1:650 births in Brazil. The most widely adopted classification system in that country is the method developed by Spina, and cheiloplasty and palatoplasty are the main surgeries performed. Methods: This was a retrospective descriptive study using data collected from the Smile Train Express organization regarding patients with orofacial clefts treated by a reference surgical team between March 1, 2014 and December 1, 2016. Results: A total of 477 patients were identified, predominantly male and in the first two years of life at admission. The most prevalent type of malformation was left unilateral transforamen cleft. The most frequent surgical treatment was cheiloplasty. Conclusions: The epidemiological pattern is consistent with the findings described in the national literature.

Demographic and clinical profile of craniofacial clefts at comprehensive rehabilitation service in Uganda

Background: The true incidence of Craniofacial cleft (CFC) is unknown because of their scarcity and because of the difficulty in recognizing sometimes subtle physical findings in mild malformations. Craniofacial anomalies in the African population are reported infrequently. Aim: To contribute to the general literature on rare CFC in Uganda and Africa. Methods: we conducted a retrospective search of patient data over the period 2005 to May 2017 in the unit of plastic surgery of CoRSU (Comprehensive Rehabilitation Service in Uganda) hospital, a tertiary hospital in Uganda. Patient with a diagnosis of CFC were picked out. Sixty-six patient's files with clinical diagnosis of CFC including their clinical photographs were found. Frequency data was generated and a frequency distribution table with the observed data was constructed. Results: Sex distribution showed no significant difference between male and female (1:1,2);the age on admission ranged from 1 day to 83 years; according to the laterality of the cleft, unilateral CFC (left or right side) are more common than midline clefts (Tessier 0; 14; 0,14;30); however, according to the clinical type, Tessier cleft (TC) 0 is the most common TC in our series and is associated with holoprosencephaly. Fifty percent of CFC in our series are syndromic. TC 7 are common in male and have a bilateral predilection. Conclusion: CFC are a rare set of malformations for which there is a paucity of literature. There is a need to conduct a study with a larger series including CT-Scan in order to analyze more accurate clinical diagnosis

Cierre de fístula palatina con colgajo anterior de lengua: reporte de un caso / Palatal fistula closure with anterior tongue flap: report of a case

El cierre de grandes fistulas palatinas en pacientes con fisura labio-alveolo-palatina, donde se realizaron varios intentos previos para su resolución, sin obtener éxito en el tratamiento, y en los cuales no se tuvieron en cuenta y respetaron los tiempos quirúrgicos correspondientes a los tiempos biológicos, conlleva a la implementación de técnicas alternativas para la conformación final del paladar hendido. Destacamos en este trabajo la utilización de un colgajo anterior de lengua, su técnica, y su resultado, al igual que la importancia de brindar una atención en concordancia con la edad ideal para la corrección quirúrgica de esta malformación...

Prevalence of dental anomalies of number in different subphenotypes of isolated cleft palate

OBJECTIVE: This study aimed at carrying out a radiographic analysis on the prevalence of dental anomalies of number (agenesis and supernumerary teeth) in permanent dentition, in different subphenotypes of isolated cleft palate pre-adolescent patients. METHODS: Panoramic radiographs of 300 patients aged between 9 and 12 years, with cleft palate and enrolled in a single treatment center, were retrospectively analyzed. The sample was divided into two groups according to the extension/severity of the cleft palate: complete and incomplete . The chi-square test was used for intergroup comparison regarding the prevalence of the investigated dental anomalies (P < 0.05). RESULTS: Agenesis was found in 34.14% of patients with complete cleft palate and in 30.27% of patients with incomplete cleft palate. Supernumerary teeth were found in 2.43% of patients with complete cleft palate and in 0.91% of patients with incomplete cleft palate. No statistically significant difference was found between groups with regard to the prevalence of agenesis and supernumerary teeth. There was no difference in cleft prevalence between genders within each study group. CONCLUSION: The prevalence of dental anomalies of number in pre-adolescents with cleft palate was higher than that reported for the general population. The severity of cleft palate did not seem to be associated with the prevalence of dental anomalies of number. .

OBJETIVO: o propósito deste estudo foi avaliar radiograficamente a prevalência das anomalias dentárias de número (agenesias e supranumerários), na dentição permanente, em diferentes subfenótipos da fissura isolada de palato, em pacientes pré-adolescentes. MÉTODOS: foram investigadas, de forma retrospectiva, 300 radiografias panorâmicas de pacientes com fissura palatina (pós-forame), de 9 a 12 anos de idade, matriculados em um mesmo centro. A amostra foi dividida em dois grupos de acordo com a extensão/gravidade da fissura palatina: completa e incompleta. O teste qui-quadrado foi utilizado para comparação intergrupos das prevalências de anomalias avaliadas (p < 0,05). RESULTADOS: a agenesia dentária foi encontrada em 34,14% dos pacientes com fissura pós-forame completa e em 30,27% com fissura pós-forame incompleta. A prevalência de dentes supranumerários correspondeu a 2,43% nos pacientes com fissura palatina completa e a 0,91% no grupo com fissura palatina incompleta. Não houve diferença estatística significativa entre os grupos quanto à prevalência de agenesias dentárias e supranumerários. Não se observou diferença sexual quanto à prevalência de fissura dentro de cada grupo de estudo. CONCLUSÃO: os pacientes pré-adolescentes com fissura palatina apresentam maior prevalência de anomalias dentárias em relação à população em geral. A gravidade da fissura palatina parece não se associar com a prevalência de anomalias dentárias de número. .

Fisura naso labio alveolo palatina. Fisura unilateral y bilateral primaria. Actualización / Cleft lip alveolus nasal palatal. Unilateral and bilateral primary cleft. Update

La fisura labio alveolo palatina es la malformación congénita más frecuente dentro de las fisuras de la cara. Se clasifica en fisura primaria y secundaria de acuerdo a su posición con respecto al foramen incisivo. En esta comunicación nos referiremos exclusivamente a la clasificación diagnóstico y tratamiento dela fisura primaria unilateral y bilateral

review of classification systems for cleft lip and palate patients-I. morphological classifications

Clinicians should know classifications of cleft lip and palate as grading the severity of condition will help in communication, diagnosis and treatment planning. Each classification. System has some deficiencies and sonic advantages over others. Some classification systems are simple while others are complicated incorporating more information regarding the anomaly. Some systems are descriptive while others have graphic representation. Systems with graphic representation have been explained with examples. Classification systems for cleft lip and palate can be further classified into two groups i.e.; Morphological classifications and Embryological. classifications. This paper looks at the morphological classifications of cleft lip and palate while the second article will look at the embryological classifications. Occurrence of cleft lip and palate features are different in different regions of the world. So, a clinician should adopt time classification system which best suits and covers all the necessary features of diagnostic and therapeutic interest

Tratamiento de la fisura labio palatina / Treatment of patients with cleft lip and palate

La fisura labiopalatina es una de las malformaciones congénitas más frecuentes. La incidencia en Chile es de 1.7 por mil recién nacidos, lo que significa que nacen alrededor de 400 casos cada año. Las causas determinantes son: hereditarias en 20-25 por ciento, ambientales en 10 por ciento y desconocidas hasta ahora en 70 por ciento de los casos. Con respecto a la prevención, pareciera que la suplementación con Ácido Fólico en dosis altas antes y durante los primeros meses del embarazo puede reducir el riesgo. El tratamiento es multidisciplinario y se inicia en el periodo de recién nacido. Las cirugías primarias comprenden cierre de labio (3 meses) y paladar (12 meses). La participación de diferentes especialistas odontólogos, otorrino, genetista, fonoaudiólogas, psicólogo y enfermeras coordinadoras es fundamental para lograr resultados óptimos.

Cleft lip and palate are frequent congenital malformations, in Chile 1.7 per one thousand babies are born with clefts, that is, 400 cases each year. The main causes are: hereditary 20-25 percent, environmental 10 percent and unknown reasons 70 percent up to now. In relation with prevention it seems a high dose of folic acid before and during the first months of pregnancy might reduce the risk. The interdisciplinary treatment begins at early age. Primary surgeries consist of lip closure (at 3 month of age) and palate closure (at 12 months old). To achieve the best results is essential an interdisciplinary team such as a dentist, ENT, genetist, speech therapists, psychologist and coordinator nurses.

distribution and classification of clefts in patients attending a cleft lip and palate clinic in Riyadh, Saudi Arabia

To evaluate and discuss the etiology, distribution, and classification of cleft lip and palate CLP patients in one of the most active CLP clinics in Riyadh, Saudi Arabia. The records of all 171 CLP patients attending the CLP clinic at the College of Dentistry, King Saud University in Riyadh, Saudi Arabia, were collected in November and December 2006. Variables such as etiology, age, gender, type of cleft, and location of cleft were statistically analyzed. Proportional Z test p<0.05 was used. The patients age range was 0.5-30 years with an average of 11.1 standard deviation 5.87 years. Attending male patients 63.7% were more than females 36.6% p=0.000. The unknown environmental factor was the most reported etiological factor 79.5% p=0.000. The cleft lip and palate were the most prevalent type 78.3% p=0.000. In the different types of cleft, as well as within the same cleft type, the cleft lip and palate type were significantly higher in males 49.1% 62.7%, than females 29.1% 37.3% with p=0.038 p=0.008. There were no statistical differences between the right and left cleft sides. The average age and range of CLP patients at first visit were high. Attending male patients was more than females. The environmental etiological factor was not identifiable. Males were dominant in the cleft lip and palate type. The cleft lip and palate type were the highest among oral clefts

Cleft lip and palate [cross sectional study part II]

Cleft lip and palate is defined as a common congenital deformity, although not fatal, unless associated with other serious congenital diseases. This study is done to record the distribution of the cleft types and if there is any association between different risk factors, in the period from January 2002 to March 2003. These are case series survey covering 50 patients with cleft lip and palate attending or refereed to specialized clinic. Detailed forms prepared for those patients were filled. Cleft lip and palate patients represent 56%, cleft palate was 24%, cleft lip 20%, and females were affected more than males. The third birth order child has the highest frequency and the highest percentage of babies was born in October. Cleft lip and palate shows a variation in the distribution and association between different risk factors

Proportions of oral clefts in patients visiting the cleft center of Children's Hospital and Institute of Child Health Lahore: a Five year study [2000 - 2005]

The objective of the study was to identify proportions of oral clefts in patients visiting Children's Hospital Institute of Child Health, Lahore during five year period from 24-01-2000 to 24-01-2005. This observational descriptive study included 128 subjects comprising 72 males and 56 females. Age of these patients ranged from one day old to 13 years. The method used for this study was Kernahan modified double [Y] with numeric coding system. A Total of 24 combinations were used to describe all types of clefts. The data was analyzed in SPSS 10 statistical package. Out of the whole sample size an increased number of male subjects [72] were examined as compared to female subjects [56]. The most common finding of this study was complete bilateral clefts affecting 54 patients [42.2%]. The next common type was complete unilateral cleft of the lip and palate, occurring in 27patients [21%]. Among these, clefts involving left side were more common and were seen in 19 patients [14.8%]. An unusual finding of this study was complete unilateral and partial clefts of the opposite side. Increased number of complete bilateral cleft of the lip and palate was because of referrals to the CH and ICH from various surrounding and remote localities for the tertiary level treatment of this particular deformity. The unusual type of the cleft was identified with Kernahan's modified double stem of the symbolic [Y]

Propuesta de nueva clasificación para fisuras labio-palatinas / Cleft lip and palate new classification proposal

El propósito de este trabajo es prsentar una nueva clasificación que hemos desarrollado, basada en aspectos anatómicos de la morfología del paciente y en hechos diagnósticos de dificultad terapéutica. Identificamos para nuestra clasificación tres estructuras anatómicas a tener en cuenta: labio, arcada alvéolo-palatina y paladar duro y blando pos-agujero incisivo anterior. En estas estructuras describimos: a)el lado de la fisura: derecha, izquierda o bilateral b) la extensión; parcial en distintos grados o total c) evaluamos la dificultad de su tratamiento de acuerdo al ancho de la fisura. Esta clasificación anatómica y de valoración previa de la dificultad terapéutica facilita la formación de grupos homogéneos de pacientes, a quienes aplicar técnicas de tratamiento estandarizadas, y permitiendo sacar conclusiones más exactas y valederas de los resultados ortodónticos, ortopédicos y quirúrgicos que se realizan. Esta clasificación tiene también la posibilidad de expresarse gráficamente

Análisis del tratamiento quirúrgico de 53 pacientes con fisura palatina / Analysis of the surgical treatment of infants presenting with diarrhea

Se expone una revisión de 53 pacientes con fisura del paladar de distintos tipos atendidos en el Servicio de Cirugía Máxilo Facial del Hospital General Provincial Docente "Carlos Manuel de Céspedes" de Bayamo, Grannma. Para obtener el restablecimiento de la función estomatológica y psicológica del niño, se menciona la frecuencia y las técnicas quirúrgicas utilizadas en el servicio. Los resultados funcionales y estéticos fueron evaluados por un cirujano que no participó en la operación, el foniatra y el ortodoncista. Fueron catalogados de Bueno en el 88,7 porciento de los casos, el 9,4 y el 1,9 porciento fueron considerados como Regulares y Malos respectivamente. Se discuten los resultados y se comparan con la literatura médica nacional y extranjera

El niño fisurado: un problema multidisciplinario / The fissured children: a multidisciplinary problem

El niño que nace con una fisura labiopalatina lleva consigo una malformación compleja cuya corrección implica diversos tratamientos, los que deben ser realizados por múltiples especialistas, con un resultado alentador en el largo plazo. La lesión compromete varias estructuras, de ahí su gravedad y su complejidad. En nuestro país ocupa el 4º lugar de las malformaciones congénitas en el recién nacido. En Chile, en la evolución histórica de su tratamiento destaca con nitidez lafigura del Dr. Alfredo Gantz Mann, cirujano pediatra que desarrolló programas terapéuticos en el Hospital Roberto del Ríoy en la Clínica Alemana de Santiago. Es de reconocimiento público su esforzado labor pionera asistencias y docente

Fisura labiopalatina. Análisis epidemiológico de 121 pacientes / Cleft and lip palate. An epidemiological analysis of 121 patients

El propósito de este estudio, es determinar algunas variables antropométricas, sociodemográficas y factores de riesgo en 121 pacientes en fisura labial y/o palatina, atendidos en el servicio de cirugía maxilofacial del Hospital Central de San Luis de Potosí. Se observaron 94 pacientes con fisura labiopalatina; 14 con fisura labial y 13 con fisura palatina. Hubo una mayor preponderancia de varones en todas las fisuras excepto en la labial. En las fisuras labiopalatinas y labiales aisladas el lado izquierdo fue el más afectado (41.7 por ciento), seguida de la bilateral (36.1 por ciento). Los estudios nacionales de estos defectos son escasos, por lo que es indispnsable contar en cada institución con registros clínicos adecuados para planear en forma óptima los recursos técnicos y humanos idóneos, para el mejor tratamiento de estos pacientes

Classificaçäo das fissuras lábio-palatais: breve histórico, consideraçöes clínicas e sugestäo de modificaçäo / Classification of cleft lip and palate: brief review, clinical considerations and suggestion of modification

Após descrita a classificaçäo de Spina e cols. e exemplificada a apresentaçäo de casos clínicos, é apresentada uma proposta de modificaçäo, que consiste em acrescentar no grupo II (fissura transforame incisivo) a fissura mediana, tornando assim a presente classificaçäo mais completa, como esquematizado a seguir: Grupo II - fissura transforame incisivo: unilateral (lado esquerdo/lado direito); bilateral; mediana