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1.
Artigo em Chinês | WPRIM (Pacífico Ocidental) | ID: wprim-781346

RESUMO

OBJECTIVE@#To demonstrate the regularity of velopharyngeal function recovery after primary cleft palatoplasty and its correlation with different surgical procedures, ages, cleft types, and follow-up times.@*METHODS@#Patients with cleft palate under 5 years old who had more than two follow-up records were included in this study, and consecutive evaluations of postoperative velopharyngeal function were performed. Univariate and multivariate logistic regression analysis were used to reveal the regularity of postoperative velopharyngeal function and the possible influencing factors.@*RESULTS@#A total of 165 patients were included. Inconsistent functions of the velopharyngeal closure were observed in 31 patients, of which velopharyngeal insufficiency (VPI) in the first follow-up converted to velopharyngeal competence (VPC) in the second follow-up, accounting for 18.79% of the total, and 134 patients had consistent velopharyngeal function. The patients in the group who had consistent velopharyngeal function were younger than those in the group who were inconsistent, and the differences between the two groups were statistically significant. The younger the operation age, the patient's velopharyngeal function was more likely to stabilize at the first follow-up. At the time of the first follow-up in 15, 28, and 40 months, the probability that the patients had stable postoperative velopharyngeal function was 80%, 90%, and 95%, respectively.@*CONCLUSIONS@#The recovery of velopharyn-geal function after surgery is a dynamic process. The velopharyngeal status of patients can be converted from VPI to VPC. Meanwhile, VPC cannot switch to VPI. The follow-up time is the most important factor affecting the consistency of the evaluation of velopharyngeal function. Choosing appro-priate follow-up time is the key to obtain the stable evaluation of velopharyngeal function.


Assuntos
Criança , Pré-Escolar , Fissura Palatina , Humanos , Faringe , Resultado do Tratamento , Insuficiência Velofaríngea
2.
Artigo em Chinês | WPRIM (Pacífico Ocidental) | ID: wprim-781289

RESUMO

OBJECTIVE@#To assess the association of JAG2 gene single nucleotide polymorphisms with the occurrence of nonsyndromic cleft lip with or without cleft palate (NSCLP) among northwest Chinese population.@*METHODS@#A case-control study was carried out on 301 NSCLP patients and 304 healthy controls. An iMLDR(TM) genotyping technique was used to detect three single nucleotide polymorphisms (SNPs) [rs741859 (T/C), rs11621316 (A/G) and rs1057744(C/T)] of the JAG2 gene. Allelic and genotypic frequencies and haplotypic distribution among the two groups were compared.@*RESULTS@#A significant difference was found in the frequency of C and T alleles for rs741859 between the two groups. The CT genotype of rs741859 could significantly reduce the risk for NSCLP to 65% (P 0.8), whose distribution difference between the two groups was not statistically significant (P> 0.05).@*CONCLUSION@#The CT genotype of the JAG2 gene rs741859 may confer a protective effect for NSCLP among northwest Chinese population.


Assuntos
Estudos de Casos e Controles , China , Fenda Labial , Genética , Fissura Palatina , Genética , Frequência do Gene , Genótipo , Humanos , Proteína Jagged-2 , Genética , Polimorfismo de Nucleotídeo Único
3.
Artigo em Espanhol | LILACS (Américas) | ID: biblio-1047141

RESUMO

Introducción: La deformidad nasal en pacientes con fisura nasolabiopalatina trae consigo problemas tanto estéticos como funcionales. La rinoplastia definitiva en estos pacientes representa un verdadero desafío debido a que se trata en la mayoría de los casos de cirugías secundarias o terciarias dependiendo de cuantas veces el paciente se haya operado antes de culminado su crecimiento. Objetivo: Presentar una serie de casos sobre Rinoplastia definitiva en pacientes con Fisura Labiopalatina Unilateral. Presentación del caso: Serie de casos de 4 pacientes operados de rinoseptoplastia con secuelas de fisura nasolabiopalatina unilateral en el Centro Nacional de Quemaduras y Cirugías Reconstructivas (CENQUER) entre los años 2016 y 2017. El abordaje abierto fue realizado es todos los pacientes, las osteotomías fueron asimétricas en su mayoría, la septumplastia fue realizado en un 100%, así como la colocación de un poste columelar e injerto de Sheen (tipo escudo) en la punta en todos los casos. Conclusión: La corrección adecuada de la nariz fisurada se puede lograr teniendo en cuenta el conocimiento profundo de las alteraciones de cada paciente en particular. A pesar no existir un algoritmo ideal, el cirujano debe contar con un esquema mental que le permita tratar de forma individualizada cada caso siempre centrándose en dos metas principales: la corrección de la asimetría y de la función. Palabras Clave: Rinoplastia, Fisura del paladar, Procedimientos Quirúrgicos Reconstructivos,Paraguay


Introduction: Nasal deformity in patients with nasolabiopalatine fissure brings both aesthetic and functional problems. The definitive rhinoplasty in these patients represents a real challenge because it is treated in the majority of cases of secondary or tertiary surgeries depending on how many times the patient has undergone surgery before completing its growth. Objective: To present a series of cases on definitive Rhinoplasty in patients with Unilateral Labiapalatine Fissure. Case presentation: Case series of 4 patients operated for rhinoseptoplasty with sequelae of unilateral nasolabiopalatine fissure at the National Center for Burns and Reconstructive Surgery (CENQUER) between 2016 and 2017. The open approach was performed in all patients, osteotomies were asymmetric in their In most cases, septumplastia was performed in 100%, as well as the placement of a columelar pole and Sheen graft (shield type) at the tip in all cases. Conclusion: Proper correction of the cracked nose can be achieved taking into account the deep knowledge of the alterations of each particular patient. Despite the absence of an ideal algorithm, the surgeon must have a mental scheme that allows him to treat each case individually, always focusing on two main goals: the correction of asymmetry and function. Key words: Rhinoplasty, Cleft palate, Reconstructive Surgical Procedures, Paraguay


Assuntos
Humanos , Masculino , Feminino , Rinoplastia , Fissura Palatina , Procedimentos Cirúrgicos Eletivos , Reconstrução Mandibular
4.
Rev. Bras. Saúde Mater. Infant. (Online) ; 19(4): 947-956, Sept.-Dec. 2019. tab, graf
Artigo em Inglês | LILACS (Américas) | ID: biblio-1057128

RESUMO

Abstract Objectives: to analyze the trend and the associated factors with the presence of cleft lip and/or cleft palate in Brazilian newborns, in order to verify possible associations with maternal care and newborn factors. Methods: a cross-sectional and ecological study, involving all live births in Brazil, recorded in the Information System on Live Births from 2005 to 2016. Maternal and infant information were evaluated using trend analysis and odds ratio, with a 95% confidence interval. The analyses were performed using SPSS software. Results: we analyzed 17,800 live births with presence of cleft lip and/or cleft palate. The Brazilian prevalence rate was 0.51 / 1000 live births, with South and Southeast Regions registering higher rates than the national rate. There was an association with maternal age above 35 years old, with no partner, less than seven prenatal consultations, premature birth and cesarean section. About the factors of the newborn, being male, Apgar less than seven in the 1st and 5th minutes of life, low birth weight and white color were associated. Conclusions: Brazil has an increasing tendency for cleft lip and/or cleft palate (p=0.019), reinforcing the need to strengthen health care networks, providing adequate support for newborn with cleft lip and/or cleft palate and their families.


Resumo Objetivos: analisar a tendência e os fatores associados à presença de fissura labial e/ou fenda palatina em recém-nascidos brasileiros, a fim de verificar possíveis associações da mesma com fatores maternos, assistenciais e do recém-nascido. Métodos: estudo transversal, ecológico, envolvendo todos os nascimentos vivos do Brasil, registrados no Sistema de Informação sobre Nascidos Vivos de 2005 a 2016. Foram avaliadas informações maternas e infantis, utilizando-se análise de tendência e razão de chances, com intervalo de confiança de 95%. As análises foram realizadas através do software SPSS. Resultados: foram analisados 17.800 nascidos vivos com presença de fissura labial e/ou fenda palatina. A taxa de prevalência brasileira foi de 0,51/1000 nascidos vivos, sendo que as Regiões Sul e Sudeste registraram taxas maiores do que a nacional. Houve associação com idade materna superior a 35 anos, sem companheiro, menos de sete consultas de pré-natal, nascimento prematuro e cesariana. Sobre os fatores do recém-nascido, o sexo masculino, Apgar menor que sete no 1º e 5º minutos de vida, baixo peso ao nascer e raça/cor branca apresentaram associação. Conclusões: o Brasil apresenta tendência crescente das taxas de fissura labial e/ou fenda palatina (p=0,019), reforçando a necessidade de fortalecimento das redes de atenção à saúde, prevendo o amparo adequado aos bebês com fissura labial e/ou fenda palatina e suas famílias.


Assuntos
Humanos , Recém-Nascido , Brasil/epidemiologia , Fenda Labial/epidemiologia , Fissura Palatina/epidemiologia , Nascimento Vivo/epidemiologia , Sistemas de Informação em Saúde/estatística & dados numéricos , Anormalidades Congênitas , Recém-Nascido de Baixo Peso , Cesárea , Estudos Transversais , Idade Materna , Nascimento Prematuro
5.
Arq. bras. med. vet. zootec. (Online) ; 71(5): 1525-1530, set.-out. 2019. graf
Artigo em Português | LILACS (Américas), VETINDEX | ID: biblio-1038645

RESUMO

A fenda palatina é a comunicação entre a cavidade oral e a nasal através de um orifício no palato. Tem diversas etiologias, podendo ser congênita, traumática, por deficiência mineral ou por fatores hormonais. O diagnóstico é realizado por meio de exame físico da cavidade oral, e a correção cirúrgica é o tratamento de escolha. Em animais adultos, pode ser corrigida com o auxílio de retalho mucoperiosteal, apresentando bons resultados. Já em filhotes, a correção cirúrgica é mais complicada, com prognóstico menos favorável. Este trabalho relata o caso de um canino, fêmea, sem raça definida, adulta, com histórico de fenda palatina secundária, de origem traumática, no palato mole por ingestão de osso. Para a correção cirúrgica, primeiramente foi utilizada membrana biológica de pericárdio bovino, mas não se obteve êxito. O segundo procedimento foi realizado com retalho mucoperiosteal simples autólogo e, dois meses após o procedimento, já havia cicatrização completa. A técnica de retalho mucoperiosteal simples autólogo se mostrou eficaz no tratamento da fenda palatina, aliada aos cuidados adequados no pós-operatório.(AU)


The cleft palate is the communication between the oral and nasal cavity through an aperture in the palate, it's causes include an infinitude of factors: congenital, traumatic, mineral deficiency or hormonal. Examination of the oral cavity determines if the diagnosis and treatment is surgical. Correction in adult animals is performed with mucoperiosteal flap showing good results. However, surgical correction in puppies is more complicated with less favorable prognosis. This current work reports a case of an adult, female dog of undefined breed, with a history of secondary clef palate of traumatic origin in the soft palate due to bone ingestion. For correction, a biological membrane of bovine pericardium was used, but it was not successful, requiring a second surgical procedure performed with autologous simple mucoperiosteal flap. The last technique combined with adequate postoperative care was effective.(AU)


Assuntos
Animais , Feminino , Cães , Palato Mole/lesões , Retalhos Cirúrgicos/cirurgia , Retalhos Cirúrgicos/veterinária , Fissura Palatina/cirurgia , Fissura Palatina/reabilitação , Fissura Palatina/veterinária
6.
Rev. cuba. estomatol ; 56(3): e1863, jul.-set. 2019. tab, graf
Artigo em Espanhol | LILACS (Américas) | ID: biblio-1093238

RESUMO

RESUMEN Introducción: Los defectos del desarrollo se deben a malformaciones congénitas, deformaciones o disrupciones. Las fisuras de labio y/o paladar son deficiencias estructurales congénitas debidas a la falta de unión entre procesos faciales embrionarios en formación. Objetivo: Evaluar la calidad de las guías de manejo de labio y/o paladar hendido. Métodos: Se realizó un estudio descriptivo. Se evaluaron seis guías de manejo de labio y/o paladar hendido en inglés y español desde 1990 a 2012. La búsqueda se realizó de manera electrónica (nivel global) y manual (nivel local); en la electrónica se consultaron bases de datos como MEDLINE, PubMed, EMBASE y SciELO; para la búsqueda manual se solicitaron por escrito guías a entidades públicas y privadas que manejan pacientes con labio y/o paladar hendido como Hospital Militar, Hospital San José, Operación Sonrisa, y Universidad El Bosque. Estas guías fueron filtradas según título y contenido para su selección. Previo a la evaluación de estas, se realizó una estandarización entre las evaluadoras. Finalmente se evaluó la calidad de las guías según lineamientos del instrumento Agree II. Resultados: La guía clínica de Chile en los dominios 1 y 4 obtuvo 100 por ciento y la guía de la Universidad Santo Tomás en Bucaramanga, presentó menos del 50 por ciento en los seis dominios. Conclusiones: De las guías para el manejo de labio y/o paladar hendido evaluadas, ninguna cumplió con todos los criterios de calidad del instrumento Agree II(AU)


ABSTRACT Introduction: Developmental defects are due to congenital malformations, deformations or disruptions. Lip and/or palate fissures are congenital structural deficiencies caused by lack of conjunction between developing embryonic facial processes. Objective: Evaluate the quality of cleft lip and/or palate management guidelines. Methods: A descriptive study was conducted. Evaluation was performed of six cleft lip and/or palate management guidelines published in English and Spanish from 1990 to 2012. The search was both electronic (global level) and manual (local level). The electronic search included databases such as MEDLINE, PubMed, EMBASE and SciELO, whereas for the manual search written requests for guidelines were sent to public and private organizations that manage cleft lip and/or palate patients, such as the Military Hospital, San José Hospital, Operación Sonrisa (Operation Smile) and El Bosque University. For their selection, the guidelines were filtered by title and content. Before assessing the guidelines, the evaluators standardized them. Finally, evaluation of the guidelines was performed following the instructions in the AGREE II tool. Results: The Chilean clinical guideline obtained 100 percent in domains 1 and 4, whereas the guideline from Saint Thomas University in Bucaramanga obtained less than 50 percent in the six domains. Conclusions: None of the management guidelines for cleft lip and/or palate evaluated met all the quality criteria in the AGREE II tool(AU)


Assuntos
Humanos , Anormalidades Congênitas/epidemiologia , Bases de Dados Bibliográficas , Fissura Palatina/etiologia , Guia de Prática Clínica , Literatura de Revisão como Assunto , Epidemiologia Descritiva , Estudos Transversais
7.
Dent. press endod ; 9(1): 21-25, jan.-mar. 2019. tab, Ilus
Artigo em Português | LILACS (Américas), BBO | ID: biblio-1000053

RESUMO

Objetivo: avaliar, radiograficamente, a prevalência, extensão e severidade da reabsorção dentária em dentes adjacentes à área de fissura após enxerto ósseo alveolar. Métodos: radiografias de 200 indivíduos com fissura unilateral e bilateral, alveolar e palatina, foram analisadas para se investigar a presença de reabsorção dentária relacionada com o enxerto ósseo. No total, 1.315 radiografias foram analisadas (periapical, oclusal e radiografias panorâmicas), obtidas a partir de 200 indivíduos com fissura labiopalatina unilateral e bilateral completa ubmetidos a cirurgia de enxerto, disponíveis a partir dos arquivos da Seção de Radiologia do HRAC-USP. Resultados: entre os 200 indivíduos, 33 tinham reabsorções dentárias externas. Dessas, 15 estavam presentes nas radiografias pré-operatórias e 18 só depois do enxerto ósseo. No geral, 30 reabsorções localizaram- se no terço apical da raiz e 3 no terço cervical; o incisivo central esquerdo foi o mais afetado. Não foram observadas reabsorções dentárias no terço médio da raiz e nenhuma reabsorção afetou mais de um terço. Não existiu diferença estatisticamente significativa entre a idade do paciente durante a cirurgia de enxerto ósseo e a presença de reabsorção dentária externa. Conclusões: a prevalência da reabsorção dentária em dentes adjacentes à área da fissura em indivíduos submetidos a enxerto ósseo foi baixa (16,5%). O terço apical da raiz foi o local mais frequente de reabsorção radicular externa, e não houve reabsorções afetando mais de um terço da raiz. (AU)


Assuntos
Humanos , Masculino , Feminino , Perda do Osso Alveolar/diagnóstico por imagem , Fenda Labial/cirurgia , Fissura Palatina/cirurgia , Enxerto de Osso Alveolar/métodos , Reabsorção de Dente , Distribuição de Qui-Quadrado
8.
Rev. Odontol. Araçatuba (Impr.) ; 40(2): 33-37, maio/ago. 2019. ilus
Artigo em Português | LILACS (Américas), BBO | ID: biblio-1006546

RESUMO

Este trabalho tem como objetivo apresentar o protocolo de reabilitação por meio de prótese obturadora palatina, preconizado pela Universidade Federal de Alfenas (UNIFAL-MG), através do relato de um caso clínico de paciente maxilectomizada. A paciente apresentava comunicação buco-sinu-nasal e ausência parcial de dentes maxilares e mandibulares. Foi realizada moldagem de estudo, obtenção do modelo de trabalho, delineamento, planejamento das armações metálicas, preparos específicos, moldagem de trabalho e obtenção das armações; que foram provadas, os registros intermaxilares tomados, modelos montados em articulador e selecionados os dentes artificiais. Foi realizada prova estética e funcional com ênfase na pronúncia em função da existência de comunicação. Foi selecionada a cor da base e as próteses foram instaladas. Conclui-se que a prótese obturadora constitui um método satisfatório para a reabilitação de defeitos palatinos, pois proporcionou o vedamento da comunicação, proteção aos tecidos da área afetada, melhoras funcionais e estéticas, favorecendo a reintegração da paciente ao convívio social(AU)


The purpose of this study was the proposal of the clinical therapy and treatment of prosthetic patient under the Federal University of Alfenas (UNIFAL-MG), using a clinical report of a maxilectomized patient. The patient presented buco-sinu-nasal communication and partial absence of maxillary and mandibular teeth. It was made the study impression, obtaining the working model, designing, planning of metal frames, specific preparation, working impression and obtaining frames were carried out; which were tested, taken intermaxillary records, articulator mounted models and selected artificial teeth. Aesthetic and functional tests were performed with emphasis on pronunciation as a function of the existence of communication. The color of the base was selected and the prostheses were installed. It was concluded that the obturator prosthesis is a satisfactory method for the rehabilitation of palatal defects, since it provided the seal of communication, protection to the tissues of the affected area, functional and aesthetic improvements, favoring the reintegration of the patient to social interaction(AU)


Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Obturadores Palatinos , Prótese Parcial Removível , Palato , Fissura Palatina , Prótese Dentária , Reabilitação Bucal
9.
Rev. salud pública ; 21(2): 209-216, ene.-abr. 2019. tab
Artigo em Português | LILACS (Américas) | ID: biblio-1094392

RESUMO

RESUMO Objetivo Descrever o perfil clínico-epidemiológico dos portadores de fissuras orofaciais, atendidos em um Centro de Referência do Nordeste do Brasil. Métodos Estudo descritivo, baseado em dados secundários de prontuários médicos. Informações sociodemográficas do portador e da mãe, uso de medicamentos durante a gestação, aspectos clínicos e cirúrgicos relacionados às fissuras, histórico familiar da malformação e consanguinidade dos pais foram investigadas. Os dados foram analisados descritivamente, com o uso do programa estatístico SPSS (Statistical Package for te Social Sciences), no qual foram obtidas medidas de frequência, média e desvio padrão. Resultados 51,1% dos portadores de fissuras orofaciais eram do sexo feminino, 46,2% menores de um ano e 54,4% eram procedentes na zona urbana. A maioria das mães encontrava-se na faixa etária entre 16 a 25 anos durante o período gestacional e relatou uso de medicação em 59,2% dos casos. A fissura transforame incisivo foi a mais diagnosticada (34,4%). No momento de cadastro ao Centro de Reabilitação de Anomalias Craniofaciais, 90,5% dos indivíduos ainda não haviam realizado tratamento cirúrgico. História familiar de fissura foi observada em 29,8% dos casos estudados e em apenas 7,1% desses foi reportado consanguinidade entre os pais. Conclusão Os fatores socioeconômicos e genéticos podem exercer influência sobre o desenvolvimento de fissuras orofaciais, o que exige uma maior atenção governamental assim como novos estudos para melhor investigação.(AU)


ABSTRACT Objective To describe the clinical-epidemiological profile of patients with orofacial fissures treated at a reference center from northeast Brazil. Materials and Methods Descriptive study, based on secondary data obtained from medical records. Sociodemographic information of patients and their mothers, use of medication during pregnancy, clinical and surgical aspects related to fissures, family history of malformation, and consanguinity among the parents were investigated. Data were analyzed descriptively using the SPSS (Statistical Package for Social Sciences) statistical program to obtain frequency, mean and standard deviation measures. Results 51.1% of the patients with orofacial fissures were female, 46.2% were under one year of age and 54.4% lived in urban areas. The majority of mothers were between the ages of 16 and 25 during the gestational period, and 59.2% reported the use of medication. Cleft lip and palate were the most prevalent types of fissures (34.4%). On admission to the Craniofacial Anomaly Rehabilitation Center, 90.5% of the individuals had not yet undergone surgical treatment. Family history of fissure was found in 29.8% of the cases studied, but inbreeding among parents was reported in only 7.1% of them. Conclusion Socioeconomic and genetic factors can influence the development of orofacial fissures; this requires greater governmental attention as well as new studies for better investigation.(AU)


RESUMEN Objetivo Describir el perfil clínico-epidemiológico de los portadores de fisuras orofaciales, atendidos en un Centro de Referencia del Nordeste de Brasil. Métodos Estudio descriptivo, basado en datos secundarios de pronóstico médicos. La información sociodemográfica del portador y de la madre, uso de medicamentos durante la gestación, aspectos clínicos y quirúrgicos relacionados con las fisuras, historia familiar de la malformación y consanguinidad de los padres fueron investigadas. Los datos fueron analizados descriptivamente, con el uso del programa estadístico SPSS (Statistical Package for te Social Sciences), en el cual se obtuvieron medidas de frecuencia, media y desviación estándar. Resultados 51,1% de los portadores de fisuras orofaciales eran del sexo femenino, 46,2% menores de un año y 54,4% eran procedentes en la zona urbana. La mayoría de las madres se encontraban en el grupo de edad entre 16 a 25 años durante el período gestacional y relató uso de medicación en el 59,2% de los casos. La fisura transforam incisiva fue la más diagnosticada (34,4%). En el momento de la inscripción en el Centro de Rehabilitación de Anomalías Craneofaciales, el 90.5% de los individuos aún no se habían sometido a tratamiento quirúrgico. La historia familiar de fisura fue observada en el 29,8% de los casos estudiados y en apenas el 7,1% de esos fue reportado consanguinidad entre los padres. Conclusión Los factores socioeconómicos y genéticos pueden influir en el desarrollo de fisuras orofaciales, lo que exige una mayor atención gubernamental así como nuevos estudios para una mejor investigación.


Assuntos
Humanos , Perfil de Saúde , Fenda Labial/epidemiologia , Fissura Palatina/epidemiologia , Estudos Epidemiológicos , Epidemiologia Descritiva , Estudo Observacional
10.
Rev. bras. cir. plást ; 34(1): 94-100, jan.-mar. 2019. ilus, tab
Artigo em Inglês, Português | LILACS (Américas) | ID: biblio-994554

RESUMO

Introdução: As fissuras labiopalatinas são as malformações congênitas mais comuns dentre as que ocorrem na cabeça e pescoço, e se devem à falha de fusão dos processos faciais embrionários durante as primeiras 12 semanas de gestação. Sua apresentação fenotípica é variada e com diferentes níveis de complexidade. O objetivo é determinar o perfil epidemiológico dos pacientes portadores de fissuras labiopalatinas atendidos no Hospital Regional da Asa Norte (HRAN) quanto a sexo, tipo de fissura, lateralidade, idade, presença de síndromes associadas e procedimentos cirúrgicos corretivos. Métodos: Trata-se de um estudo descritivo retrospectivo no qual foram analisados 322 prontuários de pacientes atendidos pela equipe do HRAN no período de agosto de 2013 a julho de 2017. Os dados colhidos foram lançados em planilha Excel e submetidos à análise estatística. O trabalho foi aprovado pelo Comitê de Ética e Pesquisa. Resultados: Dos 322 pacientes atendidos no serviço, 169 eram do sexo masculino (52,48%). O tipo de fissura mais frequente foi a transforâmica (65,25%). Com relação à lateralidade, observou-se maior predomínio da fissura à esquerda (20,50%). Apenas 19% dos pacientes possuem malformações associadas. A queiloplastia foi a correção cirúrgica mais realizada pelo serviço (54%). A idade dos pacientes variou de 1 ano até 53 anos, com mediana de 1,87 anos. Conclusão: O estudo contribuiu com informações importantes para a sociedade, governo e profissionais envolvidos no tratamento. Em consonância com a literatura, observou-se que a fissura mais prevalente foi a transforâmica unilateral esquerda e a cirurgia mais realizada foi a queiloplastia.


Introduction: Cleft lip and palate, the most common congenital malformations of the head and neck, result from fusion failure of embryonic facial processes during the first 12 weeks of pregnancy. Their phenotypic presentation varies and involves different levels of complexity. The objective is to determine the epidemiological profile of patients with cleft lip and palate treated at the Hospital Regional da Asa Norte regarding sex, cleft type, laterality, age, presence of associated syndromes, and corrective surgical procedures. Methods: This was a retrospective descriptive study of 322 medical records of patients treated by the HRAN team from August 2013 to July 2017. The data collected were entered into an Excel spreadsheet and submitted to statistical analysis. The study received ethical approval. Results: Of the 322 patients enrolled in the service, 169 were male (52.48%). The most frequent type of cleft was the trans-foramen (65.25%). With regard to laterality, a higher prevalence of cleft was observed on the left (20.50%). Only 19% of the patients had associated malformations. Cheiloplasty was the most frequent surgical correction performed by service (54%). The age of the patients was 1­53 years (median, 1.87 years). Conclusion: The study contributes information important to society, government, and treatment professionals. In line with the literature, the more prevalent cleft was unilateral left trans-foramen and the most frequent surgery was cheiloplasty.


Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Pacientes/estatística & dados numéricos , Anormalidades Congênitas , Fissuras Dentárias/congênito , Fenda Labial , Fissura Palatina/cirurgia , Fissura Palatina/complicações , Fissura Palatina/genética , Procedimentos Cirúrgicos Reconstrutivos/métodos
11.
Pesqui. bras. odontopediatria clín. integr ; 19(1): 4642, 01 Fevereiro 2019. tab, ilus, graf
Artigo em Inglês | LILACS (Américas), BBO | ID: biblio-998043

RESUMO

Objective: To evaluate the craniofacial morphology of Japanese patients with unilateral cleft lip and palate and to evaluate the multiple congenital factors that affects craniofacial morphology in unilateral cleft lip and palate patients. Material and Methods: Lateral cephalograms of 140 subjects with unilateral cleft lip and palate were taken before any orthodontic treatment and alveolar bone graft. Subjects mean age was 6.85 ±1.56 years. Primary surgeries performed by surgeons from Hokkaido University Hospital. The craniofacial morphology of the 140 subjects was assessed by angular and linear cephalometric measurements. Gender, side of cleft, complete/incomplete type of cleft, presence/absence of lateral incisor in the affected side, family history of cleft and family history of skeletal Class III was chosen as congenital factors. To compare the assessments using congenital factors affecting craniofacial morphology in the unilateral cleft lip and palate subjects, angular and linear cephalometric measured values from each individual subject (control group) were converted into Z scores in relation to the means and standard deviation of the two parameters. Results: Twelve out of 13 craniofacial morphology outcomes were insignificant in 5 out of 6 dependent variables. Only 1 dependent variable showed 3/13 significant differences. Conclusion: Current study revealed the evidence that there were almost no significant differences in the craniofacial morphology outcome among various congenital factors. This will provide base line information and help determine the effectiveness of such factors.


Assuntos
Anormalidades Congênitas , Fenda Labial , Fissura Palatina , Japão , Anormalidades da Boca , Aparelhos Ortodônticos , Registros Médicos , Cefalometria/métodos , Estudos Retrospectivos , Interpretação Estatística de Dados , Estudo de Avaliação , Enxerto de Osso Alveolar
12.
Pesqui. bras. odontopediatria clín. integr ; 19(1): 4680, 01 Fevereiro 2019. tab, graf
Artigo em Inglês | LILACS (Américas), BBO | ID: biblio-998249

RESUMO

Objective: To evaluate and compare the effect of each congenital and postnatal treatment factors in treatment outcome based on dental arch relationship (DAR) of four different populations at a time using GOSLON yardstick. Material and Methods: 432 unilateral cleft lip and palate subjects (Japanese, Malay ethnic group, Bangladeshi and Pakistani populations) age 5 to 12 years were taken before orthodontic treatment and alveolar bone grafting. The DAR was assessed by GOSLON Yardstick. Independent t-test was performed to compare the GOSLON score for each factors. A multiple comparison (Anova) was also conducted between the GOSLON score of four different populations. The significance level was set at p<0.05. Results: Statistically no significant different was found among the congenital factors. However, the family history of Class III malocclusion showed most likely to associate with, though there was no significant difference (p=0.069). Significant difference revealed between two techniques of cheiloplasty in both Malay ethnic group and Pakistani population (p=0.038 and p=0.000, respectively). Gender and Techniques of palatoplasty also showed significant difference in Pakistani population (p=0.026 and p=0.000, respectively). Japanese and Bangladeshi population showed no significant differences. Also no significant differences found between the GOSLON score and different countries. Conclusion: The treatment outcome based on DAR significantly varies in individual population [Malay ethnic group (cheiloplasty); Pakistan (gender, cheiloplasty and palatoplasty)].


Assuntos
Humanos , Masculino , Pré-Escolar , Criança , Anormalidades Congênitas , Criança , Fissura Palatina , Má Oclusão , Análise de Variância , Japão
13.
Pesqui. bras. odontopediatria clín. integr ; 19(1): 4695, 01 Fevereiro 2019. maps, tab
Artigo em Inglês | LILACS (Américas), BBO | ID: biblio-998271

RESUMO

Objective: To evaluate the prevalence, cleft types distribution and etiological risk factors among newly born babies with cleft lip and/or palate (CL±P) in four governorate of the Arab Republic of Egypt, beginning the 1st of January 2013 till the 31st of December 2013. Material and Methods: Total 237,783 newly born babies from Cairo (162174), Aswan (42880), Luxor (32729), and New Valley (877) governorate in the Arab Republic of Egypt were included in this study. Incidence of CL±P babies per 1000 births was calculated in each district for the four studied governorates. Percentage distribution of cleft types within each governorate. Chi-square test was used for determining significance of difference of incidence and percentages within and between the governorates. Results: The mean prevalence value of CL±P in the four Egyptian studied governorates was 0.40/1000. The highest percentage of cleft type was cleft lip and palate followed by cleft lip and isolated cleft palate. The highest etiological risk factor was maternal passive smoking in the four studied governorates followed by consanguineous marriage and medicine intake during pregnancy. Conclusion: These data provided a picture of the prevalence of CL±P in four different governorate of Egypt and also provided a useful reference for cleft types distribution and etiological risk factors of CL±P data in Egypt and internationally.


Assuntos
Humanos , Recém-Nascido , Recém-Nascido , Fatores de Risco , Fenda Labial , Fissura Palatina , Anormalidades da Boca/patologia , Distribuição de Qui-Quadrado , Epidemiologia , Prevalência , Egito
14.
Artigo em Inglês | WPRIM (Pacífico Ocidental) | ID: wprim-762779

RESUMO

Craniofacial cleft is a rare disease, and has multiple variations with a wide spectrum of severity. Among several classification systems of craniofacial clefts, the Tessier classification is the most widely used because of its simplicity and treatment-oriented approach. We report the case of a Tessier number 3 cleft with wide soft tissue and skeletal defect that resulted in direct communication among the orbital, maxillary sinus, nasal, and oral cavities. We performed soft tissue reconstruction using the straight-line advanced release technique that was devised for unilateral cleft lip repair. The extension of the lateral mucosal and medial mucosal flaps, the turn over flap from the outward turning lower eyelid, and wide dissection around the orbicularis oris muscle enabled successful soft tissue reconstruction without complications. Through this case, we have proved that the straight-line advanced release technique can be applied to severe craniofacial cleft repair as well as unilateral cleft lip repair.


Assuntos
Classificação , Fenda Labial , Fissura Palatina , Anormalidades Congênitas , Anormalidades Craniofaciais , Pálpebras , Seio Maxilar , Órbita , Doenças Raras , Procedimentos Cirúrgicos Reconstrutivos
15.
Artigo em Inglês | WPRIM (Pacífico Ocidental) | ID: wprim-766353

RESUMO

This study evaluated and compared the donor site morbidity following minimally invasive and conventional open harvesting of iliac bone for secondary alveolar bone grafting in cleft palate patients. A thorough electronic search of PubMed, Google Scholar, EMBASE, and an institutional library and manual search of various journals was done; Inclusion criteria: 1) full-text articles using a minimally invasive or conventional open harvesting technique for iliac bone for secondary alveolar grafting in cleft palate patients and 2) articles published between January 1, 2001 and June 30, 2017 and Exclusion criteria: 1) articles published in languages other than English, 2) case reports, case series, animal studies, in vitro studies, and letters to the editor, and 3) full-text article unavailable even after writing to the authors. Preliminary screening of 274 studies excluded 223 studies for not meeting the eligibility criteria. Of the remaining 51 studies, 19 were removed for being duplicates. Of the remaining 32 studies, 15 were excluded after reading the abstract. Of the 17 studies that were left, 2 were excluded because they were in a language other than English, and 2 were excluded because the study group did not mention cleft palate patients. Thus, 13 studies providing results for a total of 654 patients were included in this qualitative synthesis. Minimally invasive bone graft harvest techniques are better than the conventional open iliac bone harvest method because they offer shorter operative time, decreased requirement for pain medications, less pain on discharge, and a shorter hospital stay.


Assuntos
Enxerto de Osso Alveolar , Animais , Transplante Ósseo , Fissura Palatina , Humanos , Técnicas In Vitro , Tempo de Internação , Programas de Rastreamento , Métodos , Duração da Cirurgia , Doadores de Tecidos , Transplantes , Redação
16.
Artigo em Inglês | WPRIM (Pacífico Ocidental) | ID: wprim-764510

RESUMO

SHORT syndrome is an extremely rare congenital condition due to a chromosomal mutation of the PIK3R1 gene found at 5q13.1. SHORT is a mnemonic representing six manifestations of the syndrome: (S) short stature, (H) hyperextensibility of joints and/or inguinal hernia, (O) ocular depression, (R) Rieger anomaly, and (T) teething delay. Other key aspects of this syndrome not found in the mnemonic include lipodystrophy, triangular face with dimpled chin (progeroid facies, commonly referred to as facial gestalt), hearing loss, vision loss, insulin resistance, and intrauterine growth restriction (IUGR). 3q duplication syndrome is rare syndrome that occurs due to a gain of function mutation found at 3q25.31-33 that presents with a wide array of manifestations including internal organ defects, genitourinary malformations, hand and foot deformities, and mental disability. We present a case of a 2 year and 3 month old male with SHORT syndrome and concurrent 3q duplication syndrome. The patient presented at birth with many of the common manifestations of SHORT syndrome such as bossing of frontal bone of skull, triangular shaped face, lipodystrophy, micrognathia, sunken eyes, and thin, wrinkled skin (progeroid appearance). Additionally, he presented with findings associated with 3q duplication syndrome such as cleft palate and cryptorchidism. Although there is no specific treatment for these conditions, pediatricians should focus on referring patients to various specialists in order to treat each individual manifestation.


Assuntos
Queixo , Fissura Palatina , Criptorquidismo , Depressão , Facies , Retardo do Crescimento Fetal , Deformidades do Pé , Osso Frontal , Mãos , Perda Auditiva , Hérnia Inguinal , Humanos , Resistência à Insulina , Articulações , Lipodistrofia , Masculino , Micrognatismo , Parto , Pele , Crânio , Especialização , Dente , Erupção Dentária
17.
Artigo em Coreano | WPRIM (Pacífico Ocidental) | ID: wprim-719555

RESUMO

Patients with cleft lip and palate have several problems such as oro-nasal communication, dental cross-bite caused by the insufficient growth of maxilla, poor pronunciation and esthetic problem. Removable denture with maxillary double crown near cleft palate and with clasp in the posterior teeth was used to solve the problems of the patient with cleft lip and plate. Double crowns make up for the insufficient mucosal support caused by the mucosa and alveolar bone loss in cleft lip and palate. Double crowns also allow easy repair of denture in case of abutment teeth extraction. In this case, 55-year-old female patient had bilateral cleft lip and palate and few remaining teeth on anterior maxilla. Prosthetic treatment was done for patient with bilateral cleft lip and palate to close oro-nasal communication using maxillary double crown and clasp retained removable denture. As a result, oro-nasal communication was effectively closed and the cross-bite was easily corrected by double crown and clasp retained denture. In addition, pronunciation and appearance were also improved.


Assuntos
Perda do Osso Alveolar , Fenda Labial , Fissura Palatina , Coroas , Dentaduras , Feminino , Humanos , Maxila , Pessoa de Meia-Idade , Membrana Mucosa , Palato , Dente
18.
Ultrasonography ; : 13-24, 2019.
Artigo em Inglês | WPRIM (Pacífico Ocidental) | ID: wprim-731045

RESUMO

Craniofacial abnormalities are common. It is important to examine the fetal face and skull Epub ahead of print during prenatal ultrasound examinations because abnormalities of these structures may indicate the presence of other, more subtle anomalies, syndromes, chromosomal abnormalities, or even rarer conditions, such as infections or metabolic disorders. The prenatal diagnosis of craniofacial abnormalities remains difficult, especially in the first trimester. A systematic approach to the fetal skull and face can increase the detection rate. When an abnormality is found, it is important to perform a detailed scan to determine its severity and search for additional abnormalities. The use of 3-/4-dimensional ultrasound may be useful in the assessment of cleft palate and craniosynostosis. Fetal magnetic resonance imaging can facilitate the evaluation of the palate, micrognathia, cranial sutures, brain, and other fetal structures. Invasive prenatal diagnostic techniques are indicated to exclude chromosomal abnormalities. Molecular analysis for some syndromes is feasible if the family history is suggestive.


Assuntos
Encéfalo , Aberrações Cromossômicas , Fissura Palatina , Suturas Cranianas , Anormalidades Craniofaciais , Craniossinostoses , Feminino , Feto , Humanos , Imagem por Ressonância Magnética , Micrognatismo , Palato , Gravidez , Primeiro Trimestre da Gravidez , Diagnóstico Pré-Natal , Crânio , Ultrassonografia , Ultrassonografia Pré-Natal
19.
Artigo em Chinês | WPRIM (Pacífico Ocidental) | ID: wprim-819038

RESUMO

OBJECTIVE@#To analyze clinical and genetic features of a family affected with Van der Woude syndrome.@*METHODS@#The umbilical cord blood of the proband and the peripheral blood of the parents were used for the whole exon sequencing to find the candidate gene.Peripheral blood of 9 members of the family were collected for Sanger sequencing verification, bioinformatics analysis and genotype-phenotype correlation analysis.@*RESULTS@#The proband was diagnosed with cleft lip and palate by ultrasound. His father and grandmother had hollow lower lip and all other family members did not have the similar phenotype. A missense c.263A>G (p.N88S) mutation was found in exon 4 of gene in the proband, his father and his grandmother.The mutation was not found in other family members.@*CONCLUSIONS@#A missense c.263A>G (p.N88S) mutation in gene probably underlies the pathogenesis of Van der Woude syndrome in the family and the mutation has been firstly discovered in China.


Assuntos
Anormalidades Múltiplas , Genética , China , Fenda Labial , Diagnóstico por Imagem , Genética , Fissura Palatina , Diagnóstico por Imagem , Genética , Cistos , Genética , Feminino , Humanos , Fatores Reguladores de Interferon , Genética , Lábio , Anormalidades Congênitas , Masculino , Mutação , Linhagem , Ultrassonografia
20.
Artigo em Chinês | WPRIM (Pacífico Ocidental) | ID: wprim-781366

RESUMO

OBJECTIVE@#To explore the prognostic factors affecting the primary surgical management of aged patients with cleft palate.@*METHODS@#This study reviewed aged patients with cleft palate who received Furlow palatoplasty (surgical age≥5 years) at the cleft center at West China Hospital of Stomatology from 2009 to 2014. The study retrieved intraoperative mea-surements, including velar length, pharyngeal depth, cleft width, maxillary width, cleft palate index, and palatopharyngeal ratio. Speech evaluation results at follow-up at least a year after surgery were also obtained. Logistic regression and retrospec-tive analyses were performed to identify correlative prognostic factors.@*RESULTS@#One hundred and thirty-one patients were included (70 males and 61 females). Dichotomy logistic regression analysis revealed that pharyngeal depth was the only mea-surement considerably associated with postoperative velopharyngeal function. Pharyngeal depth deeper than 16 mm indicated high risk of postoperative velopharyngeal insufficiency.@*CONCLUSIONS@#Pharyn-geal depth is a significant prognostic factor for the primary surgical management of aged patients with cleft palate. Pharyn-goplasty might be considered when planning the primary management of aged patients.


Assuntos
Pré-Escolar , China , Fissura Palatina , Feminino , Humanos , Masculino , Palato Mole , Faringe , Estudos Retrospectivos , Resultado do Tratamento , Insuficiência Velofaríngea
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