ABSTRACT
PURPOSE: Children with cleft lip and/or palate may have associated malformations, whether or not they are included in a syndromic form. This study's purpose was to provide a better understanding of the epidemiology and distribution of malformations and syndromes associated with these clefts. METHODS: Retrospective study of 324 patients with cleft lip or palate born between 1994 and 2011. The associated malformations were diagnosed during the 1st year of life. RESULTS: Cleft lip or labioalveolar clefts were less frequently associated with other malformations than cleft palate. These nonsyndromic malformations preferentially affected the urogenital and renal system in case of cleft palate (48.5%) and the cardiovascular system for clefts with a lip defect (30.5%). The syndromic forms were rare in the cleft lip and labioalveolar clefts (3.47%). In contrast, cleft palate appeared much more frequently included in a syndromic form, with 52 children out of 151 (34.4%). The Pierre-Robin sequence was the most frequent syndrome with more than 25% of the cleft palate population. The defect of the palate was associated with a higher rate of other malformations or syndromes (36.51% vs 29.9% for the entire population with a cleft) (n=324) (P<0.001). CONCLUSIONS: The distribution of malformations appears to be linked to the type of cleft. These findings underline the importance of conducting a systematic neonatal malformation workup in children born with clefts in order to diagnose abnormalities and organize effective and consistent management.
Subject(s)
Abnormalities, Multiple/epidemiology , Cleft Lip/epidemiology , Cleft Palate/epidemiology , Female , Humans , Infant , Infant, Newborn , Male , Retrospective StudiesABSTRACT
OBJECTIVE: Description of two atypical clinical cases of myasthenia gravis with pharyngeal dysphagia. CASES REPORTS: A retrospective study from two cases report of myasthenia gravis with pharyngeal dysphagia. CONCLUSION: The decrease of the laryngeal ascent and the desynchronization of the upper oesophageal sphincter opening appears as the main physiopathological mechanisms. The aspirations are frequent. In front of pharyngeal dysphagia, myasthenia have to be evocated. The alteration of the pharyngeal swallowing can be inaugural in this disease. The cholinesterase inhibitors can help for the diagnostic.
Subject(s)
Deglutition Disorders/etiology , Myasthenia Gravis/complications , Adult , Aged , Cineradiography , Deglutition Disorders/diagnosis , Deglutition Disorders/therapy , Female , Humans , Male , Manometry , Myasthenia Gravis/diagnosis , Severity of Illness IndexABSTRACT
We present a case of severe maxillary hypoplasia in a 16 years old cleft patient treated by distraction osteogenesis maxillary advancement. Initial evaluation showed vertical and antero-posterior maxillary deficiencies, and a Class III malocclusion. Two intraoral distractors (Zurich Pediatric Maxillary Distractor, KLS Martin, Tuttlingen, Germany) were placed in a high Le Fort I osteotomy. An initial advancement of 11 mm was obtained, but the resulting occlusion was unsatisfactory (end-to-end occlusion). The consolidation period was reduced to 3 weeks to allow the mechanical manipulation of the newly formed bone with Class III elastics. An additional advancement of 3 mm, caused by elastic orthodontic traction produced both normal skeletal relationship and satisfactory occlusion. This observation shows that it is possible to carry on a skeletal maxillary displacement by interdental elastics before the complete fusion of the callus. After 12 months of postoperative follow-up no osseous relapse could be detected and the occlusal result was stable.
Subject(s)
Cleft Palate/complications , Malocclusion, Angle Class III/therapy , Maxilla/surgery , Micrognathism/surgery , Oral Surgical Procedures/methods , Osteogenesis, Distraction , Adolescent , Extraoral Traction Appliances , Female , Humans , Malocclusion, Angle Class III/etiology , Malocclusion, Angle Class III/surgery , Micrognathism/complications , Micrognathism/etiology , Osteotomy, Le Fort/methods , Treatment OutcomeABSTRACT
The radiological study of the mechanism has helped to define the physiology of the oral and pharyngeal phase of deglutition. Being a dynamic examination, it is part of the work-up in swallowing disorders, such as cervical dysphagia and inhalation episodes. Among the various techniques available, videofluoroscopy remains the examination of choice.
