Midline cleft of the upper lip associated with a microform unilateral cleft and a proboscis-like structure: a case report.

A midline or median cleft lip is rare, and a midline cleft associated with a unilateral cleft and a proboscis-like structure is rarer still. We present a case managed at our center in which a 5-year-old male had a median cleft of the upper lip with an associated 'proboscis' and a microform unilateral cleft lip.

Factors Associated with Deterioration in Quality of Life of Subjects after Maxillofacial Fractures - A Prospective Study.

Introduction: Maxillofacial fractures (MFs) are quite common and are managed by oral and maxillofacial surgeons. Despite these interventions, a pre-traumatic facial profile is often not achieved with consequent social and psychologic consequences. Materials and Methods: Patients with fractures to the middle and lower third of the face that presented within 48 hours and healthy controls (subjects without facial fracture) that were sex- and age-matched with the fracture patients were recruited into the study. World Health Organization Quality of Life - Brief Version (WHOQOL-BREF) questionnaire was used to compare the Quality of Life (QoL) values according to age, gender, educational status, employment status, marital status, site of trauma and type of fracture. Results: Only the age of subjects was associated with deterioration in QoL after MF while other variables were not. Discussion: Increasing age of the patients was associated with higher QoL possibly because those with age <30 years are single and unemployed and may have fear and anxiety that the fracture could affect their chances of getting married or being employed, causing reduced QoL. Psychosocial rehabilitation is very important in patients with MF, especially for the young age group.

Qualitative Assessment of Surgical Repair of Three Types of Unilateral Cleft Lip

Abstract Objective: To assess the effect of the three types of unilateral cleft lip (UCL) [cleft lip only, cleft lip and alveolus, and cleft lip alveolus and palate] on the outcome of the repair. Material and Methods: This study was a case series of effect of types of UCL on the outcome of the repair. Fifteen subjects each were in three UCL phenotypes groups. Evaluation of the scar, lip, and nose was done qualitatively by both parents/guardians and professionals using a modified form of the criteria described by Christofides et al. (2006). Results: In the assessment of the surgical scar, the parents found a difference between the three types of cleft in terms of texture, shape, and width of the scar and presence of columella deviation. The professional assessors, however, only found the three types of cleft to be different in the presence of alar flattening. Conclusion: Differences truly exist in the outcome of surgical repair of the three types of unilateral cleft lip, especially in the aesthetics of the nose and in the width and shape of the residual lip scar. Thus, it is important to consider this in the assessment of UCL repair because putting the subtypes together might have a negative impact on the assessment.

Effect of Cleft Types on Outcome of Unilateral Cleft Lip Repair.

INTRODUCTION: It is generally assumed that the major phenotypes of unilateral cleft lip (UCL) represent its extent of severity. There are a few studies on this, but objectivity has been lacking. It was the aim of this study to assess the effect of different phenotypes of UCL on the outcome of surgical repair. METHODOLOGY: This study was a case series of the effect of phenotypes of cleft on the outcome of repair of UCL. Fifteen subjects each were in three UCL phenotype groups. Surgical outcome was assessed quantitatively with anthropometric measurements recorded from a full frontal face photograph of subjects. The analysis was done using Student's t-test and one-way ANOVA at P = 0.05. RESULTS: The mean values of the preoperative horizontal and vertical lip height, and nasal width on the cleft side in the cleft lip (CL) group were closest to those of the noncleft side and control. The postoperative mean values of the horizontal and vertical lip height, and nasal width on the cleft side in the CL group were closest to those of the noncleft side and control, while those of the CL, alveolus and palate group were farthest from those of the noncleft side and the control. DISCUSSION: The different phenotypes of UCL have different degrees of tissue distortion and deficiencies. CL group had its measurements closest to that of the noncleft sides and control, suggesting that it has the least distortion. CONCLUSION: The comparison between the three groups did not reveal any difference, suggesting that the skill of the surgeon and the selection of a well proven technique are more important factors in the outcome of repair of unilateral cleft lip.

Comparison of operative 'difficulty' with post-operative sequelae in lower third molar surgery

Background: The outcome of studies on the effect of patients' factors, dental factors and operative factors on postoperative sequelae following surgical extraction of lower third molar have been unequivocal. Objective: To determine the effect of surgical difficulty (using Pederson's scale), Body Mass Index (BMI) and operative time on the extent of post-operative pain, swelling and trismus following third molar surgery. Methods: The study was a prospective analytical study of the effect of surgical difficulty, BMI, age and operative time ­ Total Intervention Time (TIT) - on the extent of post-operative pain, swelling and trismus. Eighty-four subjects with surgical extraction of impacted lower third molar were studied. All the subjects had a standard Peri-apical radiograph through which the difficulty index was calculated for all third molars using the Pederson scale. Anthropometric vertical and horizontal facial measurements and pain measurement were taken pre-operatively and post-operatively on days 1, 3, 5 and 7. Results: Of the 84 subjects, 16 (19%) were males, while 68 (81%) were females in the ratio of 1:4.2. BMI showed a positive correlation with all the three variables and was significant for swelling on the post-operative days assessed while TIT showed a negative correlation with most of the variables and was significant for trismus. Conclusion: This study showed that age and operative time might have an inverse relationship with the common post-operative complications after lower third molar surgery and BMI might influence the extent of these complications

Comparison of professional and laypeople evaluation of nasolabial esthetics following unilateral cleft lip repair.

OBJECTIVES: The objective is to know the extent of agreement of clinicians' perception of nasolabial esthetic compared to that of laypeople (parents). MATERIALS AND METHODS: This was a prospective study of comparison of clinician's perception of nasolabial esthetics with that of laypeople following surgical repair of UCL. Participants were recruited from the Cleft Clinic of the Lagos University Teaching Hospital, and surgical repair of the cleft was performed under general anesthesia. Surgical evaluation was done through direct clinical evaluation using the modified form of the Christofides' criteria by laypeople and professionals. RESULTS: A total of 48 cleft participants were enrolled in the study. The evaluation of the lip by both the laypeople and professionals was similar, and there was no difference (0.588) in their rating. However, there was a significant disagreement (P = 0.001) between them in the nose assessment. CONCLUSION: Neither the solitary opinion of the professionals nor that of the laypeople is satisfactory in the evaluation of facial esthetics; both are equally important, especially in the assessment of nasal esthetics. However, opinion of either the laypeople or the professional might be enough in the evaluation of the lip esthetics.