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Jafar B, Alemayehu H, Bhat R, Zayek M. Multiple Intestinal Anomalies in a Newborn with 22q11.2 Microdeletion Syndrome: A Case Report and Literature Review. J Pediatr Genet 2024; 13:237-244. [PMID: 39086451 PMCID: PMC11288709 DOI: 10.1055/s-0042-1750748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Accepted: 05/11/2022] [Indexed: 10/16/2022]
Abstract
Although 40 years have passed since the first case of DiGeorge's syndrome was described, and the knowledge about this disorder has steadily increased since that time, 22q11.2 deletion syndrome (DS) remains a challenging diagnosis because its clinical presentation varies widely. We describe an infant with 22q11.2 DS who presented with annular pancreas, anorectal malformation, Morgagni-type congenital diaphragmatic hernia, and ventricular septal defect. This constellation of anomalies has never been described in DiGeorge's syndrome. Here, we provide a case presentation and a thorough review of the literature.
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Affiliation(s)
- Bedour Jafar
- Department of Pediatrics, University of South Alabama, Mobile, Alabama, United States
| | - Hanna Alemayehu
- Division of Pediatric Surgery, Department of Surgery, University of South Alabama, Mobile, Alabama, United States
| | - Ramachandra Bhat
- Division of Neonatology, Department of Pediatrics, Louisiana State University Health Science Center, Shreveport, Louisiana, United States
| | - Michael Zayek
- Division of Neonatology, Department of Pediatrics, University of South Alabama, Mobile, Alabama, United States
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Alforaidi S, Zreaqat M, Hassan R. Dental Arch Relationships of Saudi Children with Unilateral Cleft Lip and Palate. J Contemp Dent Pract 2023; 24:987-990. [PMID: 38317397 DOI: 10.5005/jp-journals-10024-3606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2024]
Abstract
AIM To determine dental arch relationships of Saudi children born with nonsyndromic complete unilateral cleft lip and palate (UCLP). MATERIAL AND METHODS This is a retrospective cohort study that comprised dental study models of 74 UCLP Saudi children aged 8-10 years who were recruited from 14 referral cleft centers. All participants had their cleft lip and palate repaired with no history of alveolar bone graft or any orthodontic treatment. Dental arch relationships of UCLP patients were assessed using the Great Ormond Street, London, and Oslo (GOSLON) Yardstick-a clinical tool that categorizes dental relationships of UCLP children into five discrete grades from I to V. The reliability of the rating was assessed with weighted kappa (κ) statistics. RESULTS Three children (4.1%) had excellent surgical outcomes (grade I), 18 children (24.3%) filled into grade II (good outcome), 22 subjects (29.7%) had grade III (fair outcome), 27 children (36.5%) had grade IV (poor outcome), and 4 subjects (5.4%) were ranked as having very poor outcomes (grade V). The mean GOSLON score was 3.39. Intrarater and interrater agreements were high indicating good reproducibility. CONCLUSION Based on the dental arch relationships, the treatment outcome of UCLP Saudi children was unsatisfactory, with a mean GOSLON score of 3.39. Delayed palate repair and the use of presurgical orthopedics may be considered in the future for cleft deformity management. CLINICAL SIGNIFICANCE To address the effect of particular cleft surgical protocol on dental arch relationships of UCLP patients. How to cite this article: Alforaidi S, Zreaqat M, Hassan R. Dental Arch Relationships of Saudi Children with Unilateral Cleft Lip and Palate. J Contemp Dent Pract 2023;24(12):987-990.
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Affiliation(s)
- Sahal Alforaidi
- Department of Pediatric Dentistry and Orthodontics, College of Dentistry, Taibah University, Saudi Arabia
| | - Maen Zreaqat
- Department of Orthodontics, School of Dental Sciences, Universiti Sains Malaysia, Malaysia, Phone: +60 97673719, e-mail:
| | - Rozita Hassan
- Department of Orthodontics, School of Dental Sciences, Universiti Sains Malaysia, Malaysia
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Charoenvicha C, Wongkawinwoot K, Sirikul W, Khwanngern K, Sirimaharaj W. Predisposing factors of non-syndromic cleft lip and cleft palate in the northern Thai population: A 10-year retrospective case-control study. Congenit Anom (Kyoto) 2023; 63:147-153. [PMID: 37515453 DOI: 10.1111/cga.12529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 04/01/2023] [Accepted: 06/04/2023] [Indexed: 07/30/2023]
Abstract
The most common congenital anomaly is orofacial cleft, which is categorized into two main types: cleft lip with or without cleft palate (CL/P) and cleft palate only (CPO). One of the most accepted etiologies is multifactorial (gene-environment). This study aimed to identify the amendable risk factors of an orofacial cleft in Northern Thailand. A retrospective case-control study in Maharaj Nakorn Chiang Mai Hospital was conducted from 2011 to 2020. One hundred and seventeen cases of CL/P and CPO were included. Forty-nine normal children were enrolled in a time-matched control group. Exploratory survey data on maternal exposures were collected. Multivariate logistic regression was used to estimate the adjusted association between maternal exposures and CL/P, and CPO occurrence. Multivariate analysis identified three predisposing factors that increased the risk of CL/P and CPO. The first factor was caffeine consumption with a total amount of 560 mg/week (adjusted OR: 7.59; 95% CI: 2.48-23.23; p < 0.001). The second factor was any smoker or passive smoking (adjusted OR: 8.47; 95% CI: 1.63-43.92; p = 0.011). The third factor was a low socioeconomic status (income of lower than 270 USD/month; adjusted OR: 4.05; 95% CI: 1.07-15.27; p = 0.039). From the 10-year study in Northern Thailand: caffeine consumption, exposure to cigarette smoke, and low socioeconomic status were identified as associated negative factors for orofacial clefts. We propose that preconceptional counseling for risk reduction should be emphasized in reducing the mother's exposure to these factors. Future investigations in large multicenter populations are suggested.
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Affiliation(s)
- Chirakan Charoenvicha
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Faculty of Medicine, Chiangmai University, Chiang Mai, Thailand
- Clinical Research Center, Chiangmai University, Chiang Mai, Thailand
- Princess Sirindhorn IT Foundation Craniofacial Center, Chiang Mai University, Chiang Mai, Thailand
| | - Karn Wongkawinwoot
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Faculty of Medicine, Chiangmai University, Chiang Mai, Thailand
| | - Wachiranun Sirikul
- Faculty of Medicine, Department of Community Medicine, Chiangmai University, Chiang Mai, Thailand
| | - Krit Khwanngern
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Faculty of Medicine, Chiangmai University, Chiang Mai, Thailand
- Clinical Research Center, Chiangmai University, Chiang Mai, Thailand
- Princess Sirindhorn IT Foundation Craniofacial Center, Chiang Mai University, Chiang Mai, Thailand
| | - Wimon Sirimaharaj
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Faculty of Medicine, Chiangmai University, Chiang Mai, Thailand
- Clinical Research Center, Chiangmai University, Chiang Mai, Thailand
- Princess Sirindhorn IT Foundation Craniofacial Center, Chiang Mai University, Chiang Mai, Thailand
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Benitez BK, Brudnicki A, Nalabothu P, Jackowski JAV, Bruder E, Mueller AA. Histologic Aspect of the Curved Vomerine Mucosa in Cleft Lip and Palate. Cleft Palate Craniofac J 2021; 59:1048-1055. [PMID: 34291694 PMCID: PMC9272516 DOI: 10.1177/10556656211031419] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Background: Common surgical techniques aim to turn the entire vomerine mucosa
with vomer flaps either to the oral side or to the nasal side.
The latter approach is widely performed due to the similarity in
color to the nasal mucosa. However, we lack a histologic
description of the curved vomerine mucosa in cleft lip and
palate malformations. Methods: We histologically examined an excess of curved vomerine mucosa in 8
patients using hematoxylin–eosin, periodic acid–Schiff, Elastin
van Gieson, and Alcian blue stains. Tissue samples were obtained
during surgery at 8 months of age. Results: Our histological analysis of the mucoperiosteum overlying the
curved vomer revealed characteristics consistent with those of
an oral mucosa or a squamous metaplasia of the nasal mucosa, as
exhibited by a stratified squamous epithelium containing
numerous seromucous glands. Some areas showed a palisaded
arrangement of the basal cells compatible with metaplasia of
respiratory epithelium, but no goblet cells or respiratory cilia
were identified. Abundant fibrosis and rich vascularity were
present. Conclusion: The vomer mucosa showed no specific signs of nasal mucosa. These
findings should be considered in presurgical cleft orthopedics
and palatal surgery for further refinement. Shifting the vomer
mucosa according to a fixed physiologic belief should not
overrule other important aspects of cleft repair such as primary
healing and establishing optimal form and function of palatal
roof and nasal floor.
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Affiliation(s)
- Benito K Benitez
- Department of Oral and Craniomaxillofacial Surgery, University Hospital Basel and University of Basel, Switzerland.,Department of Clinical Research, University of Basel, Switzerland.,Department of Biomedical Engineering, University of Basel, Allschwil, Switzerland
| | - Andrzej Brudnicki
- Department of Maxillofacial Surgery, Clinic of Pediatric Surgery, Institute of Mother and Child, Warsaw, Poland
| | - Prasad Nalabothu
- Department of Oral and Craniomaxillofacial Surgery, University Hospital Basel and University of Basel, Switzerland.,Department of Clinical Research, University of Basel, Switzerland.,Department of Biomedical Engineering, University of Basel, Allschwil, Switzerland
| | | | - Elisabeth Bruder
- Pathology, Institute of Medical Genetics and Pathology, University Hospital Basel and University of Basel, Switzerland
| | - Andreas Albert Mueller
- Department of Oral and Craniomaxillofacial Surgery, University Hospital Basel and University of Basel, Switzerland.,Department of Clinical Research, University of Basel, Switzerland.,Department of Biomedical Engineering, University of Basel, Allschwil, Switzerland
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Elbaz B, Veyssière A, Boutros M, Ambroise B, Preudhomme R, Bénateau H. Correction of lip and nasal deformities in bilateral cleft operated with Le Mesurier procedure. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2021; 123:322-328. [PMID: 34216817 DOI: 10.1016/j.jormas.2021.06.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 05/12/2021] [Accepted: 06/24/2021] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Bilateral cleft lip surgery recently evolved with the generalization of cheilorhinoplasty replacing cheiloplasty alone. The aim of this study was to analyze lip and nasal deformities of bilateral cleft lip operated on with the Le Mesurier procedure, and then to evaluate possible secondary surgical solutions used in our Cleft Center. PATIENTS AND METHODS We retrospectively reviewed a total of 39 patients born between 1991 and 2009 with a bilateral cleft all type included (isolated lip, lip and alveolar, associated or not with a cleft palate), all treated at the Caen University Hospital with a Le Mesurier procedure for the primary cleft lip closure. We studied population characteristics, the number of secondary surgical procedures for lip and nasal deformities. We analysed therapeutic approaches of the different secondary surgical procedures used and their morphological results. RESULTS 85% of patients needed at least one secondary surgical procedure, 28% two procedures, 15% three procedures and 8% four or more procedures. Median age at secondary surgery was 6,8. 79% had a "scar repositioning", 33% managed the vermilion, 18% a restoration of the volume of the lip, 12% a philtral tissue sacrifice, 9% a procedure on Cupid's bow, 24% a surgery for nasal tip projection, 45% a columella lengthening and 58% a reposition of the alar base. DISCUSSION Le Mesurier procedure for bilateral clefts leads to deformities that require secondary surgical procedures. We propose an algorithm to manage loop scar in this procedure.
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Affiliation(s)
- Bénédicte Elbaz
- Department of maxillofacial Surgery, Universitary Hospital of Caen, Caen 14000, France
| | - Alexis Veyssière
- Department of maxillofacial Surgery, Universitary Hospital of Caen, Caen 14000, France; Health University of Caen, Normandie, Caen 14000, France.
| | - Mariam Boutros
- Department of Anaesthesiology, Universitary Hospital of Caen, Caen 14000, France
| | - Béatrice Ambroise
- Department of maxillofacial Surgery, Universitary Hospital of Caen, Caen 14000, France
| | - Renaud Preudhomme
- Department of maxillofacial Surgery, Universitary Hospital of Caen, Caen 14000, France
| | - Hervé Bénateau
- Department of maxillofacial Surgery, Universitary Hospital of Caen, Caen 14000, France; Health University of Caen, Normandie, Caen 14000, France
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Sándor-Bajusz K, Maros T, Olasz L, Sándor G, Hadzsiev K, Vástyán A. The influence of genetic syndromes on the algorithm of cleft lip and palate repair – A retrospective study. Ann Maxillofac Surg 2021; 11:270-273. [PMID: 35265497 PMCID: PMC8848705 DOI: 10.4103/ams.ams_77_21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2021] [Revised: 04/08/2021] [Accepted: 08/31/2021] [Indexed: 12/02/2022] Open
Abstract
Introduction: This study aimed to determine if the treatment algorithm used for nonsyndromic cleft patients required alteration to manage syndromic cleft lip and/or palate patients. Methods: The records of patients managed by the Pécs Cleft Team between January 1999 and December 2015 were analyzed retrospectively. The sources of the data included clinical and genetic records. Results: A total of 607 patients were managed by the cleft team during the study. Sixteen patients (2.6%) were noted to be afflicted with a particular identifiable syndrome. Seven different genetic syndromes and one sequence were present in the study. The Pierre Robin sequence occurred most often, comprising 50% of the cohort. The treatment algorithm used in managing nonsyndromic clefts required modification in 13 of the 16 syndromic patients. Discussion: The presence of a genetic syndrome may notably affect the treatment algorithm in children born with cleft lip and/or palate. The surgical treatment of certain associated anomalies has by necessity, priority over the timing of the reconstruction of the cleft lip and/or cleft palate in syndromic patients.
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Impellizzeri A, Giannantoni I, Polimeni A, Barbato E, Galluccio G. Epidemiological characteristic of Orofacial clefts and its associated congenital anomalies: retrospective study. BMC Oral Health 2019; 19:290. [PMID: 31870360 PMCID: PMC6929424 DOI: 10.1186/s12903-019-0980-5] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2017] [Accepted: 11/29/2019] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND To evaluate the relationship between gender, ethnicity/citizenship, clinical phenotype, total prevalence, and the various congenital malformations associated with oral clefts (OC) in Italy across the period 2001-2014. METHODS A retrospective analysis (2001-2014) was conducted based on the National Congenital Malformation Registries network of Italy (Emilia-Romagna Registry of Birth Defects [IMER] and Registro Toscano Difetti Congeniti [RTDC]), which were analyzed to investigate time trends, geographical/ethnic clusters, topography, sex ratio, and associated congenital anomalies of OC phenotypes. RESULTS Among 739 registered cases, 29.8% were syndromic or had multi-malformed associated anomalies, compared with 70.2% having isolated orofacial cleft. Cleft lip (CL) was observed in 22%, cleft palate (CP) in 40%, and cleft lip and palate (CLP) in 38% of live births, stillbirths, and terminations of pregnancy for fetal anomaly cases. Other associated conditions were major anomalies of cardiovascular defects (39%), followed by defects of the limbs (28%), neuroectodermal defects (23%), and urogenital malformations (10%). Male-to-female sex ratio was 1:1.14 in CP, 1.22:1 in CL, and 1.9:1 in CLP. Foreigners were represented by 29% from Southeast Asia, 25% from Balkans, 25% from North-Central Africa, 9% from the East, 7% from Western Europe, and 5% from South America. Total prevalence of OC cases ranged from 0.9 (RTDC) to 1.1 (IMER) of 1000 births. CONCLUSIONS This retrospective study provides a population-based, clinical-epidemiological description of the orofacial cleft phenomenon. As a relatively frequent congenital malformation, its social and economic impact is worthy of further study. These abnormalities can cause significant problems that may be solved or minimized by early diagnosis and treatment.
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Affiliation(s)
- A. Impellizzeri
- Unit of Orthodontics, Department of Oral and Maxillofacial Sciences, “Sapienza” University of Rome, Rome, Italy
| | | | - A. Polimeni
- Department of Oral and Maxillo-facial Sciences, Pediatric Dentistry Unit, “Sapienza” University of Rome, Rome, Italy
| | - E. Barbato
- Sapienza” University of Rome, Rome, Italy
| | - G. Galluccio
- Department of Oral and Maxillofacial Sciences, “Sapienza” University of Rome, Rome, Italy
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Rojnueangnit K, Mikhail FM, Cui X, Yu S, Robin NH. Predictor(s) of Abnormal Array Comparative Genomic Hybridization Results in Patients with Cleft Lip and/or Palate. Cleft Palate Craniofac J 2018; 52:724-31. [DOI: 10.1597/14-088] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Objectives Cleft lip and/or cleft palate (CL/P) occurs either as an isolated anomaly or as one manifestation of genetic syndromes. Chromosomal abnormalities from karyotype analysis are commonly seen in cases of nonisolated CL/P. This study was designed to evaluate the usefulness of clinical array comparative genomic hybridization (aCGH) testing in patients with CL/P. Our objectives were to identify the clinical phenotypes that are predicative of an abnormal aCGH result, correlate aCGH results with language outcome, and analyze the data in the abnormal aCGH results group. Methods Nonisolated CL/P patients who had clinical aCGH testing performed between 2009 and 2012 in the University of Alabama at Birmingham cytogenetics lab were enrolled. The demographic data, clinical phenotypes, and speech outcome were collected. Results Two hundred forty-five nonisolated CL/P patients were studied, with 62 having an abnormal aCGH result compared to 183 patients with a normal aCGH result. The presence of developmental delay/intellectual disability (DD/ID), dysmorphic features, congenital anomalies, and/or family history of DD/ID were significantly higher in the abnormal aCGH group ( P < .05). Neither the aCGH results nor the type of CL/P correlated with speech outcome. Finally, analysis of the abnormal aCGH result group revealed that DD/ID had a strong positive association with the copy number variation pathogenicity and the number of genes involved. Conclusions This study demonstrated the diagnostic value of clinical aCGH testing in CL/P patients who present with DD/ID, dysmorphic features, other congenital anomalies, and/or family history of DD/ID.
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Affiliation(s)
- Kitiwan Rojnueangnit
- Department of Genetics, University of Alabama at Birmingham, Birmingham, Alabama, Department of Pediatrics, Faculty of Medicine, Thammasat University, Pathumthani, Thailand
| | - Fady M. Mikhail
- Department of Genetics; Department of Biostatistics; Department of Biostatistics; Departments of Genetics and Pediatrics, University of Alabama at Birmingham, Birmingham, Alabama
| | - Xiangqin Cui
- Department of Genetics; Department of Biostatistics; Department of Biostatistics; Departments of Genetics and Pediatrics, University of Alabama at Birmingham, Birmingham, Alabama
| | - Shaohua Yu
- Department of Genetics; Department of Biostatistics; Department of Biostatistics; Departments of Genetics and Pediatrics, University of Alabama at Birmingham, Birmingham, Alabama
| | - Nathaniel H. Robin
- Department of Genetics; Department of Biostatistics; Department of Biostatistics; Departments of Genetics and Pediatrics, University of Alabama at Birmingham, Birmingham, Alabama
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Ingrao T, Lambert L, Valduga M, Bosser G, Albuisson E, Leheup B. [22q11.2 microdeletion syndrome: Analysis of the care pathway before the genetic diagnosis]. Arch Pediatr 2017; 24:1067-1075. [PMID: 28967605 DOI: 10.1016/j.arcped.2017.08.017] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2016] [Revised: 08/15/2017] [Accepted: 08/28/2017] [Indexed: 11/16/2022]
Abstract
BACKGROUND 22q11.2 deletion syndrome (22q11.2DS) is a very broad phenotypic spectrum disorder. It can affect many organs or systems. 22q11.2DS is the most common microdeletion syndrome in humans, with a prevalence ranging from one in every 2000 to one in 4000 newborns. It seems to be more prevalent than reported and under-recognized or undiagnosed because of its inherent clinical variability and heterogeneity. In France, 15,000 patients may be affected by this disease, more than half without knowing it. The aim of this study was to analyze the care pathway before the genetic diagnosis of 22q11.2DS. METHODS We conducted a single-center, retrospective analysis of postnatally diagnosed patients recruited by the cytogenetic laboratory of Nancy (France) from January 2000 to December 2015. Clinical data were first collected by consulting the medical files of patients and then by calling them directly. Written informed consent was obtained and the study was approved by local research ethics boards. Data concerned only clinical features before the diagnosis. RESULTS The cohort consisted of 32 individuals with 22q11.2DS. The average age at diagnosis was 9 years and 2 months and the median age was 2 years and 11 months. Fetal echography was abnormal in 15 pregnancies. During the neonatal period, the most important features were eating difficulties and congenital malformations (n=20), with a majority of complex heart diseases (n=16), dominated by conotruncal malformations (n=6). In case of malformation, the average age at diagnosis decreased to 2 years and 6 months. A congenital heart disease brought the average age of diagnosis down to 2 years and 6 months. Hypocalcemia and dysmorphism were also classical features (n=14). Before the age of 3 years, speech delay occurred in nine patients. After 3 years of age, rhinolalia was predominant (n=11). Academic disabilities were present in all subjects. At least 14 patients had a de novo deletion. Five patients were diagnosed within genetic counseling, with the deletion was inherited from the mother in three out of four cases. One was the monozygotic twin of a patient. Seven patients were diagnosed as adults. Four of them were diagnosed only because of the clinical presentation of their children or fetuses. Retrospectively, all adult patients had clinical signs suggesting the 22q11.2DS diagnosis. Relational disorders affected eight patients. None of them had been referred to the geneticist for this reason. In most cases, the pediatric cardiologist referred patients to the geneticist (n=9). Physiotherapists (n=15) and speech-language pathologists (n=12) were frequently requested but did not participate in the diagnosis. CONCLUSION The present study highlights the difficulty of establishing the diagnosis when the major features of the 22q11.2DS are absent during the 1st months of life. This is particularly true when there is no congenital defect. Special attention must be given to speech disorders in childhood and neuropsychological disorders later in life. The association between 22q11.2DS and early-onset parkinson disease implies that adult neurologists should be aware of this diagnosis. For adult patients, familial occurrence is the most frequent cause of diagnosis in spite of clinical signs suggestive of 22q11.2DS. The management of these patients involves better information of medical and paramedical staff in order to refer them to the geneticist earlier in life.
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Affiliation(s)
- T Ingrao
- Service de génétique clinique, CHRU de Nancy, rue du Morvan, 54511 Vandœuvre-Lès-Nancy, France.
| | - L Lambert
- Service de génétique clinique, CHRU de Nancy, rue du Morvan, 54511 Vandœuvre-Lès-Nancy, France
| | - M Valduga
- Service de cytogénétique et génétique moléculaire, laboratoire de génétique médicale, CHRU de Nancy, rue du Morvan, 54511 Vandœuvre-Lès-Nancy, France
| | - G Bosser
- Service de cardiologie infantile, CHRU de Nancy, rue du Morvan, 54511 Vandœuvre-Lès-Nancy, France
| | - E Albuisson
- Unité ESPRI-BioBase-méthodologie-réglementation-biostatistiques, plateforme d'aide à la recherche clinique (PARC), CHRU de Nancy, rue du Morvan, 54511 Vandœuvre-Lès-Nancy, France
| | - B Leheup
- Service de génétique clinique et pédiatrie, CHRU de Nancy, rue du Morvan, 54511 Vandœuvre-Lès-Nancy, France
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Azeez B, Keyla PR, Deborah VD, Ronald M, Mekonen AE, Wasiu LA, Peter AM. Descriptive epidemiology of orofacial clefts in Africa using data from 46,502 Smile Train surgeries. ACTA ACUST UNITED AC 2017. [DOI: 10.5897/jphe2016.0906] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Friedlander L, Choquet R, Galliani E, de Chalendar M, Messiaen C, Ruel A, Vazquez MP, Berdal A, Alberti C, De La Dure Molla M. Management of rare diseases of the Head, Neck and Teeth: results of a French population-based prospective 8-year study. Orphanet J Rare Dis 2017; 12:94. [PMID: 28526043 PMCID: PMC5437557 DOI: 10.1186/s13023-017-0650-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2017] [Accepted: 05/11/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In the last ten years, national rare disease networks have been established in France, including national centres of expertise and regional ones, with storage of patient data in a bioinformatics tool. The aim was to contribute to the development and evaluation of health strategies to improve the management of patients with rare diseases. The objective of this study has been to provide the first national-level data concerning rare diseases of the head, neck and teeth and to assess the balance between demand and supply of care in France. METHODS Centres of expertise for rare diseases record a minimum data set on their clinical cases, using a list of rare Head, Neck and Teeth diseases established in 2006. The present analysis focuses on 2008 to 2015 data based on the Orphanet nomenclature. Each rare disease RD "case" was defined by status "affected" and by the degree of diagnostic certainty, encoded as: confirmed, probable or non-classifiable. Analysed parameters, presented with their 95% confidence intervals using a Poisson model, were the following: time and age at diagnosis, proportions of crude and standardized RD prevalence by age, gender and geographical site. The criteria studied were the proportions of patients in Paris Region and the "included cases geography", in which these proportions were projected onto the other French Regions, adjusting for local populations. RESULTS In Paris Region, estimated prevalence of these diseases was 5.58 per 10,000 inhabitants (95% CI 4.3-7.1). At December 31st 2015, 11,342 patients were referenced in total in France, of whom 7294 were in Paris Region. More than 580 individual clinical entities (ORPHA code) were identified with their respective frequencies. Most abnormalities were diagnosed antenatally. Nearly 80% of patients recorded come to Paris hospitals to obtain either diagnosis, care or follow up. We observed that the rarer the disease, the more patients were referred to Paris hospitals. CONCLUSIONS A health network covering a range of aspects of the rare diseases problematic from diagnostics to research has been developed in France. Despite this, there is still a noticeable imbalance between health care supply and demand in this area.
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Affiliation(s)
- Lisa Friedlander
- Université Paris Diderot - Sorbonne Paris Cité, INSERM, Laboratoire ECEVE UMR1123, Paris, France.
- Centre de référence des malformations rares de la face et de la cavité buccale, Hôpital Rothschild, AP-HP, Paris, France.
| | - Rémy Choquet
- Banque Nationale de Données Maladies Rares, Hôpital Necker Enfants Malades, AP-HP, Paris, France
| | - Eva Galliani
- Centre de référence des malformations rares de la face et de la cavité buccale, Hôpital Necker, AP-HP, Paris, France
- Université Paris Descartes-Sorbonne Paris Cité, Paris, France
- Service de chirurgie maxillo-faciale et de chirurgie plastique, Hôpital Necker, AP-HP, Paris, France
| | - Myriam de Chalendar
- Filière de santé maladies rares TETECOU: malformations rares de la tête, du cou et des dents, Hôpital Necker, Paris, France
| | - Claude Messiaen
- Banque Nationale de Données Maladies Rares, Hôpital Necker Enfants Malades, AP-HP, Paris, France
| | - Amélie Ruel
- Banque Nationale de Données Maladies Rares, Hôpital Necker Enfants Malades, AP-HP, Paris, France
| | - Marie-Paule Vazquez
- Centre de référence des malformations rares de la face et de la cavité buccale, Hôpital Necker, AP-HP, Paris, France
- Université Paris Descartes-Sorbonne Paris Cité, Paris, France
- Service de chirurgie maxillo-faciale et de chirurgie plastique, Hôpital Necker, AP-HP, Paris, France
- Filière de santé maladies rares TETECOU: malformations rares de la tête, du cou et des dents, Hôpital Necker, Paris, France
| | - Ariane Berdal
- Centre de référence des malformations rares de la face et de la cavité buccale, Hôpital Rothschild, AP-HP, Paris, France
- Université Paris Diderot - Sorbonne Paris Cité, INSERM, Laboratoire de physiopathologie orale et moléculaire, UMRS 1138, Paris, France
| | - Corinne Alberti
- Université Paris Diderot - Sorbonne Paris Cité, INSERM, Laboratoire ECEVE UMR1123, Paris, France
| | - Muriel De La Dure Molla
- Centre de référence des malformations rares de la face et de la cavité buccale, Hôpital Rothschild, AP-HP, Paris, France
- INSERM UMR_S1163 Bases moléculaires et physiopathologiques des ostéochondrodysplasies, Institut Imagine, Necker, Paris, France
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Nagalo K, Ouédraogo I, Laberge JM, Caouette-Laberge L, Turgeon J. Congenital malformations and medical conditions associated with orofacial clefts in children in Burkina Faso. BMC Pediatr 2017; 17:72. [PMID: 28292285 PMCID: PMC5351250 DOI: 10.1186/s12887-017-0833-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2015] [Accepted: 03/08/2017] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Orofacial clefts are usually isolated cases but can be associated with other congenital malformations that are either recognised or unrecognised syndromes. The reported prevalence and pattern of such associated malformations, however, vary among studies. OBJECTIVES To assess the frequencies and aetiologies of congenital malformations and associated medical conditions in children with orofacial clefts in Burkina Faso (Western Africa). METHODS A retrospective descriptive study was carried out at the El Fateh-Suka Clinic in Ouagadougou, Burkina Faso. All children who attended surgery for the repair of a cleft lip and/or palate were included in this study. RESULTS The frequency of congenital malformations associated with cleft lip and/or palate was 39/185 (21.1%). In the group with multiple congenital malformations of unknown origin (34 patients; 18.4%), 66.7% had cleft lip and palate, followed by isolated cleft lip (27.4%) and isolated cleft palate (5.9%). The digestive system (35.3%), the musculoskeletal system (19.6%), and eye, ear, face, and neck (15.7%) were the most affected systems. In the group of syndromic malformations (five patients; 2.7%), amniotic band syndrome (one patient), Van der Woode syndrome (one patient), Goltz syndrome (one patient), and holoprosencephaly (two patients) were identified. Medical conditions included anaemia (39.4%), infections (9.2%), malnutrition (7.5%), and haemoglobinopathies (4.3%). CONCLUSIONS Congenital malformations and medical co-morbidities were frequent in children with OFCs. Further studies and a National Malformations Registry are needed to improve the comprehension of OFCs in Burkina Faso.
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Affiliation(s)
- Kisito Nagalo
- Service of Paediatrics, El Fateh-Suka Clinic, Ouagadougou, Burkina Faso
- UFR/SDS, University of Ouagadougou, Ouagadougou, Burkina Faso
| | - Isso Ouédraogo
- UFR/SDS, University of Ouagadougou, Ouagadougou, Burkina Faso
- Service of Paediatric Surgery, Charles De Gaulle Pediatric University Teaching Hospital, Ouagadougou, Burkina Faso
| | - Jean-Martin Laberge
- ”Mission Sourires d’Afrique”, Montréal, Canada
- Department of Paediatric Surgery, The Montreal Children’s Hospital, McGill University, Montreal, Canada
| | - Louise Caouette-Laberge
- ”Mission Sourires d’Afrique”, Montréal, Canada
- Department of Surgery, St Justine University Teaching Hospital, University of Montreal, Montreal, Canada
| | - Jean Turgeon
- ”Mission Sourires d’Afrique”, Montréal, Canada
- Department of Paediatrics, St Justine University Teaching Hospital, University of Montreal, Montreal, Canada
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Épidémiologie des malformations associées aux fentes labiales et palatines à propos d’une étude rétrospective de 324 cas. Arch Pediatr 2015; 22:816-21. [DOI: 10.1016/j.arcped.2015.05.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2014] [Revised: 04/05/2015] [Accepted: 05/20/2015] [Indexed: 11/21/2022]
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Vilaplana F, Muiños SJ, Nadal J, Elizalde J, Mojal S. Stickler syndrome. Epidemiology of retinal detachment. ARCHIVOS DE LA SOCIEDAD ESPANOLA DE OFTALMOLOGIA 2015; 90:264-268. [PMID: 25817961 DOI: 10.1016/j.oftal.2014.11.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/04/2014] [Revised: 10/28/2014] [Accepted: 11/03/2014] [Indexed: 06/04/2023]
Abstract
OBJECTIVE A review was performed on all patients with Stickler syndrome that had been treated in our Centre since it was diagnosed, in order to evaluate the risk of suffering a retinal detachment (RD). METHODS A total of 14 patients, diagnosed by clinical criteria, were included. The following variables were evaluated: age, gender, ocular background, follow-up, initial and final visual acuity (VA), optical prescription, prophylactic treatment, surgery and techniques performed. The risk age to suffer a RD, as well as cataracts, was determined by using the Kaplan-Meier survival curve analysis. RESULTS From a total of 5 men and 9 women, the median initial VA was 0.35, which was the same as the final VA. The median optical prescription was -9.5 D myopia. The median of follow-up was 7 years. Ocular background was 4 RD cases and 2 Lasik surgeries. The operations performed were 8 RD, 12 cataract, 2 glaucoma, 2 macular hole, and one endotropia. The median age of RD was 20 years and cataract 34 years. As regards surgical tecnique, 4 scleral buckle cases, and 4 scleral buckle+pars plana vitrectomy cases were formed. The prophylactic treatments performed were: one scleral buckle case, 4 endolaser photocoagulation, and one cryotherapy. Two of which presented with RD. CONCLUSION In the series presented, retinal detachment in Stickler syndrome mainly occurs in the second decade of life, with cataracts mainly developing in the fourth decade.
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Affiliation(s)
- F Vilaplana
- Centro de Oftalmología Barraquer, Barcelona, España.
| | - S J Muiños
- Centro de Oftalmología Barraquer, Barcelona, España
| | - J Nadal
- Centro de Oftalmología Barraquer, Barcelona, España
| | - J Elizalde
- Centro de Oftalmología Barraquer, Barcelona, España
| | - S Mojal
- Consulting Service on Methodology for Miomedical Research, IMIM, Barcelona, España
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Lithovius RH, Ylikontiola LP, Harila V, Sándor GK. A descriptive epidemiology study of cleft lip and palate in Northern Finland. Acta Odontol Scand 2014; 72:372-5. [PMID: 24255959 DOI: 10.3109/00016357.2013.840737] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE The aim of this study was to determine the incidence of cleft lip and/or cleft palate in a population uniquely from Northern Finland. MATERIALS AND METHODS The records of a total of 214 cleft patients treated between 1998-2011 at the Oulu Cleft Lip and Palate Center at the University of Oulu were assessed on a retrospective basis. Data regarding cleft type, sex and side of cleft was collected and analyzed. Family history of clefting was investigated. RESULTS Cleft palate (68.7%) was most frequently found, followed by cleft lip and palate (18.7%) and cleft lip with or without alveolus (12.6%). Cleft palate occurred more frequently in females (63.3%) and cleft lip and palate was more frequently found in males (62.5%). The left side was more frequently affected in both male and female patients. Left-sided clefts were observed in 82% of patients compared to right-sided clefts in 18%. A family history of clefting was detected in 20.1% of patients. CONCLUSION The incidence of clefts in Northern Finland is higher than the corresponding incidence in other European countries. Cleft palate was the most frequent cleft type and it was more frequent in females. In males, cleft lip and palate was more frequent. The left side was more frequently affected in both genders. One fifth of the patients had a family history of clefts.
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Affiliation(s)
- Riitta H Lithovius
- Department of Oral and Maxillofacial Surgery, Institute of Dentistry, University of Oulu, Oulu Cleft Lip and Palate Center, Oulu University Hospital , Oulu , Finland
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Bergendal B. Orodental manifestations in ectodermal dysplasia-a review. Am J Med Genet A 2014; 164A:2465-71. [PMID: 24719393 DOI: 10.1002/ajmg.a.36571] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2013] [Accepted: 03/12/2014] [Indexed: 12/26/2022]
Abstract
Oral signs and symptoms are present in most ectodermal dysplasias (EDs). The aim of this article is to summarize some of the literature on current knowledge of oral manifestations and orofacial function in EDs. The review will focus on the most common forms where dental manifestations can be crucial for a differential diagnosis of ED among individuals with hypodontia and oligodontia, and preferably where the investigations included persons who had a genetically verified diagnosis. Disturbances in tooth development are common and can appear as tooth agenesis, variations in size and shape of teeth, defects in the mineralized tissues, and problems in tooth eruption. Abnormalities in number, size, and shape of teeth, and reduced salivary secretion, present in isolated oligodontia as well as in hypohidrotic ED and incontinentia pigmenti. In some more rare EDs these symptoms appear in combination with clefts of lip and/or palate in some affected individuals. Leukokeratosis in the oral mucosa presents in 70% of genetically confirmed cases of pachyonychia congenita. Also, orofacial function is often affected in ED, due to malformations, an incomplete dentition, and low salivary secretion which can compromise chewing, swallowing, and speech. In conclusion, there is a clinical overlap in oral signs and symptoms between isolated oligodontia and the most common EDs. Studies with genetically confirmed diagnoses and larger cohorts, as well as multicenter collaboration and the establishing of international registries, would create a basis for refined diagnostics, where oral examinations should be an integrated part of clinical assessment.
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Affiliation(s)
- Birgitta Bergendal
- National Oral Disability Centre for Rare Disorders, The Institute for Postgraduate Dental Education, Jönköping, Sweden
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