1
|
Pisek A, McKinney CM, Muktabhant B, Pitiphat W. Maternal micronutrient biomarkers and risk of non-syndromic cleft lip/palate: A case-control study. Oral Dis 2024. [PMID: 39039700 DOI: 10.1111/odi.15079] [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: 01/22/2024] [Revised: 06/30/2024] [Accepted: 07/09/2024] [Indexed: 07/24/2024]
Abstract
OBJECTIVE This case-control study investigated the associations between maternal plasma vitamin B12, homocysteine, and red blood cell (RBC) folate levels and the risk of cleft lip with or without cleft palate (CL/P) in offspring. SUBJECTS AND METHODS The study compared 94 mothers and children with non-syndromic CL/P from a teaching hospital in Thailand to 94 mother-infant controls from local well-baby clinics, frequency-matched by birth date and mother's education. Data included anthropometric measurements, blood sample analyses, and a questionnaire. Odds ratios (ORs) and 95% confidence intervals (CIs) estimated the associations through multiple logistic regression, adjusting for confounders. RESULTS Mothers with higher plasma vitamin B12 levels had a lower risk of having a child with CL/P compared to those in the lowest quartile. This association was more pronounced among mothers without a family history of orofacial clefts and those who were not underweight. Conversely, elevated homocysteine levels, a marker of impaired B vitamin metabolism, increased the risk of CL/P. No association was found between RBC folate and CL/P. CONCLUSION Higher maternal vitamin B12 levels are associated with a reduced risk of CL/P, while elevated homocysteine levels may increase the risk.
Collapse
Affiliation(s)
- Araya Pisek
- Division of Dental Public Health, Department of Preventive Dentistry, Faculty of Dentistry, Khon Kaen University, Khon Kaen, Thailand
| | - Christy M McKinney
- Division of Craniofacial Medicine, Department of Pediatrics, University of Washington, and Seattle Children's Research Institute, Seattle, Washington, USA
| | - Benja Muktabhant
- Department of Public Health Administration, Health Promotion and Nutrition, Faculty of Public Health, Khon Kaen University, Khon Kaen, Thailand
| | - Waranuch Pitiphat
- Division of Dental Public Health, Department of Preventive Dentistry, Faculty of Dentistry, Khon Kaen University, Khon Kaen, Thailand
| |
Collapse
|
2
|
Pradubwong S, Paggasang Y, Pisek P, Winaikosol K, Jenwitheesuk K, Chowchuen B. Evaluation of nasolabial esthetics in 8- to 12-year-old patients with cleft lip and palate by healthcare professionals in Northeast Thailand. SAGE Open Med 2024; 12:20503121241260622. [PMID: 38887321 PMCID: PMC11181885 DOI: 10.1177/20503121241260622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Accepted: 05/23/2024] [Indexed: 06/20/2024] Open
Abstract
Objective To assess the aesthetics of the nasolabial appearance of patients with cleft lip and palate aged 8-12 years by experienced and inexperienced professionals. Methods A cross-sectional study was conducted on 32 patients with cleft lip and palate, who underwent surgery and follow-up treatment at the Cleft Center. The research tools included a parent-completed survey providing GO graphic data and two-dimensional frontal view photographs of patients from both left and right sides. The aesthetic of the lip, nose, and nasolabial region was evaluated by an experienced and inexperienced medical professional team in groups of four individuals. In addition, data analysis was performed using descriptive statistics, mean values, standard deviations, Cronbach's alpha reliability coefficient, and the Wilcoxon signed-rank test. Results The average age of patients was 10.32 years, mainly male (65.63%), had unilateral cleft lip and palate (62.50%), and underwent bone grafting (96.88%). Regarding the assessment in three aspects, the aesthetic score assessed by experienced evaluators is fair level (2.64 ± 1.09) with an acceptable value of 0.73. In contrast, the inexperienced evaluator showed a high level (2.43 ± 0.83) with a high inter-rater reliability acceptable value of 0.60. Inexperienced evaluators showed higher scores for the lip and nasolabial region than experienced evaluators, which was statistically significant (p-values < 0.01). Conclusions The inexperienced evaluators showed significantly higher scores for appearance than experienced evaluators. This result can improve surgical techniques in future procedures to meet the needs of patients seeking lip and nasolabial appearance corrections across different age groups.
Collapse
Affiliation(s)
- Suteera Pradubwong
- Research Center of Cleft Lip-Cleft Palate and Craniofacial Deformities, Khon Kaen University in Association with Tawanchai Project, Khon Kaen University, Khon Kaen, Thailand
| | - Yupin Paggasang
- Division of Surgery, Faculty of Medicine, Surgical Nursing Department, Srinagarind Hospital, Khon Kaen University, Khon Kaen, Thailand
| | - Poonsak Pisek
- Divisions of Orthodontics, Faculty of Dentistry, Department of Preventive Dentistry, Khon Kaen University, Khon Kaen, Thailand
| | - Kengkart Winaikosol
- Division of Plastic and Reconstructive Surgery, Faculty of Medicine, Department of Surgery, Khon Kaen University, Khon Kaen, Thailand
| | - Kamonwan Jenwitheesuk
- Division of Plastic and Reconstructive Surgery, Faculty of Medicine, Department of Surgery, Khon Kaen University, Khon Kaen, Thailand
| | - Bowornsilp Chowchuen
- Division of Plastic and Reconstructive Surgery, Faculty of Medicine, Department of Surgery, Khon Kaen University, Khon Kaen, Thailand
| |
Collapse
|
3
|
Sarilita E, Sjamsudin E, Mossey PA. Scoping review of outcome measures in cleft care used in research and reports. Orthod Craniofac Res 2024; 27 Suppl 1:42-48. [PMID: 37767819 DOI: 10.1111/ocr.12711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 08/10/2023] [Accepted: 09/05/2023] [Indexed: 09/29/2023]
Abstract
Treatment outcome measures are critical in the decision making of best practices in the OFC field. OFC consortium working groups provided standardization of outcome measures based on previous treatment outcome studies. However, the implementation of such standardization in OFC centres worldwide is unknown. This study presented mapped outcome measures in cleft care using a structured review method complemented by quantitative overview of the relevant published research to provide initial guidelines for the implementation of treatment outcome standardization. A scoping review of the literature of treatment outcomes in cleft care following Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews guidelines was performed. The selected indexed paper in outcome measures mapped following the international consortium in standard set of outcome measures in cleft care. Three hundred and sixty-five articles were filtered. The most discussed domains of cleft care were dental and oral health, appearance and speech/communication. Overall, the majority of publications were produced in high-income countries. The current review indicates that there are inequalities of treatment outcome studies among the domain of cleft care. In addition, there are also inequalities of published articles from HIC versus LMIC in treatment outcomes. This information can be used to develop targeted interventions aimed at encouraging cleft centres worldwide to adapt standardized outcome measures.
Collapse
Affiliation(s)
- Erli Sarilita
- Department of Oral Biology, Faculty of Dentistry, Universitas Padjadjaran, Bandung, Indonesia
| | - Endang Sjamsudin
- Department of Oral Maxillofacial Surgery, Faculty of Dentistry, Universitas Padjadjaran, Bandung, Indonesia
| | - Peter A Mossey
- Division of Oral Health Sciences and WHO Collaborating Centre for Oral Health & Craniofacial Anomalies, University of Dundee, Dundee, Scotland, UK
| |
Collapse
|
4
|
Mabrouk MM, Abdullateef KS, Abdelsattar AH, Elbarbary M, Kaddah S, Mohamed W. Comparative Study between Modified Millard and White Roll Vermilion Flap Techniques in Unilateral Lip Repair: A Randomised Controlled Study. Afr J Paediatr Surg 2024; 21:18-27. [PMID: 38259015 PMCID: PMC10903735 DOI: 10.4103/ajps.ajps_20_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 06/12/2023] [Indexed: 01/24/2024] Open
Abstract
BACKGROUND Cleft lip and palate, which affects 0.5-1.6 out of every 1000 live births, is the most prevalent congenital defect of the head and neck. Several approaches, including quadrangular flaps, triangular flaps and rotation-advancement procedures, White Roll Vermilion Turn Down Flap (WRV flap) from the lateral lip element were employed by Mishra to modify Millard's technique to create the vermilion and white roll on the medial lip segment. This study aimed to use the anthropometric measurements taken pre- and post-operation to evaluate quantitative assessment of modified Millard technique compared with WRV flap technique in unilateral cleft lip (UCL) repair. MATERIALS AND METHODS Prospective, randomised controlled study recruited infants scheduled for UCL repair. Infants aged 3-6 months, either complete or incomplete deformity. A total of 42 patients were randomized in 1:1 ratio to undergo either WRV flap technique (group A) or modified Millard technique (group B) and another control included 21 age-matched healthy children. We compared WRV flap procedure to Modified Millard's procedure in terms of both qualitative (another surgeon's opinion) and quantitative (anthropometric) evaluation. RESULTS Vertical lip length and philtral lip height significantly longer in Millard group (B) than WRV flap group (A) in immediate postoperative assessment and nasal width was significantly wider in WRV flap group (A) than Millard group (B) in 3-month post-operative assessment. The lip shape, the vermilion shape was better in Millard technique than WRV flap technique; however, this was statistically insignificant. However, no major difference in the overall results between the WRV flap and Millard rotation-advancement repairs. CONCLUSION Anthropometric measurement of surgical outcome evaluates the surgical technique used and helps to compare between cleft and non-cleft side showing the degree of deformity and we used subjective assessment to analyse facial aesthetics. Overall results demonstrate no significant differences between modified Millard technique and WRV flap technique.
Collapse
Affiliation(s)
- Mohamed M Mabrouk
- Department of Pediatric Surgery, Cairo University Children Specialized Hospital, Giza, Egypt
| | | | | | | | | | | |
Collapse
|
5
|
Hayakawa T, Imura H, Inoue C, Mori T, Aihara Y, Tsujiuchi S, Niimi T, Natsume N. Efficacy of telepractice, an alternative therapy tool during the coronavirus disease 2019 pandemic, for speech disorders related to congenital anomalies. Congenit Anom (Kyoto) 2023; 63:206-210. [PMID: 37749073 DOI: 10.1111/cga.12543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2023] [Revised: 09/05/2023] [Accepted: 09/10/2023] [Indexed: 09/27/2023]
Abstract
Since telepractice regulation does not yet exist in Japan, we assessed telepractice efficacy and the level of satisfaction with telepractice versus that with face-to-face practice (FTFP) in speech therapy to establish effective telepractice in Japan. Changes in the number of therapy sessions and therapy levels were compared between telepractice and FTFP sessions conducted during the study period. Additionally, the patients' parents completed a questionnaire survey regarding telepractice. The mean number of sessions was not significantly different between the two types of therapy; the therapy levels, according to stepwise speech therapy, either increased or remained unchanged. The survey showed satisfaction with telepractice among all parents. Telepractice for cleft palate speech was delivered successfully with complete parental satisfaction.
Collapse
Affiliation(s)
- Toko Hayakawa
- Department of Health Science, Aichi Gakuin University, Nisshin, Japan
| | - Hideto Imura
- Cleft Lip and Palate Center, Aichi Gakuin University Dental Hospital, Nagoya, Japan
- Division of Research and Treatment for Oral Maxillofacial Congenital Anomalies, School of Dentistry, Aichi Gakuin University, Nagoya, Japan
| | - Chisako Inoue
- Cleft Lip and Palate Center, Aichi Gakuin University Dental Hospital, Nagoya, Japan
| | - Tomoko Mori
- Cleft Lip and Palate Center, Aichi Gakuin University Dental Hospital, Nagoya, Japan
- Division of Research and Treatment for Oral Maxillofacial Congenital Anomalies, School of Dentistry, Aichi Gakuin University, Nagoya, Japan
| | | | - Shion Tsujiuchi
- Cleft Lip and Palate Center, Aichi Gakuin University Dental Hospital, Nagoya, Japan
| | - Teruyuki Niimi
- Cleft Lip and Palate Center, Aichi Gakuin University Dental Hospital, Nagoya, Japan
- Division of Research and Treatment for Oral Maxillofacial Congenital Anomalies, School of Dentistry, Aichi Gakuin University, Nagoya, Japan
| | - Nagato Natsume
- Cleft Lip and Palate Center, Aichi Gakuin University Dental Hospital, Nagoya, Japan
- Division of Research and Treatment for Oral Maxillofacial Congenital Anomalies, School of Dentistry, Aichi Gakuin University, Nagoya, Japan
| |
Collapse
|
6
|
Surakunprapha P, Pradubwong S, Jenwitheesuk K, Pisek P, Chowchuen B. Evaluating the Cost-Effectiveness of Plastic Surgery Based on the Satisfaction with Quality of Life and Nasolabial Appearance in Thai Preteens with Cleft Lip and Palate. Open Nurs J 2022. [DOI: 10.2174/18744346-v16-e2209261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background:
Cleft Lip and Palate (CLP) negatively affect the quality of life (QoL) and nasolabial appearance, especially in preteen patients who start to be interested in their own appearance and society.
Objective:
The objective of this study is to evaluate the cost-effectiveness of plastic surgery for Thai preteen CLP patients through their satisfaction with their QoL and nasolabial appearance.
Methods:
A cross-sectional study covered purposively selected 30 samples aged between 8 and 12 years old.Their satisfaction with their QoL and appearance was reflected through an interview and a questionnaire with the cooperation of their parents as their caregivers including satisfaction with their nasolabial appearance evaluated by five experts. They compared the photos of patients’nasolabial appearance with those of normal faces of children of the same age using 5-rating scales.
Results:
General findings showed 53.3% of samples were male patients with mostly (63.3%) UCLP whose parents were mainly (73.3%) poor, so they relied on government financial supports for the treatment. Only some (15%) earned up to 5,001 to 10,000 baht per month because of their low education with just high school level. Specific findings indicated the overall satisfaction with QoL through five dimensions at average level (3.26±1.39). This was based on the satisfaction with the center services, the overall treatments, the medical additional costs, parental satisfaction with psychosocial effects including concerns about the impacts of CLP on the family ranged from high to low i.e. 4.30±0.98, 3.72±1.15, 3.70±1.14, 3.33±1.08 and 2.81±1.46 respectively. Moreover, five experts trended to be highly satisfied with patients’ nasolabial appearance by rating it from Good (53.3%) to Fair (43.43%) with only Poor (3.3%).
Conclusion:
The good cost-effectiveness of the surgery was represented through the average and high satisfaction of CLP patients with their QoL and their appearance respectively indicating the absence of disability weights for these treated CLP patients.
Collapse
|
7
|
Chonnapasatid W, Viwattanatipa N, Manopatanakul S, Jaruratanasirikul S. Thai Universal Health Care Coverage scheme promotes the accessibility to cleft lip/palate treatment: the result of cleft care provision assessment using modified Geographic Information System. BMC Health Serv Res 2022; 22:416. [PMID: 35351111 PMCID: PMC8966314 DOI: 10.1186/s12913-022-07784-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Accepted: 03/15/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND This study assessed the cleft lip/palate (CL/P) healthcare provision using data from the Thailand National Health Security Office from fiscal years 2012-2016. METHODS Four national databases of Thailand comprising 1) admitted patient visit, 2) non-admitted patient visit, 3) birth defects registry and 4) civil registration databases were analyzed. All duplicate records were removed by a matching process using national identity number and date of birth prior to data extraction. Modified Geographic Information System was also used to compare each provincial patients with CL/P of Thailand to the number of provincial live births with CL/P. RESULTS The results showed that the number of live births with CL/P during this period was 7,775 cases (1,555 cases/fiscal year). While the number of cases with CL/P registered under the Universal Health Care Coverage with hospital stay was 6,715 (86.37%), 927 cases (11.92%) visited hospitals without a stay, and the remaining 133 cases (1.71%) never visited any hospital. Modified Geographic Information System result showed that the provincial CL/P healthcare was relatively well-balanced with the provincial live births with CL/P (r = 0.92, p < 0.05). Moreover, provinces with CL/P tertiary care centers attracted more patients from the surrounding provinces. CONCLUSION This study showed that the percentage of patients with CL/P receiving hospital treatment was 98. The Thai Universal Health Care Coverage scheme has promoted the accessibility to CL/P treatment. In order to achieve the best possible comprehensive cleft care coverage, periodical assessment and improvement of the function and accuracy of the national database registry are recommended.
Collapse
Affiliation(s)
- Wannapong Chonnapasatid
- Samutprakan Provincial Public Health Office, Mueang Samutprakan District, 20 Phoem Toem 2 Alley, Samutprakan, 10270, Thailand
| | - Nita Viwattanatipa
- Department of Orthodontics, Faculty of Dentistry, Mahidol University, 6 Yothi Street, Ratchthewi, Bangkok, 10400, Thailand
| | - Somchai Manopatanakul
- Department of Advanced General Dentistry, Faculty of Dentistry, Mahidol University, 6 Yothi Street, Ratchthewi, Bangkok, 10400, Thailand.
| | | |
Collapse
|
8
|
Chaisooktaksin N, Chimruang J, Worasakwutiphong S, Tansalarak R. Three-dimensional Changes of Maxillary Alveolar Morphology After Using Modified Nasoalveolar Molding in Patients with Complete Unilateral Cleft lip and Palate. Cleft Palate Craniofac J 2022:10556656221086816. [PMID: 35285744 DOI: 10.1177/10556656221086816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE This study aimed to evaluate the three-dimensional changes in maxillary alveolar morphology after using modified NAM in patients with complete unilateral cleft lip and palate. DESIGN This is a retrospective study. SETTING The study was carried out in the dental hospital, Faculty of Dentistry of Naresuan University, Phitsanulok, which serves as a tertiary care center. PATIENTS The population sample consisted of 19 patients with nonsyndromic complete unilateral cleft lip and palate. INTERVENTION All patients received the modified NAM treatment based on the treatment protocol of the Naresuan University Cleft and Craniofacial Center, Thailand. MAIN OUTCOME MEASURE Dental models obtained at pre-treatment (T0) and post-treatment (T1) were scanned to construct the digital models. The maxillary digital models that showed dimensional changes between T0 and T1 were measured using a computer graphic software. RESULTS The modified NAM resulted in a significant decrease in the anterior cleft width, posterior cleft width, and anterior arch width. Conversely, it caused a significant increase in the length of the lesser cleft segment and the greater segment rotation. However, the change in the height of both segments and posterior arch width was not found to be significant. CONCLUSIONS The modified NAM was an effective device for reducing the alveolar cleft width while improving the alignment of alveolar cleft segments.
Collapse
Affiliation(s)
- Nuntabhorn Chaisooktaksin
- Department of Preventive Dentistry, Faculty of Dentistry, 59212Naresuan University, Phitsanulok 65000, Thailand
| | - Jutharat Chimruang
- Department of Preventive Dentistry, Faculty of Dentistry, 59212Naresuan University, Phitsanulok 65000, Thailand.,Naresuan University Cleft and Craniofacial Center, Phitsanulok 65000, Thailand
| | - Saran Worasakwutiphong
- Department of Surgery, Faculty of Medicine, 59212Naresuan University, Phitsanulok 65000, Thailand.,Naresuan University Cleft and Craniofacial Center, Phitsanulok 65000, Thailand
| | - Ratchawan Tansalarak
- Department of Preventive Dentistry, Faculty of Dentistry, 59212Naresuan University, Phitsanulok 65000, Thailand.,Naresuan University Cleft and Craniofacial Center, Phitsanulok 65000, Thailand
| |
Collapse
|