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Almoammar KA. Harnessing the Power of Artificial Intelligence in Cleft Lip and Palate: An In-Depth Analysis from Diagnosis to Treatment, a Comprehensive Review. CHILDREN (BASEL, SWITZERLAND) 2024; 11:140. [PMID: 38397252 PMCID: PMC10886996 DOI: 10.3390/children11020140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/23/2023] [Revised: 01/09/2024] [Accepted: 01/14/2024] [Indexed: 02/25/2024]
Abstract
Cleft lip and palate (CLP) is the most common craniofacial malformation, with a range of physical, psychological, and aesthetic consequences. In this comprehensive review, our main objective is to thoroughly examine the relationship between CLP anomalies and the use of artificial intelligence (AI) in children. Additionally, we aim to explore how the integration of AI technology can bring about significant advancements in the fields of diagnosis, treatment methods, and predictive outcomes. By analyzing the existing evidence, we will highlight state-of-the-art algorithms and predictive AI models that play a crucial role in achieving precise diagnosis, susceptibility assessment, and treatment planning for children with CLP anomalies. Our focus will specifically be on the efficacy of alveolar bone graft and orthodontic interventions. The findings of this review showed that deep learning (DL) models revolutionize the diagnostic process, predict susceptibility to CLP, and enhance alveolar bone grafts and orthodontic treatment. DL models surpass human capabilities in terms of precision, and AI algorithms applied to large datasets can uncover the intricate genetic and environmental factors contributing to CLP. Additionally, Machine learning aids in preoperative planning for alveolar bone grafts and provides personalized treatment plans in orthodontic treatment. In conclusion, these advancements inspire optimism for a future where AI seamlessly integrates with CLP management, augmenting its analytical capabilities.
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Affiliation(s)
- Khalid A Almoammar
- Department of Pediatric Dentistry and Orthodontics, College of Dentistry, King Saud University, P.O. Box 60169, Riyadh 11545, Saudi Arabia
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2
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da Silva AM, de Lavôr JR, Freitas VS, Vieira AR. Coast-or Inland Residence and Differences in the Occurrence of Cleft Lip and Cleft Palate. Cleft Palate Craniofac J 2023:10556656231204503. [PMID: 37743563 DOI: 10.1177/10556656231204503] [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: 09/26/2023] Open
Abstract
OBJETIVE To analyze if differences in lifestyle and environment between coastal and inland areas are associated with differences in frequency of orofacial cleft types. DESIGN Populational cross-sectional study. SETTING All live borns with orofacial cleft registered at Brazilian Live Birth Information System between 1999 and 2020. PARTICIPANTS 33,699 live borns with orofacial cleft. INTERVENTION Data from borns with orofacial cleft were collected at Brazilian Live Birth Information System. MAIN OUTCOME MEASURE Differences in frequencies between the cleft types and covariates were determined using chi-square. Bivariate analysis was done to obtain the prevalence ratio of types of clefts by geographic origin. Multiple logistic regression analysis was used to determine adjusted odds ratios, controlling for covariates, establishing a significance level of p value <0.05. RESULTS The frequency of cleft types was statistically significant different according to geographic origin (inland x coast). For syndromic clefts, the prevalence ratio for cleft lip with/without palate was 3.6 times higher inland (p value = 0.000). Regarding non-syndromics, the prevalence ratio for cleft lip with/without palate was two times higher inland (p value = 0.000). Logistic regression suggested cleft lip with/without palate was 6.33 more likely to occur in inland regions (p value = 0.000). CONCLUSION Geographic origin was associated with the type of cleft in Brazil, with a higher prevalence of cleft lip with/without palate in inland areas, compared to cleft palate, which was higher in the coast.
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Affiliation(s)
- Adriana Mendonça da Silva
- Public Health PhD Graduate Program, State University of Feira de Santana, Feira de Santana, BA, Brazil
- Department of Oral and Craniofacial Sciences, University of Pittsburgh, Pittsburgh, PA, USA
| | - Juliane Rolim de Lavôr
- Department of Oral and Craniofacial Sciences, University of Pittsburgh, Pittsburgh, PA, USA
- Pediatric Dentistry PhD Graduate Program, State University of Pernambuco, Recife, PE, Brazil
| | - Valéria Souza Freitas
- Department of Health, State University of Feira de Santana, Feira de Santana, BA, Brazil
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Mink van der Molen AB, van Breugel JMM, Janssen NG, Admiraal RJC, van Adrichem LNA, Bierenbroodspot F, Bittermann D, van den Boogaard MJH, Broos PH, Dijkstra-Putkamer JJM, van Gemert-Schriks MCM, Kortlever ALJ, Mouës-Vink CM, Swanenburg de Veye HFN, van Tol-Verbeek N, Vermeij-Keers C, de Wilde H, Kuijpers-Jagtman AM. Clinical Practice Guidelines on the Treatment of Patients with Cleft Lip, Alveolus, and Palate: An Executive Summary. J Clin Med 2021; 10:jcm10214813. [PMID: 34768332 PMCID: PMC8584510 DOI: 10.3390/jcm10214813] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Revised: 10/06/2021] [Accepted: 10/10/2021] [Indexed: 11/16/2022] Open
Abstract
Significant treatment variation exists in the Netherlands between teams treating patients with cleft lip, alveolus, and/or palate, resulting in a confusing and undesirable situation for patients, parents, and practitioners. Therefore, to optimize cleft care, clinical practice guidelines (CPGs) were developed. The aim of this report is to describe CPG development, share the main recommendations, and indicate knowledge gaps regarding cleft care. Together with patients and parents, a multidisciplinary working group of representatives from all relevant disciplines assisted by two experienced epidemiologists identified the topics to be addressed in the CPGs. Searching the Medline, Embase, and Cochrane Library databases identified 5157 articles, 60 of which remained after applying inclusion and exclusion criteria. We rated the quality of the evidence from moderate to very low. The working group formulated 71 recommendations regarding genetic testing, feeding, lip and palate closure, hearing, hypernasality, bone grafting, orthodontics, psychosocial guidance, dentistry, osteotomy versus distraction, and rhinoplasty. The final CPGs were obtained after review by all stakeholders and allow cleft teams to base their treatment on current knowledge. With high-quality evidence lacking, the need for additional high-quality studies has become apparent.
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Affiliation(s)
- Aebele B. Mink van der Molen
- Department of Plastic and Reconstructive Surgery, University Medical Center Utrecht, 3584 CX Utrecht, The Netherlands; (J.M.M.v.B.); (L.N.A.v.A.)
- Correspondence: ; Tel.: +31-88-7554-004
| | - Johanna M. M. van Breugel
- Department of Plastic and Reconstructive Surgery, University Medical Center Utrecht, 3584 CX Utrecht, The Netherlands; (J.M.M.v.B.); (L.N.A.v.A.)
| | - Nard G. Janssen
- Department Maxillo Facial Surgery and Dentistry, University Medical Center Utrecht, 3584 CX Utrecht, The Netherlands; (N.G.J.); (D.B.)
| | - Ronald J. C. Admiraal
- Department of Oto-Rhino-Laryngology, Radboud University Medical Center, 6500 HB Nijmegen, The Netherlands;
| | - Leon N. A. van Adrichem
- Department of Plastic and Reconstructive Surgery, University Medical Center Utrecht, 3584 CX Utrecht, The Netherlands; (J.M.M.v.B.); (L.N.A.v.A.)
| | | | - Dirk Bittermann
- Department Maxillo Facial Surgery and Dentistry, University Medical Center Utrecht, 3584 CX Utrecht, The Netherlands; (N.G.J.); (D.B.)
| | | | - Pieter H. Broos
- Knowledge Institute of the Federation of Medical Specialists, 3528 BL Utrecht, The Netherlands; (P.H.B.); (A.L.J.K.)
| | | | | | - Andrea L. J. Kortlever
- Knowledge Institute of the Federation of Medical Specialists, 3528 BL Utrecht, The Netherlands; (P.H.B.); (A.L.J.K.)
| | - Chantal M. Mouës-Vink
- Department of Plastic and Reconstructive Surgery, Medical Center Leeuwarden, 8934 AD Leeuwarden, The Netherlands;
| | | | | | - Christl Vermeij-Keers
- Dutch Association for Cleft Palate and Craniofacial Anomalies, 3643 AE Mijdrecht, The Netherlands;
| | - Hester de Wilde
- Department of Speech Therapy, University Medical Center Utrecht, 3584 CX Utrecht, The Netherlands;
| | - Anne Marie Kuijpers-Jagtman
- Department of Orthodontics, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands;
- Department of Orthodontics and Dentofacial Orthopedics, School of Dental Medicine, Medical Faculty, University of Bern, CH-3010 Bern, Switzerland
- Faculty of Dentistry, Universitas Indonesia, Jakarta 10430, Indonesia
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Yow M, Jin A, Yeo GSH. Epidemiologic trends of infants with orofacial clefts in a multiethnic country: a retrospective population-based study. Sci Rep 2021; 11:7556. [PMID: 33824370 PMCID: PMC8024282 DOI: 10.1038/s41598-021-87229-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Accepted: 03/23/2021] [Indexed: 11/08/2022] Open
Abstract
Cleft births surveillance is essential in healthcare and prevention planning. Data are needed in precision medicine to target upstream management for at-risk individuals. This study characterizes Singapore's population-based orofacial cleft topography by ethnicity and gender, and establishes the cleft cohort's infant mortality rate. Data, in the decade 2003 to 2012, were extracted by the National Birth Defects Registry. Trend testing by linear regression was at p < 0.05 significance level. Prevalence per 10,000 for population-based cleft live births was 16.72 with no significant upward trend (p = 0.317). Prevalence rates were 8.77 in the isolated cleft group, 7.04 in the non-isolated cleft group, and 0.91 in the syndromic cleft group. There was significant upward trend in infants with non-isolated clefts (p = 0.0287). There were no significant upward trends in infants with isolated clefts and syndromic clefts. Prevalence rates were sexually dimorphic and ethnic-specific: male 17.72; female 15.78; Chinese group 17.17; Malay group 16.92; Indian group 10.74; and mixed ethnic origins group 21.73. The overall infant mortality rate (IMR) was 4.8% in the cohort of 608 cleft births, which was more than double the population-based IMR of 2.1% in the same period. Infants with non-isolated and syndromic clefts accounted for 96.6% of the deaths.
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Affiliation(s)
- Mimi Yow
- Department of Orthodontics, National Dental Centre Singapore, Second Hospital Avenue, Singapore, 168938, Singapore.
- Department of Dental Medicine, Karolinska Institutet, Alfred Nobels Allé 8, Huddinge, Sweden.
| | - Aizhen Jin
- Centre for Healthy Longevity, Yong Loo Lin School of Medicine, National University of Singapore, 10 Medical Drive, Singapore, 117597, Singapore
| | - George Seow Heong Yeo
- Department of Maternal and Fetal Medicine, KK Women's and Children's Hospital, 100 Bukit Timah Road, Singapore, 229899, Singapore
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Nasreddine G, El Hajj J, Ghassibe-Sabbagh M. Orofacial clefts embryology, classification, epidemiology, and genetics. MUTATION RESEARCH-REVIEWS IN MUTATION RESEARCH 2021; 787:108373. [PMID: 34083042 DOI: 10.1016/j.mrrev.2021.108373] [Citation(s) in RCA: 44] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 02/21/2021] [Accepted: 02/23/2021] [Indexed: 01/14/2023]
Abstract
Orofacial clefts (OFCs) rank as the second most common congenital birth defect in the United States after Down syndrome and are the most common head and neck congenital malformations. They are classified as cleft lip with or without cleft palate (CL/P) and cleft palate only (CPO). OFCs have significant psychological and socio-economic impact on patients and their families and require a multidisciplinary approach for management and counseling. A complex interaction between genetic and environmental factors contributes to the incidence and clinical presentation of OFCs. In this comprehensive review, the embryology, classification, epidemiology and etiology of clefts are thoroughly discussed and a "state-of-the-art" snapshot of the recent advances in the genetics of OFCs is presented.
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Affiliation(s)
- Ghenwa Nasreddine
- Department of Natural Sciences, School of Arts and Sciences, Lebanese American University, P.O. Box: 13-5053, Chouran, 1102 2801, Beirut, Lebanon.
| | - Joelle El Hajj
- Department of Natural Sciences, School of Arts and Sciences, Lebanese American University, P.O. Box: 13-5053, Chouran, 1102 2801, Beirut, Lebanon.
| | - Michella Ghassibe-Sabbagh
- Department of Natural Sciences, School of Arts and Sciences, Lebanese American University, P.O. Box: 13-5053, Chouran, 1102 2801, Beirut, Lebanon.
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Yow M, Hermann NV, Wei Y, Karsten A, Kreiborg S. Dental Subphenotypes in Infants With Orofacial Clefts-A Longitudinal Population-Based Retrospective Radiographic Study of the Primary and Secondary Dentitions. Cleft Palate Craniofac J 2021; 58:1526-1535. [PMID: 33541114 DOI: 10.1177/1055665621990148] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVES To determine the developmental patterns of primary and secondary dentitions in infants with orofacial clefts. DESIGN Retrospective, longitudinal, population-based cohort study. MATERIALS Longitudinal records and radiographs of 192 nonsyndromic Northern European infants with isolated unilateral cleft lip (UCL, n = 111) and isolated cleft palate (CP, n = 81). METHODS Radiographic assessments of primary and secondary dentition anomalies and dental maturation, by gender and cleft severity for comparisons between the groups and with historical controls. RESULTS In infants with UCL, the frequencies of dental anomalies were high in both primary (38.7%) and secondary (18.0%) dentitions. Primary and secondary dentition anomalies were not observed in infants with CP and different in the UCL group (P = .003). Risk differences involved primary supernumerary teeth (P = .0001) and talon cusp formation (P = .0001), and secondary tooth agenesis (P = .001) of the maxillary lateral incisor on the side of the cleft lip. Delayed primary and secondary dental maturation occurred in the UCL and CP groups, greater in infants with UCL (P < .0001). Primary and secondary dental maturation featured sexual dimorphism with greater delay in males (UCL, P < .0001; CP, .0001 > P = .001). The effect of cleft severity on dental maturation was significant in infants with UCL (P = .0361) and CP (P = .0175) in the primary but not in the secondary dentition. CONCLUSIONS There were different dental anomalies in the primary and secondary dentitions in operated infants with UCL and no dental anomalies in unoperated infants with CP. Dental maturation was delayed in infants with UCL and CP with greater delay in males compared to females.
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Affiliation(s)
- Mimi Yow
- Department of Orthodontics, National Dental Centre, SingHealth Duke-NUS Oral Health Academic Programme, Second Hospital Avenue, Singapore.,Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden
| | - Nuno V Hermann
- Department of Pediatric Dentistry and Clinical Genetics, School of Dentistry, Faculty of Health Sciences, University of Copenhagen, Denmark
| | - Yuan Wei
- Singapore Clinical Research Institute (SCRI), Singapore
| | - Agneta Karsten
- Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden
| | - Sven Kreiborg
- Department of Pediatric Dentistry and Clinical Genetics, School of Dentistry, Faculty of Health Sciences, University of Copenhagen, Denmark
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van der Lek LM, Pool SMW, de Jong K, Vermeij-Keers C, Mouës-Vink CM. Seasonal Influence on the Numbers of Gender-Related Orofacial Cleft Conceptions in the Netherlands. Cleft Palate Craniofac J 2021; 58:1422-1429. [PMID: 33467910 DOI: 10.1177/1055665620987693] [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
BACKGROUND In the multifactorial etiology of orofacial clefts (OFCs), environmental factors play an important role. To trace the influence of these factors, the timing of the cell biological mechanisms that occur during embryological development of the primary and secondary palates must be taken into account. That is, the fusion process of the facial and palatal processes, respectively, followed by their differentiation into bone and musculature, which take place during the first trimester of pregnancy. During this period, harmful seasonal influences such as viral infections and vitamin deficiencies could induce OFC in the embryo. AIMS The aim of this study is to find out whether a seasonal conception period with an increased risk of OFC development exists, particularly gender related. METHODS This was a retrospective cross-sectional study on children with OFC born in the Netherlands from 2006 to 2016. Total conception rates of live births in the Netherlands were used as a control group. χ2 tests were performed to analyze monthly and seasonal differences. Males and females, positive and negative family history and subphenotype groups based on fusion and/or differentiation (F- and/or D-) defects, and their timing in embryogenesis were analyzed separately. RESULTS In total, 1653 children with OFC, 1041 males and 612 females, were analyzed. Only males with FD-defects showed a significant seasonal variation with an increase in conceptions during spring, most often in May. CONCLUSIONS Males with FD-defects showed a significant seasonal variation with an increase in conceptions during spring. No other seasonal trends could be demonstrated.
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Affiliation(s)
- Lisanne M van der Lek
- Department of Ear, Nose and Throat, 4480Medical Center Leeuwarden, Leeuwarden, the Netherlands
| | - Shariselle M W Pool
- Department of Plastic Surgery, 10173University Medical Center Utrecht, the Netherlands
| | - Kim de Jong
- Department of Epidemiology, 4480Medical Center Leeuwarden, Leeuwarden, the Netherlands
| | - Christl Vermeij-Keers
- Department of Plastic and Reconstructive Surgery, Erasmus MC, 10173University Medical Center Rotterdam, the Netherlands; Dutch Association for Cleft Palate and Craniofacial Anomalies the Netherlands
| | - Chantal M Mouës-Vink
- Department of Plastic Surgery, 4480Medical Center Leeuwarden, Leeuwarden, the Netherlands
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Kruse T, Mangold E, Braumann B. Impact of Maternal Smoking on Nonsyndromic Clefts: Sex-Specific Associations With Side and Laterality. Cleft Palate Craniofac J 2020; 58:181-188. [PMID: 32844678 DOI: 10.1177/1055665620951099] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVE To compare the incidence of right-sided versus left-sided, and unilateral versus bilateral, nonsyndromic clefting in the affected offspring of smoking and nonsmoking mothers. DESIGN Self-report data on periconceptual and first trimester smoking behavior were collected from 842 mothers of children with nonsyndromic orofacial clefting. Differences in the incidence of left- versus right-sided clefts, and of unilateral versus bilateral clefts, were analyzed between the children of smoking and nonsmoking mothers. SETTING Interviews and clinical examinations took place at 8 specialist centers in Germany. PATIENTS AND PARTICIPANTS Children with nonsyndromic clefts were recruited during the course of surgical or orthodontic treatment, or within the context of the annual control consultation. Patients with cleft palate only or missing data were excluded. The final cohort comprised 842 patients (540 males and 302 females) with unilateral or bilateral clefts. The respective mothers were interviewed. MAIN OUTCOME MEASURE Side and laterality of nonsyndromic clefts were the main outcome measures. RESULTS Children of smoking mothers more often had right-sided clefts than children of nonsmoking mothers (42% right-sided clefts in children of smoking mothers vs 31% of nonsmoking mothers). Children of smoking mothers more often had bilateral clefts than children of nonsmoking mothers (35% bilateral clefts in children of smoking mothers vs 29% of nonsmoking mothers). Sex-specific analyses confirmed substantially and statistically significant associations only for girls. CONCLUSIONS The results suggest that maternal smoking is a sex-specific, exogenous determinant of laterality and side in nonsyndromic clefts.
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Affiliation(s)
- Teresa Kruse
- Department of Orthodontics, 14309University of Cologne, Cologne, Germany.,Center for Rare Diseases Cologne, 14309University of Cologne, Cologne, Germany
| | | | - Bert Braumann
- Department of Orthodontics, 14309University of Cologne, Cologne, Germany.,Center for Rare Diseases Cologne, 14309University of Cologne, Cologne, Germany
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Pool SMW, der Lek LMV, de Jong K, Vermeij-Keers C, Mouës-Vink CM. Embryologically Based Classification Specifies Gender Differences in the Prevalence of Orofacial Cleft Subphenotypes. Cleft Palate Craniofac J 2020; 58:54-60. [PMID: 32602363 PMCID: PMC7739112 DOI: 10.1177/1055665620935363] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Background: A recently published validated classification system divides all orofacial cleft (OFC) subphenotypes into groups based on underlying developmental mechanisms, that is, fusion and differentiation, and their timing, that is, early and late periods, in embryogenesis of the primary and secondary palates. Aims: The aim of our study was to define gender differences in prevalence for all subphenotypes in newborns with OFC in the Netherlands. Methods: This was a retrospective cross-sectional study on children with OFC born from 2006 to 2016. Clefts were classified in early (E-), late (L-), and early/late (EL-) embryonic periods, in primary (P-), secondary (S-), and primary/secondary (PS-) palates, and further divided into fusion (F-), differentiation (D-), and fusion/differentiation (FD-) defects, respectively. Results: A total of 2089 OFC children were analyzed (1311 males and 778 females). Orofacial cleft subphenotypes in females occurred significantly more frequent in the L-period compared to males (66% vs 55%, P = .000), whereas clefts in males occurred significantly more in the EL-periods (40% vs 27%, P = .000). Females had significantly more S-palatal clefts (42% vs 23%, P = .000), while males had significantly more PS-palatal clefts (44% vs 30%, P = .000). Furthermore, the clefts in females were significantly more frequent the result of an F-defect (60% vs 52%, P = .000). Conclusions: Orofacial cleft in females mainly occur in the L-period are mostly S-palatal clefts, and are usually the result of an F-defect. Orofacial cleft in males more commonly occur in the EL-periods, are therefore more often combined PS-palatal clefts, and are more frequent D- and FD-defects.
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Affiliation(s)
- Shariselle M W Pool
- Department of Plastic Surgery, 10173University Medical Center Groningen, Groningen, the Netherlands
| | - Lisanne M van der Lek
- Department of Ear, Nose and Throat, 4480Medical Center Leeuwarden, Leeuwarden, the Netherlands
| | - Kim de Jong
- Department of Epidemiology, 4480Medical Center Leeuwarden, Leeuwarden, the Netherlands
| | - Christl Vermeij-Keers
- Department of Plastic and Reconstructive Surgery, 6993Erasmus University Medical Center, Rotterdam, the Netherlands.,Dutch Association for Cleft Palate and Craniofacial Anomalies, Mijdrecht, the Netherlands
| | - Chantal M Mouës-Vink
- Department of Plastic Surgery, 4480Medical Center Leeuwarden, Leeuwarden, the Netherlands
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Saleem K, Zaib T, Sun W, Fu S. Assessment of candidate genes and genetic heterogeneity in human non syndromic orofacial clefts specifically non syndromic cleft lip with or without palate. Heliyon 2019; 5:e03019. [PMID: 31886431 PMCID: PMC6921104 DOI: 10.1016/j.heliyon.2019.e03019] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Revised: 11/25/2019] [Accepted: 12/06/2019] [Indexed: 12/26/2022] Open
Abstract
Non syndromic orofacial clefts specifically non-syndromic cleft lip/palate are one of the most common craniofacial malformation among birth defects in human having multifactorial etiology with an incidence of 1:700/1000. On the basis of association with other congenital malformations or their presence as isolated anomaly, OFC can be classified as syndromic (30%) and nonsyndromic (70%) respectively. The major cause of disease demonstrates complex interplay between genetic and environmental factors. The pathogenic mechanism of underlying factors have been provided by different genetic studies on large-scale with significant recent advances in genotyping technologies usually based on linkage or genome wide association studies (GWAS). On the basis of recent studies, new tools to identify causative genes involved in NSCL/P reported approximately more than 30 genetic risk loci that are responsible for pathogenesis of facial deformation. Despite these findings, it is still uncertain that how much of variance in NSCL/P predisposing factors can be explain by identified risk loci, as they all together accounts for only 20%-25% of NSCL/P heritability. So there is need of further findings about the problem of rare low frequency coding variants and other missing responsive factors or genetic modifiers. This review will described those potential genes and loci reported in different studies whose involvement in pathogenesis of nonsyndromic OFC has wide scientific evidence.
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Affiliation(s)
- Komal Saleem
- Laboratory of Medical Genetics, Harbin Medical University, Harbin 150081, China.,Key Laboratory of Preservation of Human Genetics Resources and Disease Control in China (Harbin Medical University), Ministry of Education, China
| | - Tahir Zaib
- Laboratory of Medical Genetics, Harbin Medical University, Harbin 150081, China.,Key Laboratory of Preservation of Human Genetics Resources and Disease Control in China (Harbin Medical University), Ministry of Education, China
| | - Wenjing Sun
- Laboratory of Medical Genetics, Harbin Medical University, Harbin 150081, China.,Key Laboratory of Preservation of Human Genetics Resources and Disease Control in China (Harbin Medical University), Ministry of Education, China
| | - Songbin Fu
- Laboratory of Medical Genetics, Harbin Medical University, Harbin 150081, China.,Key Laboratory of Preservation of Human Genetics Resources and Disease Control in China (Harbin Medical University), Ministry of Education, China
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11
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Lara-Reyna J, Carlton J, Parker WE, Greenfield JP. Synchronous complex Chiari malformation and cleft palate-a case-based review. Childs Nerv Syst 2018; 34:2353-2359. [PMID: 30128838 DOI: 10.1007/s00381-018-3950-3] [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: 02/22/2018] [Accepted: 08/13/2018] [Indexed: 11/26/2022]
Abstract
BACKGROUND The association between mid-facial clefts and Chiari malformation in the medical literature has been restricted to patients with syndromic craniofacial abnormalities. A common shared developmental pathway including causative factors for facial clefts and "complex" Chiari malformations, both midline skull base pathologies, seems logical but has not been reported. The coincident presentation of these findings in a single patient, and our subsequent discovery of other patients harboring these mutual findings prompted further investigation. CASE ILLUSTRATION We describe the case of a patient born with a cleft palate which was repaired during his first year of life, subsequently presenting as a teenager to our hospital with a severe and symptomatic complex Chiari malformation. We discuss his treatment strategy, suboccipital decompression with occipitocervical fusion and endoscopic anterior decompression surgeries, as well as his favorable radiological and clinical outcome, demonstrated at long-interval follow-up. Furthermore, we review his two pathologies, cleft palate and Chiari malformation, and posit a common embryological linkage. CONCLUSIONS The embryologic interaction between the paraxial mesoderm and ectoderm may explain the co-occurrence of cleft palate and complex Chiari malformation in a single patient. Complete radiological, clinical, and genetic evaluation and counseling is advised in this situation and raises the question of whether the presence of a cleft palate independently increases the risk for other skull base developmental abnormalities.
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Affiliation(s)
- Jacques Lara-Reyna
- Department of Neurological Surgery, New York Presbyterian Hospital-Weill Cornell Medical College, 520 East 70th Street, Starr Pavilion, Suite 651, New York, USA
| | - Johnny Carlton
- Department of Neurological Surgery, New York Presbyterian Hospital-Weill Cornell Medical College, 520 East 70th Street, Starr Pavilion, Suite 651, New York, USA
| | - Whitney E Parker
- Department of Neurological Surgery, New York Presbyterian Hospital-Weill Cornell Medical College, 520 East 70th Street, Starr Pavilion, Suite 651, New York, USA
| | - Jeffrey P Greenfield
- Department of Neurological Surgery, New York Presbyterian Hospital-Weill Cornell Medical College, 520 East 70th Street, Starr Pavilion, Suite 651, New York, USA.
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Vermeij-Keers C, Rozendaal AM, Luijsterburg AJM, Latief BS, Lekkas C, Kragt L, Ongkosuwito EM. Subphenotyping and Classification of Cleft Lip and Alveolus in Adult Unoperated Patients: A New Embryological Approach. Cleft Palate Craniofac J 2018; 55:1267-1276. [PMID: 29652537 DOI: 10.1177/1055665618767106] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVE Previously, a new embryological classification was introduced subdividing oral clefts into fusion and/or differentiation defects. This subdivision was used to classify all subphenotypes of cleft lip with or without alveolus (CL±A). Subsequently, it was investigated whether further morphological grading of incomplete CLs is clinically relevant, and which alveolar part is deficient in fusion/differentiation defects. DESIGN Observational cohort study. SETTING Three hundred fifty adult unoperated Indonesian cleft patients presented themselves for operation. Cephalograms, dental casts, and intraoral and extraoral photographs-eligible for the present study-were used to determine morphological severity of CL±A. PATIENTS Patients with unilateral or bilateral clefts of the primary palate only were included. MAIN OUTCOME MEASURES Clefts were classified-according to developmental mechanisms and timing in embryogenesis-as fusion and/or differentiation defects. Grades of incomplete CLs were related to the severity of alveolar clefts (CAs) and hypoplasia, and permanent dentition was used to investigate which alveolar part is deficient in fusion/differentiation defects. RESULTS One hundred eight adult patients were included. All subphenotypes-96 unilateral and 12 bilateral clefts-could be classified into differentiation (79%), fusion (17%), fusion-differentiation (2%), or fusion and differentiation (2%) defects. The various grades of incomplete CLs were related to associated CAs and hypoplasia, and all alveolar deformities were located in the premaxillae. CONCLUSIONS This study showed that all CL±A including the Simonart bands can be classified, that further morphological grading of incomplete CLs is clinically relevant, and that the premaxilla forms the deficient part in alveolar deformities.
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Affiliation(s)
- Christl Vermeij-Keers
- 1 Department of Plastic and Reconstructive Surgery, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Anna M Rozendaal
- 1 Department of Plastic and Reconstructive Surgery, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Antonius J M Luijsterburg
- 1 Department of Plastic and Reconstructive Surgery, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Benny S Latief
- 2 Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, University of Indonesia, Jakarta, Indonesia
| | - Costas Lekkas
- 3 Department of Oral and Maxillofacial Surgery, Leiden University Medical Center, Leiden, The Netherlands
| | - Lea Kragt
- 4 Department of Oral and Maxillofacial Surgery, Special Dental Care and Orthodontics, Erasmus MC-Sophia Children's Hospital, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Edwin M Ongkosuwito
- 5 Unit of Orthodontics, Department of Oral and Maxillofacial Surgery, Special Dental Care and Orthodontics, Erasmus MC-Sophia Children's Hospital, University Medical Center Rotterdam, Rotterdam, The Netherlands
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13
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do Nascimento RL, Castilla EE, Dutra MDG, Orioli IM. ICD-10 impact on ascertainment and accuracy of oral cleft cases as recorded by the Brazilian national live birth information system. Am J Med Genet A 2018; 176:907-914. [PMID: 29424949 DOI: 10.1002/ajmg.a.38634] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2017] [Revised: 01/12/2018] [Accepted: 01/16/2018] [Indexed: 12/12/2022]
Abstract
We compared Brazilian oral cleft (OC) frequencies between the population-based Brazilian System of Live Birth (SINASC) and the hospital-based Latin American Collaborative Study of Congenital Malformations (ECLAMC), trying to understand the paucity of cleft of lip and palate (CLP) in the first system. SINASC uses the International Classification of Disease version 10 (ICD-10) for congenital defects coding, ECLAMC uses ICD-8 with modifications. In SINASC, the CLP frequency was 1.7 per 10,000 (95% confidence limits 1.7-1.8), cleft lip (CL) 1.6 (1.5-1.7), and cleft palate (CP) 2.0 (1.9-2.1). In ECLAMC, the CLP frequency was 10.4 per 10,000 (9.0-12.1), CL 5.5 (4.5-6.7), and CP 4.4. (4.5-6.7). In SINASC, only 33% of the oral clefts were CLP, versus 51% in ECLAMC. Part of this discrepancy may have been due to the relative excess of CP and CL cases. Although congenital defect frequencies are usually lower in population than in hospital-based registries, differences in the proportion of the main OC categories are not expected and are probably due to ICD-10 coding issues, such as lumping of unilateral CL and CL without other specifications. ICD-10 codes, whose deficiency for oral clefts is fully explained in the literature, lack modifiers for severity, or clinical subtypes. This paper shows the practical aspect of the ICD-10 system deficiency in capturing cleft lip and palate (CLP) subtypes, as demonstrated in SINASC covering three million births per year. Such errors are expected to occur in any registry that uses the ICD-10 coding system, and must be adjusted, given its relevance worldwide.
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Affiliation(s)
- Ricardo Lima do Nascimento
- Department of Genetics, Institute of Biology, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.,INAGEMP (National Institute of Population Medical Genetics), Rio de Janeiro, Brazil
| | - Eduardo E Castilla
- INAGEMP (National Institute of Population Medical Genetics), Rio de Janeiro, Brazil.,LEMC (Laboratory of Congenital Malformations Epidemiology), Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil.,CEMIC (Center for Medical Education and Clinical Research), Buenos Aires, Argentina
| | - Maria da Graça Dutra
- INAGEMP (National Institute of Population Medical Genetics), Rio de Janeiro, Brazil.,LEMC (Laboratory of Congenital Malformations Epidemiology), Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Iêda M Orioli
- Department of Genetics, Institute of Biology, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.,INAGEMP (National Institute of Population Medical Genetics), Rio de Janeiro, Brazil
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14
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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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15
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Peralta S, Fiani N, Kan-Rohrer KH, Verstraete FJM. Morphological evaluation of clefts of the lip, palate, or both in dogs. Am J Vet Res 2017; 78:926-933. [PMID: 28738009 DOI: 10.2460/ajvr.78.8.926] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To systematically characterize the morphology of cleft lip, cleft palate, and cleft lip and palate in dogs. ANIMALS 32 client-owned dogs with clefts of the lip (n = 5), palate (23), or both (4) that had undergone a CT or cone-beam CT scan of the head prior to any surgical procedures involving the oral cavity or face. PROCEDURES Dog signalment and skull type were recorded. The anatomic form of each defect was characterized by use of a widely used human oral-cleft classification system on the basis of CT findings and clinical images. Other defect morphological features, including shape, relative size, facial symmetry, and vomer involvement, were also recorded. RESULTS 9 anatomic forms of cleft were identified. Two anatomic forms were identified in the 23 dogs with cleft palate, in which differences in defect shape and size as well as vomer abnormalities were also evident. Seven anatomic forms were observed in 9 dogs with cleft lip or cleft lip and palate, and most of these dogs had incisive bone abnormalities and facial asymmetry. CONCLUSIONS AND CLINICAL RELEVANCE The morphological features of congenitally acquired cleft lip, cleft palate, and cleft lip and palate were complex and varied among dogs. The features identified here may be useful for surgical planning, developing of clinical coding schemes, or informing genetic, embryological, or clinical research into birth defects in dogs and other species.
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16
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Asllanaj B, Kragt L, Voshol I, Koudstaal M, Kuijpers MA, Xi T, Bergé SJ, Vermeij-Keers C, Ongkosuwito EM. Dentition Patterns in Different Unilateral Cleft Lip Subphenotypes. J Dent Res 2017; 96:1482-1489. [PMID: 28767297 DOI: 10.1177/0022034517723326] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Oral clefts play an essential role in disturbed odontogenesis of the deciduous and permanent dentition, yet little is known about this relationship. We investigated, within the categories cleft lip with or without alveolus (CL ± A) and cleft lip, alveolus and palate (CLAP), whether different CL subphenotypes based on morphological severity of the cleft show different dentition patterns and whether a more detailed subdivision of the incomplete CL has clinical relevance. In this retrospective study, 345 children with nonsyndromic unilateral CL ± A and CLAP from the Dutch Association for Cleft Palate and Craniofacial Anomalies (NVSCA) registry were included to assess the association between the CL subphenotypes and lateral incisor patterns. Five different deciduous and permanent patterns of the lateral incisor were distinguished: located in normal position (pattern z/Z), in the anterior segment (pattern x/X) or in the posterior segment of the cleft (pattern y/Y), one in each segment of the cleft (pattern xy/XY), and agenesis of the lateral incisor (pattern ab/AB). Analyses were performed by using multinomial logistic regression models. Children born with a vermillion notch or a one-third to two-thirds CL were most likely to have a deciduous pattern x and a permanent pattern X, while children born with a two-thirds to subtotal CL were most likely to have deciduous pattern xy and a permanent pattern X compared to children with a complete CL that predominantly had deciduous pattern y and a permanent pattern AB. Based on the relationship of the CL morphology with the deciduous dentition, subdivision of the CL morphology into vermillion notch to two-thirds CL, two-thirds to subtotal CL, and complete CL appears to be an optimal subdivision. Our results indicate that a more detailed subdivision of the CL has clinical relevance and that critical factors in the pathogenesis of the CL are also critical for the odontogenesis.
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Affiliation(s)
- B Asllanaj
- 1 Department of Oral and Maxillofacial Surgery, Orthodontics and Special Dental Care, Erasmus Medical Center, Rotterdam, the Netherlands
| | - L Kragt
- 1 Department of Oral and Maxillofacial Surgery, Orthodontics and Special Dental Care, Erasmus Medical Center, Rotterdam, the Netherlands
| | - I Voshol
- 1 Department of Oral and Maxillofacial Surgery, Orthodontics and Special Dental Care, Erasmus Medical Center, Rotterdam, the Netherlands
| | - M Koudstaal
- 1 Department of Oral and Maxillofacial Surgery, Orthodontics and Special Dental Care, Erasmus Medical Center, Rotterdam, the Netherlands
| | - M A Kuijpers
- 2 Department of Orthodontics and Craniofacial Biology, Radboud University Medical Center, the Netherlands
| | - T Xi
- 3 Department of Oral and Maxillofacial Surgery, Radboud University Medical Center, Nijmegen, the Netherlands
| | - S J Bergé
- 3 Department of Oral and Maxillofacial Surgery, Radboud University Medical Center, Nijmegen, the Netherlands
| | - C Vermeij-Keers
- 4 Department of Plastic, Reconstructive and Hand Surgery, Erasmus Medical Center, Rotterdam, the Netherlands; NVSCA-Registry Leader
| | - E M Ongkosuwito
- 1 Department of Oral and Maxillofacial Surgery, Orthodontics and Special Dental Care, Erasmus Medical Center, Rotterdam, the Netherlands.,2 Department of Orthodontics and Craniofacial Biology, Radboud University Medical Center, the Netherlands
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17
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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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18
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Insight into the Pathophysiologic Mechanisms behind Cognitive Dysfunction in Trigonocephaly. Plast Reconstr Surg 2017; 139:954e-964e. [DOI: 10.1097/prs.0000000000003179] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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19
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Muggenthaler MMA, Chowdhury B, Hasan SN, Cross HE, Mark B, Harlalka GV, Patton MA, Ishida M, Behr ER, Sharma S, Zahka K, Faqeih E, Blakley B, Jackson M, Lees M, Dolinsky V, Cross L, Stanier P, Salter C, Baple EL, Alkuraya FS, Crosby AH, Triggs-Raine B, Chioza BA. Mutations in HYAL2, Encoding Hyaluronidase 2, Cause a Syndrome of Orofacial Clefting and Cor Triatriatum Sinister in Humans and Mice. PLoS Genet 2017; 13:e1006470. [PMID: 28081210 PMCID: PMC5230738 DOI: 10.1371/journal.pgen.1006470] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2016] [Accepted: 11/08/2016] [Indexed: 01/25/2023] Open
Abstract
Orofacial clefting is amongst the most common of birth defects, with both genetic and environmental components. Although numerous studies have been undertaken to investigate the complexities of the genetic etiology of this heterogeneous condition, this factor remains incompletely understood. Here, we describe mutations in the HYAL2 gene as a cause of syndromic orofacial clefting. HYAL2, encoding hyaluronidase 2, degrades extracellular hyaluronan, a critical component of the developing heart and palatal shelf matrix. Transfection assays demonstrated that the gene mutations destabilize the molecule, dramatically reducing HYAL2 protein levels. Consistent with the clinical presentation in affected individuals, investigations of Hyal2-/- mice revealed craniofacial abnormalities, including submucosal cleft palate. In addition, cor triatriatum sinister and hearing loss, identified in a proportion of Hyal2-/- mice, were also found as incompletely penetrant features in affected humans. Taken together our findings identify a new genetic cause of orofacial clefting in humans and mice, and define the first molecular cause of human cor triatriatum sinister, illustrating the fundamental importance of HYAL2 and hyaluronan turnover for normal human and mouse development.
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Affiliation(s)
| | - Biswajit Chowdhury
- Department of Biochemistry & Medical Genetics, University of Manitoba, Winnipeg, Manitoba, Canada
| | - S. Naimul Hasan
- Department of Biochemistry & Medical Genetics, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Harold E. Cross
- Department of Ophthalmology, University of Arizona College of Medicine, Tucson, Arizona, United States of America
| | - Brian Mark
- Department of Microbiology, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Gaurav V. Harlalka
- RILD Wellcome Wolfson Centre, University of Exeter Medical School, Exeter, United Kingdom
| | - Michael A. Patton
- RILD Wellcome Wolfson Centre, University of Exeter Medical School, Exeter, United Kingdom
- Genetics Research Centre, St George’s University London, London, United Kingdom
| | - Miho Ishida
- Genetics and Genomic Medicine, UCL Institute of Child Health, London, United Kingdom
| | - Elijah R. Behr
- Cardiovascular Sciences Research Centre, St George's University of London, London, United Kingdom
| | - Sanjay Sharma
- Cardiovascular Sciences Research Centre, St George's University of London, London, United Kingdom
| | - Kenneth Zahka
- Pediatric Cardiology, Cleveland Clinic, Cleveland, Ohio, United States of America
| | - Eissa Faqeih
- Department of Pediatric Subspecialties, Children’s Hospital, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Brian Blakley
- Department of Otolaryngology, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Mike Jackson
- Department of Small Animal and Materials Imaging Facility, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Melissa Lees
- Department of Clinical Genetics, Great Ormond Street Hospital, London, United Kingdom
| | - Vernon Dolinsky
- Pharmacology & Therapeutics, University of Manitoba, Winnipeg, Manitoba, Canada
- Pediatrics & Child Health, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Leroy Cross
- Windows of Hope Genetic Information Centre, Holmes County, Ohio, United States of America
| | - Philip Stanier
- Genetics and Genomic Medicine, UCL Institute of Child Health, London, United Kingdom
| | - Claire Salter
- Human Genetics and Genomic Medicine, Faculty of Medicine, University of Southampton, Southampton, United Kingdom
| | - Emma L. Baple
- RILD Wellcome Wolfson Centre, University of Exeter Medical School, Exeter, United Kingdom
| | - Fowzan S. Alkuraya
- Department of Genetics, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
- Department of Anatomy and Cell Biology, College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
| | - Andrew H. Crosby
- RILD Wellcome Wolfson Centre, University of Exeter Medical School, Exeter, United Kingdom
- * E-mail: (AHC); (BTR)
| | - Barbara Triggs-Raine
- Department of Biochemistry & Medical Genetics, University of Manitoba, Winnipeg, Manitoba, Canada
- Pediatrics & Child Health, University of Manitoba, Winnipeg, Manitoba, Canada
- Manitoba Institute of Child Health, Winnipeg, Manitoba, Canada
- * E-mail: (AHC); (BTR)
| | - Barry A. Chioza
- RILD Wellcome Wolfson Centre, University of Exeter Medical School, Exeter, United Kingdom
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20
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Mcbride W, Mcintyre G, Carroll K, Mossey P. Subphenotyping and Classification of Orofacial Clefts: Need for Orofacial Cleft Subphenotyping Calls for Revised Classification. Cleft Palate Craniofac J 2016; 53:539-49. [DOI: 10.1597/15-029] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Nonsyndromic orofacial clefting (OFC) describes a range of phenotypes that represent the most common craniofacial birth defects in humans, with an overall birth prevalence of 1:700 live births. Because of the lifelong negative implications on health and well-being associated with OFC and the numbers of people affected, quality research into its etiology, diagnosis, treatment outcomes, and preventative strategies is essential. A range of different methods is used for recording and classifying OFC subphenotypes, one of which is the International Classification of Diseases (ICD) system. However, there is a general perception that research is being hampered by a lack of sensitivity and specificity in grouping those with OFC into subphenotypes, with potential heterogeneity and confounding in epidemiologic, genetic, and genotype-phenotype correlation studies. This article provides a background to the necessity of OFC research, discusses current controversies within cleft subphenotyping, and provides a brief overview of current OFC classifications as well as their limitations. The LAHSHAL classification is described in the context of a potentially useful tool for OFC that could complement the ICD-10/ICD-11 Beta coding systems to become a simply understood, universally accepted, clinically friendly, and research-sensitive instrument. Empowering registries, clinicians, and researchers to use a common classification system would have significant implications for OFC research across the world at a time when accurate subphenotyping is crucial and health care research is becoming increasingly tailored toward the individual.
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Affiliation(s)
- W.A. Mcbride
- Queen's University Dental School, Belfast, Northern Ireland
| | - G.T. Mcintyre
- Consultant of Orthodontics, Dundee Dental Hospital and School, Dundee, Scotland
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21
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Watkins SE, Meyer RE, Strauss RP, Aylsworth AS. Classification, epidemiology, and genetics of orofacial clefts. Clin Plast Surg 2014; 41:149-63. [PMID: 24607185 DOI: 10.1016/j.cps.2013.12.003] [Citation(s) in RCA: 142] [Impact Index Per Article: 14.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Orofacial clefts (OFCs) include a broad range of facial conditions that differ in cause and disease burden. In the published literature, there is substantial ambiguity in both terminology and classification of OFCs. This article discusses the terminology and classification of OFCs and the epidemiology of OFCs. Demographic, environmental, and genetic risk factors for OFCs are described, including suggestions for family counseling. This article enables clinicians to counsel families regarding the occurrence and recurrence of OFCs. Although much of the information is detailed, it is intended to be accessible to all health professionals for use in their clinical practices.
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Affiliation(s)
- Stephanie E Watkins
- Center for Health Promotion and Disease Prevention, University of North Carolina at Chapel Hill, 1700 Martin Luther King Jr Boulevard, Chapel Hill, NC, USA.
| | - Robert E Meyer
- Birth Defects Monitoring Program, Division of Public Health, North Carolina Department of Health and Human Services, State Center for Health Statistics, 222 North Dawson Street, Cotton Building, Raleigh, NC 27603, USA
| | - Ronald P Strauss
- UNC Center for AIDS Research, UNC School of Dentistry, UNC School of Medicine, University of North Carolina at Chapel Hill, 104 South Building, CB# 3000, Chapel Hill, NC 27599-3000, USA
| | - Arthur S Aylsworth
- Departments of Pediatrics and Genetics, University of North Carolina at Chapel Hill, CB# 7487, UNC Campus, Chapel Hill, NC 27599-7487, USA
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