1
|
Materne G, Disler ER, Scott AR, Marston AP. Quality of Life and Psychosocial Outcomes Among Children With Cleft Differences. Cureus 2024; 16:e69176. [PMID: 39398658 PMCID: PMC11470974 DOI: 10.7759/cureus.69176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/04/2024] [Indexed: 10/15/2024] Open
Abstract
Introduction Velopharyngeal insufficiency (VPI) and craniofacial differences can lead to diminished speech and swallowing function resulting in communication and social challenges throughout childhood. To monitor changes in patients' psychosocial health and velopharyngeal function, the Pediatric Symptom Checklist (PSC) and Velopharyngeal Insufficiency Effects on Life Outcomes (VELO) survey tools can be utilized. This study aimed to investigate the relationship between VPI quality-of-life outcomes and psychosocial disturbances through a comparative analysis of PSC and VELO parental surveys among children followed by a craniofacial team. Methods A retrospective chart review was completed using data from a single, multidisciplinary cleft and craniofacial team. Previously completed parental survey responses between 2010 and 2022 were collated and results were analyzed using a Spearman's rank correlation test (rs). Results There were 89 subjects who completed both surveys on the same day (n = 148 survey pairs (s)). Patients aged three to five years old (s = 88) had a mean VELO of 17.9 (0-65) and a mean PSC of 7.9 (0-27), while patients aged six to eight years old (s = 60) had a mean VELO of 16.6 (0-74) and a mean PSC of 12.0 (0-37). The strongest correlation observed for both age groups was between the total PSC and VELO Speech Limitations sub-scores (three to five years old: rs = 0.537, p < 0.001; six to eight years old: rs = 0.330, p = 0.010). Similarly, children in the six- to eight-year-old group with cleft lip and palate showed a correlation between the total PSC and VELO Speech Limitations (rs = 0.583, p < 0.001). Conclusion This study suggests a relationship between PSC and VELO scores among children ages three to eight years old with cleft differences and demonstrates that specific domains within the VELO questionnaire should be considered as being associated with a higher risk for psychosocial impairment. Specifically, higher VELO Speech Limitations sub-scores may portend a greater risk for poor psychosocial outcomes supporting the importance of early interventions in this group.
Collapse
Affiliation(s)
- Grace Materne
- Otolaryngology - Head and Neck Surgery, Tufts University School of Medicine, Boston, USA
| | - Emily R Disler
- Otolaryngology - Head and Neck Surgery, Tufts University School of Medicine, Boston, USA
- General Surgery, Lahey Hospital & Medical Center, Burlington, USA
| | - Andrew R Scott
- Dr. Elie E. Rebeiz Department of Otolaryngology - Head and Neck Surgery, Tufts Medical Center, Boston, USA
- Otolaryngology - Head and Neck Surgery, Massachusetts Eye and Ear, Boston, USA
- Otolaryngology - Head and Neck Surgery, Tufts University School of Medicine, Boston, USA
- Pediatric Facial Plastic and Craniofacial Surgery, Massachusetts Eye and Ear, Boston, USA
| | - Alexander P Marston
- Otolaryngology - Head and Neck Surgery, University of California Davis Health System, Sacramento, USA
- Dr. Elie E. Rebeiz Department of Otolaryngology - Head and Neck Surgery, Tufts Medical Center, Boston, USA
- Otolaryngology - Head and Neck Surgery, Tufts University School of Medicine, Boston, USA
| |
Collapse
|
2
|
Westerlund M, Heliövaara A, Leikola J, Homsy P. Finnish Translation and Linguistic Validation of the CLEFT-Q Questionnaire. Cleft Palate Craniofac J 2024; 61:1081-1086. [PMID: 36883010 PMCID: PMC11155202 DOI: 10.1177/10556656231162454] [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] [Indexed: 03/09/2023] Open
Abstract
OBJECTIVE Cleft lip and/or palate (CL/P) can have long-lasting effects on the appearance, function, and psychosocial wellbeing of patients. The CLEFT-Q questionnaire is a patient-reported outcomes instrument specifically designed to assess the health-related quality of life of patients with CL/P. The aim of this study was to produce and linguistically validate a Finnish version of the CLEFT-Q questionnaire. DESIGN The CLEFT-Q questionnaire was translated into Finnish following guidelines of the International Society for Pharmacoeconomics and Outcomes Research. Pilot testing with cognitive debriefing interviews was conducted on patients of the target age range of the questionnaire, 8-29, and with various cleft types. RESULTS The CLEFT-Q questionnaire translated readily into Finnish. A review of the backward translation led to two words being changed. Thirteen patients - ten females and three males - with a median age of 14 years, participated in the cognitive debriefing interviews. The interviews led to further nine word changes. The pilot study data suggested that the performance of the Finnish version of the instrument is in line with the original CLEFT-Q questionnaire. CONCLUSIONS The Finnish version of CLEFT-Q produced here is linguistically valid and ready for use in the evaluation of the health-related quality of life of patients with CL/P. However, future work is needed to further assess the validity and the reliability of the CLEFT-Q in the Finnish patient population.
Collapse
Affiliation(s)
- Mikael Westerlund
- Department of Plastic Surgery, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland
| | - Arja Heliövaara
- Department of Plastic Surgery, Cleft Palate and Craniofacial Center, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland
| | - Junnu Leikola
- Department of Plastic Surgery, Cleft Palate and Craniofacial Center, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland
| | - Pauliina Homsy
- Department of Plastic Surgery, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland
| |
Collapse
|
3
|
Duolikun Wufuer, Dilibaier Yimingjiang, Kamilijiang Maimaitiming, Li J, Wulifan Tuoleheng. Correlation between FOXN3-SIN3A complex expression in peripheral blood and non-syndromic cleft lip and palate in Xinjiang. HUA XI KOU QIANG YI XUE ZA ZHI = HUAXI KOUQIANG YIXUE ZAZHI = WEST CHINA JOURNAL OF STOMATOLOGY 2024; 42:313-318. [PMID: 39049650 PMCID: PMC11190867 DOI: 10.7518/hxkq.2024.2023340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 04/12/2024] [Indexed: 07/27/2024]
Abstract
OBJECTIVES This work aimed to study the correlation between FOXN3-SIN3A complex expression and non-syndromic oral clefts (NSOC) in Xinjiang. METHODS In this study, 60 patients with NSOC attending the People's Hospital of Xinjiang Uygur Autonomous Region were recruited into the case group, including 30 cleft lip with or without cleft palate (NSCL/P), 30 cleft palate only (CPO), and 30 healthy children in the control group. The expression levels of FOXN3, SIN3A, and NEAT1 in peripheral blood of each group were detected by high-throughput second-generation sequencing technology and quantitative reverse transcription polymerase chain reaction (RT-qPCR). Receiver operating characteristic (ROC) curve and area under the curve (AUC) were used to analyze the diagnostic efficiency of NSOC. RESULTS The comparison of the NSOC and control groups showed that FOXN3, SIN3A, and NEAT1 genes increased compared with the control group. The differences were all statistically significant (P<0.05). The AUCs of FOXN3, SIN3A, and NEAT1 in the NSCL/P group were 0.933 [95%CI=(0.864, 1.000)], 0.822 [(95%CI=(0.713, 0.932)], and 1.000[95%CI= (1.000, 1.000)], respectively. The AUCs of FOX-N3, SIN3A, and NEAT1 in the CPO group were 0.891 [95%CI=(0.806, 0.976)], 0.688 [95%CI=(0.552, 0.824)], and 1.000 [95%CI=(1.000, 1.000)], respectively. CONCLUSIONS The results showed a correlation between the rising gene expression of FOXN3, SIN3A, and NEAT1 in peripheral blood and the occurrence of NSOC in Xinjiang. This work provides a theoretical basis for further study of the FOXN3-SIN3A complex as biomarkers to facilitate the early screening, disease prediction, and early prevention of NSOC.
Collapse
Affiliation(s)
- Duolikun Wufuer
- Dept. of Maxillofacial Surgery, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi 830000, China
| | - Dilibaier Yimingjiang
- Dept. of Maxillofacial Surgery, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi 830000, China
| | - Kamilijiang Maimaitiming
- Dept. of Maxillofacial Surgery, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi 830000, China
| | - Jun Li
- Dept. of Maxillofacial Surgery, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi 830000, China
| | - Wulifan Tuoleheng
- Dept. of Maxillofacial Surgery, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi 830000, China
| |
Collapse
|
4
|
Yusof MS, Ibrahim H, Bressmann T, Hasbi AM. Facilitators, barriers, and strategies of communication in Malaysian school-age children with non-syndromic cleft lip and palate: Results of in-depth online qualitative interviews. CLINICAL LINGUISTICS & PHONETICS 2024:1-19. [PMID: 38637977 DOI: 10.1080/02699206.2024.2341304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Accepted: 04/02/2024] [Indexed: 04/20/2024]
Abstract
This study explores the perceptions of facilitators, barriers to communication and strategies in Malaysian school-aged children with non-syndromic cleft lip and palate (CL/P), parents, and teachers. Fourteen children with non-syndromic CL/P aged 7 to 12 years, their parents (n = 16), and their teachers (n = 10) were recruited via purposive sampling. Participants were selected based on resilience scores (RS-10; (Wagnild, 2015) distinguishing low (<34) from high resilience (35-40) (Wagnild, 2015). Individual in-depth interviews were conducted online and evaluated qualitatively. The analyses were conducted utilising the guidelines by Braun and Clarke (2006). Inductive thematic analysis was performed. Facilitators for communication identified by children, parents and teachers were the child's personal attributes, common interests, and helping others. Barriers that were identified were unfamiliar conversation partners, and insensitive comments or questions. Children used passive (e.g. ignored) and active (e.g. retorted, explained the condition) strategies to address social communication issues. Children with high resilience responded more actively than children with low resilience. Strategies that were described by the parents included accepting the child, empowering themselves, following the cleft management plan, and empowering the child. Teachers adopted general approaches such as giving encouragement, increasing confidence, and teaching empathy. The presence of face masks was perceived as both a facilitator and a barrier to communication. The study provides information on challenges encountered and coping mechanisms used by children with non-syndromic CL/P, their parents and their teachers. This knowledge may help the development of targeted interventions to support the communication of children with non-syndromic CL/P in school.
Collapse
Affiliation(s)
- Muhammad Safwan Yusof
- Faculty of Health Sciences, National University of Malaysia, Bangi, Malaysia
- Speech Therapy Unit, Otorhinolaryngology Department, Hospital Kuala Lumpur, Kuala Lumpur, Malaysia
| | - Hasherah Ibrahim
- Faculty of Health Sciences, National University of Malaysia, Bangi, Malaysia
| | - Tim Bressmann
- Department of Speech-Language Pathology, University of Toronto, Toronto, Canada
| | - Alia Munirah Hasbi
- Faculty of Health Sciences, National University of Malaysia, Bangi, Malaysia
| |
Collapse
|
5
|
Moshtaghi Fard Z, Aghadoost S, Moradi N, Sarmadi S, Mohammadi F, Bahrami N. Quality of Life in Adolescents and Young Adults with Cleft Lip and Palate with and Without Speech Therapy During COVID-19. Cleft Palate Craniofac J 2023:10556656231219413. [PMID: 38115690 DOI: 10.1177/10556656231219413] [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: 12/21/2023] Open
Abstract
OBJECTIVE Cleft-related speech concerns can affect the quality of life (QOL) in patients with cleft lip and palate (CLP). During the coronavirus disease 2019 (COVID-19), in-person speech therapy (ST) was restricted due to fear of getting infected. This study aimed to compare QOL in patients with CLP with and without ST during the pandemic. DESIGN Cross-sectional Study. SETTING CLP team at Tehran University of Medical Sciences (TUMS). PATIENTS/PARTICIPANTS Thirty-six CLP subjects with a mean age of 17.33 ± 4 years participated in two groups, including with and without ST. Fifteen subjects had cleft palate only (CPO) and others had CLP. INTERVENTIONS ST group received at least 10 ST sessions, and group without ST didn't receive ST during COVID-19. MAIN OUTCOME MEASURE(S) A virtual link of demographic and QOL adolescent cleft (QoLAdoCleft) questionnaires were sent to fill out. Results were extracted and transferred to SPSS. RESULTS Total and subscales' scores of QoLAdoCleft were lower in ST group than without ST but differences between them weren't statistically significant (P > .05). Furthermore, according to cleft type, there weren't any statistically significant differences in total, physical, and social subscales of QoLAdoCleft (P > .05); however, psychological subscale in CLP had a higher significant score than CPO (P < .05). CONCLUSIONS QOL was weak in all patients with CLP, and receiving/not receiving ST couldn't make noticeable differences between them. It seems; COVID-19 pandemic can have an adverse effect on these results. Also, subjects with CLP had weaker psychological than CPO due to negative psychosocial feedback related to Orofacial deformities received from society.
Collapse
Affiliation(s)
| | - Samira Aghadoost
- Department of Speech Therapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran
| | - Negin Moradi
- Department of Communication Sciences and Disorders, University of Wisconsin-River Falls, USA
| | - Sarvin Sarmadi
- Department of Orthodontics, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Farnoosh Mohammadi
- Craniomaxillofacial Research Center, Oral and Maxillofacial Surgery Department, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Naghmeh Bahrami
- Craniomaxillofacial Research Center, Department of Tissue Engineering and Applied Cellular Sciences, Tehran University of Medical Sciences, Tehran, Iran
| |
Collapse
|
6
|
Bi S, Ren Z, Li J, Tao Y, Gao M. Retrospective study on primary rhinoplasty for unilateral complete cleft lip nasal deformity. HUA XI KOU QIANG YI XUE ZA ZHI = HUAXI KOUQIANG YIXUE ZAZHI = WEST CHINA JOURNAL OF STOMATOLOGY 2023; 41:708-712. [PMID: 38597037 PMCID: PMC10722458 DOI: 10.7518/hxkq.2023.2023204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 09/23/2023] [Indexed: 04/11/2024]
Abstract
OBJECTIVES A retrospective study was conducted on the effect of primary rhinoplasty on infants with unilateral complete cleft lip nasal deformity. METHODS Infants with unilateral complete cleft lip in the Department of Cleft Lip and Palate Surgery, College of Stomatology, Xi'an Jiaotong University were selected. All infants underwent cheiloplasty and primary rhinoplasty. We reconstructed the nasal base and corrected the nasal septum and alar deformity at the same time. The nasal splint was worn 1 week after the surgery. The nasal morphology before surgery as well as 1 week and 1 year after surgery were analyzed. RESULTS Significant differences were found on symmetry ratios including nasal base width, nostril height, alar angle and columella deviation angle between before and after operation (P<0.05). There were statistically significant differences in the symmetry ratio of nostril height and columella deviation angle between 1 year after surgery and 1 week after surgery (P<0.05). CONCLUSIONS Infants with unilateral complete cleft lip nasal deformity can achieve satisfactory nasal morphology by primary rhinoplasty. Despite few cases of recurrence of nasal deformity, the nasal morphology can be well improved and maintained.
Collapse
Affiliation(s)
- Sisi Bi
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, Xi'an 710004, China
- Clinical Research Center of Shaanxi Province for Dental and Maxillofacial Diseases, College of Stomatology, Xi'an Jiaotong University, Xi'an 710004, China
- Dept. of Cleft Lip and Palate Surgery, College of Stomatology, Xi'an Jiaotong University, Xi'an 710004, China
| | - Zhanping Ren
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, Xi'an 710004, China
- Clinical Research Center of Shaanxi Province for Dental and Maxillofacial Diseases, College of Stomatology, Xi'an Jiaotong University, Xi'an 710004, China
- Dept. of Cleft Lip and Palate Surgery, College of Stomatology, Xi'an Jiaotong University, Xi'an 710004, China
| | - Jinfeng Li
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, Xi'an 710004, China
- Clinical Research Center of Shaanxi Province for Dental and Maxillofacial Diseases, College of Stomatology, Xi'an Jiaotong University, Xi'an 710004, China
- Dept. of Cleft Lip and Palate Surgery, College of Stomatology, Xi'an Jiaotong University, Xi'an 710004, China
| | - Yongwei Tao
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, Xi'an 710004, China
- Clinical Research Center of Shaanxi Province for Dental and Maxillofacial Diseases, College of Stomatology, Xi'an Jiaotong University, Xi'an 710004, China
- Dept. of Cleft Lip and Palate Surgery, College of Stomatology, Xi'an Jiaotong University, Xi'an 710004, China
| | - Ming Gao
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, Xi'an 710004, China
- Clinical Research Center of Shaanxi Province for Dental and Maxillofacial Diseases, College of Stomatology, Xi'an Jiaotong University, Xi'an 710004, China
- Dept. of Cleft Lip and Palate Surgery, College of Stomatology, Xi'an Jiaotong University, Xi'an 710004, China
| |
Collapse
|
7
|
van der Weijden FN, Hernández EM, Rossell Perry PE, van Essen LH. The influence of music lessons on the socio-emotional wellbeing of children with cleft lip and/or palate. Br Dent J 2023:10.1038/s41415-023-5570-x. [PMID: 36882490 DOI: 10.1038/s41415-023-5570-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Accepted: 11/08/2022] [Indexed: 03/09/2023]
Abstract
Introduction There is a dearth of psychological interventions for patients with cleft lip and/or palate (CL/P).Objective To evaluate the influence of music lessons on the socio-emotional wellbeing of children with CL/P.Setting This study was conducted at Asociación San Lucas (Moyobamba, Peru), which has a multidisciplinary programme for children with CL/P. Recorder lessons are offered to all patients aged 6-8 years. From age eight, the children can switch to flute, clarinet, violin, viola or cello.Materials and methods The Glasgow Benefit Inventory (GBI), a post-intervention questionnaire, was administered to all 26 children participating in the music programme.Results Mean GBI scores per question ranged from 59.62 (SD: 31.68) to 92.31 (SD: 23.21), showing an overall positive effect of the music lessons on the patients' socio-emotional wellbeing. Playing a musical instrument gave the children satisfaction and self-confidence. The children lost much of their shame, became less shy, and participated more in social activities. In a non-significant numerical trend, boys, flute/clarinet players and orchestra players had higher mean GBI scores than, respectively, girls, string players and children who did not play in the orchestra.Conclusions Quantitative and qualitative analysis indicated a positive influence of music lessons on the patients' socio-emotional wellbeing.
Collapse
Affiliation(s)
- Fawn N van der Weijden
- Department of Orthodontics, Academic Centre of Dentistry Amsterdam, University of Amsterdam and Vrije Universiteit, Amsterdam, The Netherlands.
| | - Edgar M Hernández
- Faculty of Medicine Alberto Hurtado, University Peruana Cayetano Heredia, Lima, Peru
| | | | | |
Collapse
|
8
|
Maternal stress as a risk factor for non-syndromic orofacial clefts: Systematic review and meta-analysis. Saudi Dent J 2023; 35:207-219. [PMID: 37091275 PMCID: PMC10114596 DOI: 10.1016/j.sdentj.2023.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 02/20/2023] [Accepted: 02/27/2023] [Indexed: 03/06/2023] Open
Abstract
Background Non-syndromic orofacial clefts (NSOFC) are among the most common congenital malformations. Several studies have investigated the association between stress and NSOFC; however, they have reported different and heterogeneous results. Therefore, this systematic review was conducted to investigate the association between maternal periconceptional stress and non-syndromic orofacial clefts in infants.The research question was "Is maternal periconceptional stress an etiological factor for non-syndromic orofacial clefts in infants"? Methods Search strategy, inclusion/exclusion criteria, and data extraction from studies reporting periconceptional maternal exposure to stress and NSOFC were implemented without language restrictions. The risks of bias in the identified studies was assessed, and this information was used in the sensitivity analyses to explain heterogeneity. A meta-analysis of the extracted data was performed. Results Twelve eligible studies were included. Forest plot for meta-analysis of the association between maternal periconceptional exposure to stress and NSOFC among studies with adjustment for potential confounders showed a statistically significant association with an increased risk of NSOFC (odds ratio [OR]:1.17; P = 0.03), which was apparent for both cleft lip with and without palate (OR:2.07; P = 0.007) and cleft palate (OR:1.72; P = 0.003). There was a substantial heterogeneity between studies, which improved when analyzing only studies that were adjusted for potential confounders. Conclusion Based on the currently available evidence, maternal exposure to periconceptional stress could be considered a risk factor for NSOFCs. Therefore, we strongly recommend research investigating the effect of stress caused by the coronavirus disease-2019 pandemic on the incidence of clefts.
Collapse
|
9
|
Hartmann GC, Guimarães LK, Maggioni CG, Gasparello GG, Júnior SLM, Pithon MM, Tanaka OM. Social attractiveness perception of a cleft lip repair in an adolescent via eye-tracking. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2022; 123:e526-e532. [PMID: 35074565 DOI: 10.1016/j.jormas.2022.01.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 01/13/2022] [Accepted: 01/15/2022] [Indexed: 06/14/2023]
Abstract
PURPOSE The present study was designed to investigate the perception of unilateral cleft lip (UCL) repair scar using an image of an adolescent and eye-tracking technology. MATERIAL AND METHODS Frontal and oblique views of an image of an adolescent with a unilateral upper lip scar result of a corrective surgery. Eighty-five laypeople respondents were divided into three groups: Group A (15-44 years of age); Group B (45-59 years of age); and Group C (≥ 60 years of age). Gaze tracking was carried out to assess the location on the image of greatest fixation, to create dot maps and to follow the trajectory of the gaze. Respondents also assessed six attention questionnaires. The answers and assessment of the VAS were compared. P-values <0.05 were considered significant in the analyses. RESULTS The central focus of the visualization was concentrated on the upper lip and the region of the nostril, followed by the eyes. Time until 1st fixation upon right lip and mouth showed differences with regard to different images. Images of the model shown in various guises including smiling or not, in a frontal or oblique views showed significant differences in VAS scoring (p<0.001). CONCLUSION The presence of a scar from the UCL repair in an adolescent was noted in the foreground by laypeople. The scar was associated with a lower degree of attractiveness, happiness, and intelligence, as well as with shyness and sympathy, although a visible scar did not influence the perception of "good hygiene habits".
Collapse
Affiliation(s)
- Giovani Ceron Hartmann
- Pontifícia Universidade Católica do Paraná, Curitiba, Brazil; School of Life Sciences, Brazil
| | - Lara Karolina Guimarães
- Pontifícia Universidade Católica do Paraná, Curitiba, Brazil; School of Life Sciences, Brazil
| | | | | | - Sergio Luiz Mota Júnior
- Visiting Professor of Orthodontics in Juiz de Fora Federal University, Juiz de Fora, Minas Gerais, Brazil, Private Practice
| | - Matheus Melo Pithon
- Southwest Bahia State University - UESB. Jequié, Bahia, Brazil; Diplomate of the Brazilian Board of Orthodontics - BBO, Brazil
| | - Orlando Motohiro Tanaka
- Pontifícia Universidade Católica do Paraná, Curitiba, Brazil; School of Life Sciences, Brazil; Diplomate of Brazilian Board of Orthodontics and Dentofacial Orthopedics, Postdoctoral Fellow at The Center for Advanced Dental Education at Saint Louis University, Brazil; Pontifícia Universidade Católica do Paraná - PUCPR, School of Life Sciences, R. Imaculada Conceição, 1155, CEP: 80215-901 - CURITIBA, Paraná, BRAZIL.
| |
Collapse
|
10
|
Maulina T, Purnomo YY, Tasman SGR, Sjamsudin E, Amaliya A. The Efficacy of Curcumin Patch as an Adjuvant Therapeutic Agent in Managing Acute Orofacial Pain on the Post-Cleft Lip and Cleft Palate Surgery Patients: A Pragmatic Trial. Eur J Dent 2022. [PMID: 36096139 DOI: 10.1055/s-0042-1750802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022] Open
Abstract
OBJECTIVE Acute pain is one of the most common pains experienced by post-cleft lip or cleft surgery patients regardless of the administration of analgesic agents. This current study aimed to evaluate the efficacy of a curcumin patch as an adjuvant analgesic agent on the post-cleft lip and cleft palate surgery patients. MATERIALS AND METHODS Fifty-five (33 male; 22 female) participants aged 36 months or less are recruited in this pragmatic trial and randomly assigned to a control group, where no curcumin patch was applied; or the experimental group, where the participants wore a curcumin patch with a dosage of 100mg. All participants (regardless of the group) received a standardized postsurgery analgesic agent immediately after the surgery was completed. A face, leg, activity, cry, and consolability (FLACC) scale was used to evaluate pain levels for three subsequent time points. STATISTICAL ANALYSIS All data were then analyzed by using the Mann-Whitney U test to compare the mean differences between the two groups. RESULTS The results of the current study revealed that there was no significant difference found between the control and the experimental group when mean pain scores were compared for the first evaluation time. Yet, there was a significant difference (p<0.01) between the two groups' mean pain scores on the second evaluation time. CONCLUSION Curcumin patch was found to be effective when used as an adjuvant analgesic agent to reduce acute-orofacial postsurgery pain in cleft lip and cleft surgery patients.
Collapse
Affiliation(s)
- Tantry Maulina
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, University of Padjadjaran, Bandung, Indonesia
| | - Yohanes Yoppy Purnomo
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, University of Padjadjaran, Bandung, Indonesia
| | | | - Endang Sjamsudin
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, University of Padjadjaran, Bandung, Indonesia
| | - Amaliya Amaliya
- Department of Periodontology, Faculty of Dentistry, University of Padjadjaran, Bandung, Indonesia
| |
Collapse
|
11
|
Akmal M, Zahir R, Zahir Z, Ahmed J, Lateef T. SaveSmile: an annual cleft repair mission in Sudan. JOURNAL OF GLOBAL HEALTH REPORTS 2022. [DOI: 10.29392/001c.35266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Low- and middle-income countries (LMICs) are often burdened by disease, beyond the scope of their healthcare capabilities. Sudan, in particular, lacks the resources and expertise to surgically repair orofacial clefts. This paper highlights Sudan’s need for medical aid from other countries and outside organizations and the procedures by which they collaborate with local entities to provide relief to those affected by cleft in Sudan. Additionally, this study reports on the prevalence of type of cleft lip and palate as well as rates and explanations of surgical complications over a period of 10 years and the short and long-term benefits to society. Paper copies of patient data was digitalized and run through statistical programs to look for patterns of demographics and diagnoses. Most patients were male, under four years old, and had a cleft lip.
Collapse
Affiliation(s)
| | - Rhea Zahir
- George Washington University School of Medicine and Pediatric Specialists of Virginia, USA
| | | | | | - Tarannum Lateef
- George Washington University School of Medicine and Pediatric Specialists of Virginia, USA
| |
Collapse
|
12
|
Sander AK, Dietrich L, Kloss-Brandstätter A, Krause M, Zimmerer R, Neuhaus M, Bartella AK, Lethaus B. The Cleft-screen-questionnaire (CSQ) - A validated screening instrument for health-related quality of life in cleft patients. J Plast Reconstr Aesthet Surg 2022; 75:3429-3435. [PMID: 35610102 DOI: 10.1016/j.bjps.2022.04.040] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 02/01/2022] [Accepted: 04/12/2022] [Indexed: 11/18/2022]
Abstract
BACKGROUND The objective of this study is to develop and validate a specific screening instrument for assessing the quality of life (QoL) of patients with orofacial clefts. The Cleft-Screen-Questionnaire (CSQ) aims at identifying the main problematic areas and is intended for the routine use in everyday clinical practice to constantly evaluate the conditions' and treatments' effects on patients' well-being. METHODS First, a pool of 58 questions is created by collecting items from validated questionnaires previously used for assessing the QoL in cleft populations. After the removal of duplicate questions, the questionnaires are answered by 152 patients from a tertiary care center. A factor analysis followed by the calculation of Cronbach's alpha as a reliability measurement led to the final CSQ presented here. RESULTS The applied factor analysis resulted in five factors. Items showing low factor loadings (seen as <0.5) were excluded initially. Accordingly, factor analysis led to a preliminary number of 43 items. A reliability analysis using Cronbach's alpha and corrected alpha if item deleted showed an overall moderate to high reliability (seen as: 0.6-0.9). After excluding questions with increasing alphas if item deleted, analyses yielded in a final number of 38 questions. CONCLUSION The final 38-item CSQ is a reliable instrument for evaluating the health-related QoL of cleft patients.
Collapse
Affiliation(s)
- A K Sander
- Department of Oral- and Maxillofacial Surgery, University Hospital Leipzig, Liebigstr. 12, 04103 Leipzig, Germany.
| | - L Dietrich
- Department of Oral- and Maxillofacial Surgery, University Hospital Leipzig, Liebigstr. 12, 04103 Leipzig, Germany
| | - A Kloss-Brandstätter
- Department of Oral- and Maxillofacial Surgery, University Hospital Leipzig, Liebigstr. 12, 04103 Leipzig, Germany
| | - M Krause
- Department of Oral- and Maxillofacial Surgery, University Hospital Leipzig, Liebigstr. 12, 04103 Leipzig, Germany
| | - R Zimmerer
- Department of Oral- and Maxillofacial Surgery, University Hospital Leipzig, Liebigstr. 12, 04103 Leipzig, Germany
| | - M Neuhaus
- Department of Oral- and Maxillofacial Surgery, University Hospital Leipzig, Liebigstr. 12, 04103 Leipzig, Germany
| | - A K Bartella
- Department of Oral- and Maxillofacial Surgery, University Hospital Leipzig, Liebigstr. 12, 04103 Leipzig, Germany
| | - B Lethaus
- Department of Oral- and Maxillofacial Surgery, University Hospital Leipzig, Liebigstr. 12, 04103 Leipzig, Germany
| |
Collapse
|
13
|
Jensen ED, Poirier BF, Oliver KJ, Roberts R, Anderson PJ, Jamieson LM. Childhood Experiences and Perspectives of Individuals With Orofacial Clefts: A Qualitative Systematic Review. Cleft Palate Craniofac J 2022:10556656221084542. [PMID: 35254151 DOI: 10.1177/10556656221084542] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE Children and adolescents with orofacial clefts may experience ongoing psychosocial impacts due to the continuous nature of cleft treatments, facial and dental differences, and speech and hearing difficulties. The aim of this qualitative systematic review was to better understand the experiences of children and adolescents with orofacial clefts. DESIGN A systematic search strategy using PubMed, Embase, Emcare, Scopus, and Web of Science databases was performed to identify relevant qualitative studies evaluating the lived experience of children and adolescents with orofacial clefts from inception through to June 2021. Eligible studies were critically appraised using the Joanna Briggs methodology and a meta-aggregative approach. RESULTS The search identified 2466 studies, with 13 found to meet the inclusion criteria. Extraction of 155 findings resulted in 27 categories, which were meta-aggregated into 7 overarching synthesized findings. These 7 core findings included aspects of child experience and findings that enhanced or impeded child experience at the individual, family, and community levels. CONCLUSIONS Factors that impeded child experience at the individual, family, and community levels were more pronounced than factors that enhanced their experience among children and adolescents with orofacial clefts. Further initiatives are needed to provide support to individuals, families, and school communities to enhance children's experience of orofacial cleft during the formative childhood and adolescent years.
Collapse
Affiliation(s)
- Emilija D Jensen
- Australian Research Centre for Population Oral Health, Adelaide Dental School, The University of Adelaide, Adelaide, Australia.,Department of Paediatric Dentistry, Women's and Children's Hospital, North Adelaide, Australia
| | - Brianna F Poirier
- Australian Research Centre for Population Oral Health, Adelaide Dental School, The University of Adelaide, Adelaide, Australia
| | - Kelly J Oliver
- Department of Paediatric Dentistry, Women's and Children's Hospital, North Adelaide, Australia
| | - Rachel Roberts
- School of Psychology, The University of Adelaide, Adelaide, Australia
| | - Peter J Anderson
- Cleft and Craniofacial South Australia, Women's and Children's Hospital, North Adelaide, Australia.,Discipline of Paediatrics, Adelaide Medical School, The University of Adelaide, Adelaide, Australia
| | - Lisa M Jamieson
- Australian Research Centre for Population Oral Health, Adelaide Dental School, The University of Adelaide, Adelaide, Australia
| |
Collapse
|
14
|
Shabbir S, Sattar A, Sami QUA, Zia B, Pervez H. Bite Force Changes in Bilateral Cleft Lip and Palate Patients Before and After ALT-RAMEC Protocol. Cleft Palate Craniofac J 2022; 60:586-590. [PMID: 35130093 DOI: 10.1177/10556656211072730] [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
To evaluate the bite force (BF) changes in bilateral cleft lip and palate (BCLP) in contrast to the non BCLP children after ALT-RAMEC Facemask therapy. The prospective study was carried out on a total of 60 subjects of age 6 to 13 years in a tertiary care hospital; treatment group, 30 children with BCLP and control group, 30 children without cleft lip and palate. Each cleft patient was received ALT-RAMEC Facemask treatment and their BF assessed at 4 different stages. Bite force taken before treatment, immediately, 3 months and 6 months after treatment. Bite force of the control group was taken at baseline to compare with the treatment group to demonstrate the difference in BF values. Independent t test and analysis of variance were used to perform statistical analysis. There was a significant difference in BF between the treatment group (BCLP) 122.53 ± 8.64 N and the control group (non BCLP) 181.38 ± 18.84 N at baseline. After the Alt RAMEC protocol, changes in BF recorded over 3 and 6 months of therapy showed significant improvement. The mean values of BF at 3months and 6 months were 106.7 ± 9.3 N and 137.4 ± 9.5 N, respectively. Bite force was significantly improved after ALT-RAMEC protocol followed by facemask therapy in BCLP patients.
Collapse
Affiliation(s)
- Sadia Shabbir
- 66812Jinnah Medical and Dental College, Karachi, Pakistan
| | - Anam Sattar
- 66818Dow International Dental College/Dow University of Health Sciences (DUHS), Karachi, Pakistan
| | - Qurat Ul Ain Sami
- 66818Dow International Dental College/Dow University of Health Sciences (DUHS), Karachi, Pakistan
| | - Babar Zia
- 66812Jinnah Medical and Dental College, Karachi, Pakistan
| | - Hana Pervez
- 66812Jinnah Medical and Dental College, Karachi, Pakistan
| |
Collapse
|
15
|
van Dalen M, Hermans MM, Leemreis WH, Kraaij V, De Laat PCJ, Pasmans SGMA, Versnel SL, Koudstaal MJ, Hillegers MHJ, Utens EMWJ, Okkerse JME. Emotional and Behavioral Problems in Children With a Cleft Lip With or Without Palate or an Infantile Hemangioma. Cleft Palate Craniofac J 2021; 59:S74-S83. [PMID: 34293942 DOI: 10.1177/10556656211031411] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE Life can be challenging for children with a visible difference due to a medical condition, and they might be at risk for emotional and behavioral problems. This study examines emotional and behavioral problems in children with a cleft lip with or without palate (CL ± P) or an infantile hemangioma (IH) in relation to the visibility of the condition, the presence of additional condition-related problems, and parental affect. SETTING This cross-sectional study took place in an academic medical hospital in the Erasmus MC Sophia Children's Hospital, the Netherlands. PARTICIPANTS A total of 309 parents (mean age = 40.34, 44.00% male) of 182 children with CL ± P and 48 parents (mean age = 39.21, 37.50% male) of 33 children with an IH completed questionnaires. Children were 1.5 to 12 years old. RESULTS Parents reported fewer child emotional and behavioral problems compared to normative data. Problems reported were mainly related to learning difficulties and parent gender, while visibility of the condition had no significant influence. Parental negative affect was related to child internalizing problems. Parental positive affect was not related to any of the outcome measures. CONCLUSIONS Parents reported fewer problems for their children compared to normative data. This is inconsistent with previous research, showing similar or worse scores for these children compared to peers. Our findings may be explained by a protective parenting style, a response shift in parents, or problems developing at a later point in life.
Collapse
Affiliation(s)
- Marije van Dalen
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC Sophia Children's Hospital, University Medical Center Rotterdam, the Netherlands
| | - Mireille M Hermans
- Department of Dermatology, Centre of Pediatric Dermatology, Erasmus MC Sophia Children's Hospital, University Medical Center Rotterdam, the Netherlands
| | - Willem H Leemreis
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC Sophia Children's Hospital, University Medical Center Rotterdam, the Netherlands
| | - Vivian Kraaij
- Clinical Psychology, Leiden University, the Netherlands
| | - Peter C J De Laat
- Department of Pediatrics, Erasmus MC, University Medical Center Rotterdam, the Netherlands
| | - Suzanne G M A Pasmans
- Department of Dermatology, Centre of Pediatric Dermatology, Erasmus MC Sophia Children's Hospital, University Medical Center Rotterdam, the Netherlands
| | - Sarah L Versnel
- Department of Plastic and Reconstructive Surgery and Hand Surgery, The Dutch Craniofacial Centre, Erasmus MC Sophia Children's Hospital, University Medical Center Rotterdam, the Netherlands
| | - Maarten J Koudstaal
- Department of Oral and Maxillofacial Surgery, The Dutch Craniofacial Centre, Erasmus MC Sophia Children's Hospital, University Medical Center Rotterdam, the Netherlands
| | - Manon H J Hillegers
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC Sophia Children's Hospital, University Medical Center Rotterdam, the Netherlands
| | - Elisabeth M W J Utens
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC Sophia Children's Hospital, University Medical Center Rotterdam, the Netherlands.,Research Institute of Child Development and Education, University of Amsterdam, the Netherlands.,Academic Center for Child Psychiatry Levvel/Department of Child and Adolescent Psychiatry, Academic Medical Center, Amsterdam, the Netherlands
| | - Jolanda M E Okkerse
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC Sophia Children's Hospital, University Medical Center Rotterdam, the Netherlands
| |
Collapse
|
16
|
Allaf H, Helal N, Basri O, AlShadwi A, Sabbagh H. Care Barriers for Patients With Nonsyndromic Orofacial Clefts in Saudi Arabia: A Cross-Sectional Study. Cleft Palate Craniofac J 2021; 59:1001-1009. [PMID: 34189936 DOI: 10.1177/10556656211026536] [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: 11/17/2022] Open
Abstract
OBJECTIVE To evaluate the barriers faced by patients with nonsyndromic orofacial clefts (NSOFC) throughout their treatment course in Saudi Arabia. DESIGN A cross-sectional study. SETTING Eleven different governmental health care centers across Saudi Arabia. Patients: Records of pediatric patients with NSOFC. INTERVENTIONS A questionnaire with multiple validation stages was designed to assess the barriers in care of these patients through telephonic interviews with the parents or guardians of patients with NSOFC. MAIN OUTCOME MEASURES We identified 3 care-barrier-related factors: (1) geographic accessibility, (2) appointment availability and accessibility, and (3) scheduling-related barriers. RESULTS Overall, 240 participants of both sexes, with orofacial cleft of various types and with various demographic characteristics (residence, family monthly income, and caregiver level of education) were included. The highest mean score of care barriers was reported for scheduling-related barriers. Overall, 186 individuals reported sometimes/often not receiving the required medical care for the following reasons: scheduling difficulties (89%; 37.1%), prolonged waiting room time (40%; 16.7%), and transportation difficulties (36%; 15.0%). A linear regression showed that parents cited late appointments as the main reason for patients with NSOFC not receiving adequate medical care. Care-barrier factors were significantly related to gender (P = .035), patient age (P < .001), place of residency (P < .001), and caregiver's level of education (P = .015). CONCLUSIONS Gaps in the health care system directly related to common care barriers need to be addressed to ensure adequate care for patients with NSOFC.
Collapse
Affiliation(s)
- Hanaa Allaf
- King Abdulaziz University, Jeddah, Saudi Arabia
| | - Narmin Helal
- King Abdulaziz University, Consultant of Pediatric Dentistry, Consultant of Orthodontics, Jeddah, Saudi Arabia
| | - Osama Basri
- King Faisal Specialist Hospital and Research Center, Consultant Craniofacial Orthodontist, Jeddah, Saudi Arabia
| | - Ahmad AlShadwi
- John Hopkins Saudi Aramco Health Services, Consultant Oral & Maxillofacial Surgeon, Jeddah, Saudi Arabia
| | - Heba Sabbagh
- King Abdulaziz University, Consultant of Pediatric Dentistry, Jeddah, Saudi Arabia
| |
Collapse
|
17
|
Correlation between alveolar cleft volume and alveolar bone quality in patients with unilateral cleft lip and palate: A cone-beam computed tomography study. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2021; 123:e69-e75. [PMID: 34186229 DOI: 10.1016/j.jormas.2021.06.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/04/2020] [Revised: 04/20/2021] [Accepted: 06/24/2021] [Indexed: 11/20/2022]
Abstract
OBJECTIVES This study aimed to determine the correlation between alveolar cleft volume and fenestration and dehiscence in the adjacent alveolar bone in patients with unilateral cleft lip and palate (UCLP) using cone-beam computed tomography (CBCT) sections. MATERIALS AND METHODS In this descriptive, cross-sectional study, CBCT scans of 68 non-syndromic patients with UCLP aged between 6 and14 years were selected. All patients were treated in Iran and had undergone lip and palate repair surgery within the first 3 to 18 months after birth. CBCT scans had been taken after orthodontic expansion and prior to alveolar bone grafting surgery. Cleft volume, fenestration and dehiscence were assessed using Mimics software. Data were analyzed using independent t-test, Kruskal-Wallis test, Spearman's correlation coefficient and logistic regression model. RESULTS The mean alveolar cleft volume was 628.66±172.84 mm3. There was a significant negative correlation between cleft volume and fenestration (P<0.001). Also, there was a significant positive correlation between cleft volume and dehiscence (P<0.001) in the adjacent bone. CONCLUSION The Mimics software can be successfully used to estimate the cleft volume prior to surgical procedures in UCLP patients. The results suggest that the alveolar cleft volume can be used as an aid to assess the periodontal condition of adjacent teeth. The cleft volume has a negative and positive correlation with fenestration and dehiscence respectively.
Collapse
|
18
|
Chung KH, deLeeuw KA, Lin HH, Lo LJ. Aesthetic Enhancement of the Vermilion Using Dermofat Graft in Patients With Cleft Lip Deformity. Cleft Palate Craniofac J 2021; 59:222-229. [PMID: 33761793 DOI: 10.1177/10556656211001727] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND There is an increasing patient expectation for better esthetics, manifesting through anatomical harmony, projection, and volume of the upper lip relative to the lower lip, in patients with cleft deformity. The aim of this study is to investigate the outcome of vermilion augmentation using autologous dermofat graft (DFG) to enhance the lip using both quantitative and qualitative assessment. METHODS Patients with secondary cleft lip deformity who received the surgical treatment in our institution from 2015 to 2018 were recruited. Panel assessment was performed on standardized preoperative and postoperative digital photographs. A patient questionnaire was used for the reported outcome. Image processing and analyses were applied to measure the lip change. Statistical analyses were performed. RESULTS A total of 91 patients were included. The mean age at operation was 22.7 years, and postoperative follow-up was 3.6 years. There were no complications in the study group. The panel assessment showed significant improvement (P < .00001) on upper lip vermilion in both frontal and lateral profile views. Ninety-five percent of patients reported improvement of the upper lip projection and volume. Quantitative image analysis showed an increase in the upper lip vermilion ratio in 97% of the cases in frontal views and improvement of the vermilion projection in 87% of the cases in the superimposed lateral views. CONCLUSIONS The use of DFG is an effective and reproducible method for vermilion augmentation and aesthetic enhancement in patients presenting with upper lip insufficiency relative to the lower lip.
Collapse
Affiliation(s)
- Kyung Hoon Chung
- Division of Oral and Maxillofacial Surgery, Department of Surgery, University of Arizona College of Medicine-Phoenix, Banner/University Medical Center-Phoenix, Phoenix, the United States
| | - Karel A deLeeuw
- Division of Oral and Maxillofacial Surgery, Department of Surgery, University of Arizona College of Medicine-Phoenix, Banner/University Medical Center-Phoenix, Phoenix, the United States
| | - Hsiu-Hsia Lin
- Craniofacial Research Center, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan
| | - Lun-Jou Lo
- Craniofacial Research Center, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan
| |
Collapse
|
19
|
Peck CJ, Parsaei Y, Lattanzi J, Gowda AU, Yang J, Lopez J, Steinbacher DM. The Geographic Availability of Certified Cleft Care in the United States: A National Geospatial Analysis of 1-Hour Access to Care. J Oral Maxillofac Surg 2021; 79:1733-1742. [PMID: 33812798 DOI: 10.1016/j.joms.2021.02.043] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 02/26/2021] [Accepted: 02/26/2021] [Indexed: 10/22/2022]
Abstract
PURPOSE Children with cleft lip and/or palate (CLP) require longitudinal multidisciplinary care. Travel distance to comprehensive cleft centers may be a barrier for some families. This study evaluated the geospatial availability of certified cleft teams across the United States. MATERIALS AND METHODS A geographic catchment area within a 1-hour travel radius of each American Cleft Palate-Craniofacial Association-certified cleft center was mapped using TravelTime distance matrix programming. The proportion of children located within each catchment area was calculated using county-level data from the National Kids Count Data Center, with aggregate estimates of patients with CLP based on state-level data from the Centers for Disease Control and Prevention. One-hour access was compared across regions and based on urbanization data collected from the US Census. RESULTS There were 182 American Cleft Palate-Craniofacial Association-certified centers identified. As per study estimates, 28,331 (27.3%) children with CLP did not live within 1-hour travel distance to any center. One-hour access was highest in the Northeast (84.2% of children, P < .001) and lowest in the South (65.7%) and higher in states with the greatest urbanization in comparison with more rural states (85.1 vs 37.4%, P < .001). Similar patterns were seen for access to 2 or more cleft centers. The number of CLP children-per-center was highest in the West (775) and lowest in the Northeast (452). CONCLUSIONS Travel distances of more than 1 hour may affect more than 25,000 (1 of 4) CLP children in the US, with significant variation across geographic regions. Future studies should seek to understand the impact of and provide strategies for overcoming geographic barriers.
Collapse
Affiliation(s)
- Connor J Peck
- Medical Student, Department of Surgery, Section of Plastic and Reconstructive Surgery, Yale School of Medicine, New Haven, CT
| | - Yassmin Parsaei
- Medical Student, Department of Surgery, Section of Plastic and Reconstructive Surgery, Yale School of Medicine, New Haven, CT; and Orthodontic Resident, Division of Orthodontics, University of Connecticut, Farmington, CT
| | - Jakob Lattanzi
- Undergraduate Research Assistant, Department of Surgery, Section of Plastic and Reconstructive Surgery, Yale School of Medicine, New Haven, CT
| | - Arvind U Gowda
- Surgical Resident, Department of Surgery, Section of Plastic and Reconstructive Surgery, Yale School of Medicine, New Haven, CT
| | - Jenny Yang
- Surgical Resident, Department of Surgery, Section of Plastic and Reconstructive Surgery, Yale School of Medicine, New Haven, CT
| | - Joseph Lopez
- Craniofacial Fellow, Department of Surgery, Section of Plastic and Reconstructive Surgery, Yale School of Medicine, New Haven, CT
| | - Derek M Steinbacher
- Chief of Oral and Maxillofacial Surgery, Professor of Plastic Surgery, Yale School of Medicine, New Haven, CT.
| |
Collapse
|
20
|
A Concise Review on Qualitative Research in Dentistry. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18030942. [PMID: 33499023 PMCID: PMC7908600 DOI: 10.3390/ijerph18030942] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Revised: 01/18/2021] [Accepted: 01/19/2021] [Indexed: 11/17/2022]
Abstract
Qualitative research collects non-numerical data that explores human behaviour, attitudes, beliefs and personality characteristics unamendable to quantitative research. The qualitative research questions are open-ended, evolving and non-directional. The study design is flexible and iterative. Purposive sampling is commonly used. The sample size is determined by theoretical saturation. Data collection is generally through in-depth interviews, focus groups and observations. Qualitative research commonly uses thematic analysis and framework analysis, although there is no consensus on analysing qualitative data. The reporting format can be comprehensive, a summary, developmental or selective, subject to the research question. Qualitative research’s potential functions are to describe the form or nature of what exists (contextual), to examine the reasons for or associations between what exists (explanatory), to appraise the effectiveness of what exists (evaluative), and to aid the development of strategies (generative). Qualitative research can be time consuming to conduct because it explores evolving questions; difficult to generalise because it recruits limited participants; and arduous when it comes to making systematic comparisons because responses are subjective. However, qualitative research can provide depth and detail, create openness, simulate people’s individual experiences and avoid pre-judgements. This concise review provides an overview and suggestions for dental researchers when conducting a qualitative study.
Collapse
|
21
|
Rosero-Salazar DH, Carvajal-Monroy PL, Wagener FADTG, Von den Hoff JW. Functional analysis of the rat soft palate by real-time wireless electromyography. Arch Oral Biol 2020; 122:105021. [PMID: 33348206 DOI: 10.1016/j.archoralbio.2020.105021] [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] [Received: 09/30/2020] [Revised: 11/30/2020] [Accepted: 12/03/2020] [Indexed: 12/16/2022]
Abstract
OBJECTIVE The aim of this study was to analyze the function of the palatal muscles in vivo by real-time wireless electromyography in rats. The effects of palatal wounding were also analyzed. METHODS Microelectrodes were implanted six rats; in the masseter muscle (two-rats) for comparison, in the unwounded soft palate (two-rats) and the soft palate that received a surgical wound (two-rats). Two weeks after implantation, a wound was made in the soft palate using a 1 mm biopsy-punch. Electromyographic measurements and video-recordings were taken weekly to monitor train-duration and peak-amplitude during eating, grooming and drinking. RESULTS The train-duration of the masseter muscle during eating was 0.49 ± 0.11 s (rat-1) and 0.56 ± 0.09 s (rat-2), which was higher than during grooming. In the unwounded soft palate the train-duration during eating was 0.63 ± 0.12 s (rat-1) and 0.69 ± 0.069 s (rat-2), which was higher than during grooming and drinking. The peak-amplitude for eating in the normal soft palate before surgery was 0.31 ± 0.001 mV (rat-1) and 0.33 ± 0.02 mV (rat-2). This decreased to 0.23 ± 0.03 mV and 0.25 ± 0.11 mV respectively, after surgery. For drinking the peak-amplitude was 0.30 ± 0.01 mV (rat-1) and 0.39 ± 0.01 mV (rat-2) before surgery, which decreased to 0.23 ± 0.09 mV and 0.20 ± 0.14 mV respectively, after surgery. CONCLUSION The reduced peak-amplitude suggests impaired soft palate function after wounding. This is the first study into the in vivo function of the soft palate after surgical wounding. This model will contribute to develop strategies to improve soft palate function in patients.
Collapse
Affiliation(s)
- Doris H Rosero-Salazar
- Department of Orthodontics and Craniofacial Biology, Radboud University Medical Centre, Nijmegen, the Netherlands; Department of Medical Basic Sciences, Faculty of Health, Universidad Icesi, Cali, Colombia
| | - Paola L Carvajal-Monroy
- Department of Orthodontics and Craniofacial Biology, Radboud University Medical Centre, Nijmegen, the Netherlands; Department of Oral and Maxillofacial Surgery, Special Dental Care and Orthodontics, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Frank A D T G Wagener
- Department of Orthodontics and Craniofacial Biology, Radboud University Medical Centre, Nijmegen, the Netherlands
| | - Johannes W Von den Hoff
- Department of Orthodontics and Craniofacial Biology, Radboud University Medical Centre, Nijmegen, the Netherlands.
| |
Collapse
|
22
|
Tan RA, Schipper IE, de Vet HCW, Griot JPWD. The Submental Nasal Appearance Scale for the Assessment of Repaired Unilateral Complete Cleft Lip: A Validation Study. Cleft Palate Craniofac J 2020; 58:637-643. [PMID: 33021103 PMCID: PMC8044622 DOI: 10.1177/1055665620961968] [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] [Indexed: 11/23/2022] Open
Abstract
Objective: To reassess reliability and validity of the Submental Nasal Appearance Scale (SNAS) compared to the preliminary pilot study, for assessment of patient photographs with repaired unilateral cleft lip and palate (UCLP). When utilizing the SNAS, 3 nasal features (1. nasal outline; 2. alar base position; 3. nostril axis) must be graded according to symmetry between the cleft and noncleft side using a 5-point scale with reference photographs for each feature. The mean score calculated from the graded features reflects the overall degree of nasal symmetry, which is considered an important goal when repairing UCLP. Design: Fifty patient photographs were selected and cropped, displaying the submental view. Six raters assessed these photographs using the SNAS and a separate 5-point scale to assess the overall submental appearance. Interrater reliability was determined for both methods and correlation was calculated between these as an indication of construct validity. Setting: Amsterdam UMC, location VUmc, Amsterdam, The Netherlands. Patients: Six- to 9-year-old patients with repaired UCLP. Results: Interrater reliability of 0.73 and 0.48 was found for the SNAS and overall appearance assessment, respectively, while in the pilot study values of 0.79 and 0.69 were found. Correlation of 0.59 and 0.74 was found in the current and pilot study, respectively, between the SNAS and overall appearance assessment. Conclusions: The SNAS is a reliable tool to assess nasal symmetry from the submental perspective. Reliability of the SNAS is higher compared to grading overall appearance, but validity of the SNAS was less well supported.
Collapse
Affiliation(s)
- R A Tan
- Department of Plastic, Reconstructive and Hand Surgery, 1209Amsterdam UMC, location VUMC, Amsterdam, the Netherlands
| | - I E Schipper
- Department of Plastic, Reconstructive and Hand Surgery, 1209Amsterdam UMC, location VUMC, Amsterdam, the Netherlands
| | - H C W de Vet
- Department of Epidemiology and Biostatistics and the Amsterdam Public Health Research Institute, 1209Amsterdam UMC, location VUmc, Amsterdam, the Netherlands
| | - J P W Don Griot
- Department of Plastic, Reconstructive and Hand Surgery, 1209Amsterdam UMC, location VUMC, Amsterdam, the Netherlands
| |
Collapse
|
23
|
Alighieri C, Peersman W, Bettens K, Van Herreweghe V, Van Lierde K. Parental perceptions and expectations concerning speech therapy-related cleft care - a qualitative study. JOURNAL OF COMMUNICATION DISORDERS 2020; 87:106028. [PMID: 32659479 DOI: 10.1016/j.jcomdis.2020.106028] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/27/2019] [Revised: 05/28/2020] [Accepted: 05/30/2020] [Indexed: 06/11/2023]
Abstract
AIMS Speech (i.e., resonance, nasal airflow and articulation) is one of the primary outcomes in individuals with a cleft of the palate with or without a cleft of the lip (CP ± L). Therefore, it is highly important to obtain information regarding parental perceptions and expectations concerning speech therapy-related cleft care. Literature investigating these parental perspectives is scarce. The present study investigated perceptions and expectations of parents of children with CP ± L concerning (outcomes of) speech therapy. METHODS Eleven parents of nine children with CP ± L were recruited from the multidisciplinary craniofacial team at the Ghent University hospital. A qualitative design, using semi-structured interviews, was used to collect data. Data were managed using NVIVO software version 10 and analyzed thematically. RESULTS The analysis resulted in three major themes: (1) service provision, (2) patient-centered care, and (3) seeking health care. Each of these identified themes were divided into three subthemes. Service provision included the effectiveness of the provided service, interdisciplinary collaboration, and expertise of the speech therapist. Information provision, child-friendly attitude and connection were categorized under patient-centered care. Seeking health care included affordability, practical considerations and the selection of a speech therapist. CONCLUSION The most prominent expectation of the parents was that they wanted to see their children progress during the speech intervention. This finding supported the importance of experienced and specialized speech-language pathologists (SLPs) in the provision of care to children with a CP ± L. Moreover, the results showed that the majority of the parents wanted more clear and comprehensive information particularly about the treatment progress, the transfer to the home environment and the prognosis. The present findings might aid SLPs, and more generally all health professionals, in gaining insight into parental perceptions and expectations concerning speech therapy-related cleft care. Thereby, treatment quality might be improved.
Collapse
Affiliation(s)
- Cassandra Alighieri
- Department of Rehabilitation Sciences, Ghent University, Corneel Heymanslaan 10, 2P1, 9000 Gent, Belgium.
| | - Wim Peersman
- Research Group Social and Community Work, Odisee University College, Warmoesberg 26, 1000 Brussel, Belgium
| | - Kim Bettens
- Department of Rehabilitation Sciences, Ghent University, Corneel Heymanslaan 10, 2P1, 9000 Gent, Belgium
| | - Vienna Van Herreweghe
- Department of Rehabilitation Sciences, Ghent University, Corneel Heymanslaan 10, 2P1, 9000 Gent, Belgium
| | - Kristiane Van Lierde
- Department of Rehabilitation Sciences, Ghent University, Corneel Heymanslaan 10, 2P1, 9000 Gent, Belgium; Faculty of Humanities, Department of Speech-Language Pathology and Audiology, University of Pretoria, Lynnwood Road Hillcrest, Pretoria, South Africa
| |
Collapse
|
24
|
Bous RM, Hazen RA, Baus I, Palomo JM, Kumar A, Valiathan M. Psychosocial Adjustments Among Adolescents With Craniofacial Conditions and the Influence of Social Factors: A Multi-Informant Study. Cleft Palate Craniofac J 2019; 57:624-636. [PMID: 31769310 DOI: 10.1177/1055665619888308] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Previous studies have investigated psychosocial adjustments among adolescents with cleft lip and/or palate (CL/P), but our understanding of other craniofacial conditions remains limited. The objective of this study is to compare psychosocial adjustments among 3 groups of adolescents: craniofacial conditions other than cleft lip and/or palate (craniofacial anomaly [CFA]), CL/P, and controls (CON). Our secondary objective is to examine how social factors may predict the adjustments levels. DESIGN Cross-sectional, multi-informant, controlled survey study. PARTICIPANTS Aged 11- to 17-year olds. Craniofacial anomaly (n = 49), isolated CL/P (n = 42), and 55 CON. Total = 146. OUTCOME MEASURES The Strengths and Difficulties Questionnaire (self-report, parent report, and teacher report). RESULTS All 3 informant groups displayed similar patterns, where CFA reported the highest difficulties, followed by CL/P, while CON scored the lowest. Parent reports demonstrated significant differences among the 3 groups for most subscales and were emphasized for peer problems. Self-reports showed significant differences between CFA and CON for total scores and peer problems, while teacher reports showed significant differences for peer problems only. Craniofacial anomaly displayed the highest frequency of abnormal psychosocial adjustments, followed by CL/P. Experiencing bullying or teasing predicted increased difficulties, while having a good friend predicted decreased difficulties. CONCLUSIONS Adolescents with CFA, and to a lesser extent CL/P, may be at a higher risk of having psychosocial problems. Peer problems may constitute the biggest challenge that CFA and CL/P confront. Social factors, especially being bullied or having a good friend, may predict the psychosocial well-being of adolescents with craniofacial conditions.
Collapse
Affiliation(s)
- Rany M Bous
- Craniofacial, Surgical and Special Care Orthodontics Fellowship Program, Department of Orthodontics, School of Dental Medicine, Case Western Reserve University, Cleveland, OH, USA
| | - Rebecca A Hazen
- Departments of Pediatrics and Psychology, Case Western Reserve University School of Medicine.,Division of Developmental/Behavioral Pediatrics and Psychology, Rainbow Babies and Children's Hospital, University Hospital's Cleveland Medical Center, Cleveland, OH, USA
| | - Irene Baus
- Cleft and Craniofacial Center, Rainbow Babies and Children's Hospital, University Hospital's Cleveland Medical Center, Cleveland, OH, USA
| | - J Martin Palomo
- Department of Orthodontics, School of Dental Medicine, Case Western Reserve University, Cleveland, OH, USA
| | - Anand Kumar
- Department of Pediatric Plastic Surgery, University Hospitals Cleveland Medical Center, Cleveland, OH, USA.,Department of Plastic Surgery, School of Medicine, Case Western Reserve University, Cleveland, OH, USA
| | - Manish Valiathan
- Craniofacial, Surgical and Special Care Orthodontics Fellowship Program, Department of Orthodontics, School of Dental Medicine, Case Western Reserve University, Cleveland, OH, USA
| |
Collapse
|