Incidence and Demographic Patterns of Orofacial Clefts in Mysuru, Karnataka, India: A Hospital-based Study

Global birth prevalence of Robin sequence in live-born infants: a systematic review and meta-analysis

Robin sequence (RS), a congenital disorder of jaw maldevelopment and glossoptosis, poses a substantial healthcare burden and has long-term health implications if airway obstruction is suboptimally treated. This study describes the global birth prevalence of RS and investigates whether prevalence estimates differ by geographical location, ethnicity or study data source (registry versus non-registry data). The protocol was prospectively registered with PROSPERO.Databases were searched using keywords and subject terms for "Robin sequence", "epidemiology", "incidence" and "birth prevalence". Meta-analysis was performed fitting random effects models with arcsine transformation.From 34 eligible studies (n=2722 RS cases), pooled birth prevalence was 9.5 per 100 000 live births (95% CI 7.1-12.1) with statistical heterogeneity. One third of studies provided a case definition for RS and numerous definitions were used. A total of 22 countries were represented, predominantly from European populations (53% of studies). There was a trend towards higher birth prevalence in European populations and lower prevalence from registry-based studies. Only two studies reported ethnicity.This study indicates that RS occurs globally. To investigate geographical differences in prevalence, additional studies from non-European populations and reporting of ethnicity are needed. Heterogeneity of estimates may be due to variable diagnostic criteria and ascertainment methods. Recently published consensus diagnostic criteria may reduce heterogeneity among future studies.

Demographic Profile of Patients with Cleft Lip and Palate Anomaly: 15-year Experience from a Tertiary Care Hospital and Teaching Institute in Wardha District of Maharashtra, India

Background

Cleft lip and palate (CLP) is considered to be a congenital defect involving the orofacial region. This defect affects the esthetics, speech as well and psychological well-being of a person. The study was performed to analyze the prevalence of different types of cleft deformity reported in a tertiary care hospital which would aid in spreading awareness and thereby reducing the prevalence of this congenital defect.

Aim

To study the demographic profile of patients with CLP in the Wardha region.

Materials and methods

A single-center retrospective cross-sectional study was performed. The patients with cleft deformity report under the "Smile Train Project" under the Department of Orthodontics and Dentofacial Orthopedics along with the Department of Oral and Maxillofacial Surgery. The data retrieved included the name of the patient, age, gender, residential address, contact details, and type of cleft. This data was segregated focusing on the gender and type of cleft as per the concern of this study. The datasets were then entered in the Microsoft Excel sheet and the statistical graphical representation was done using Microsoft PowerPoint.

Results

In the present study we tried to find out the profile of CLP in the local population. We reported the high prevalence of this orofacial deformity among the population of this area.

Conclusion

The data from the present study will help to provide a deeper insight into the burden of CLP anomaly. Based on the data obtained from the present study, future research can be conducted, and cleft-care improvement outcomes can be measured.

Clinical significance

There are several etiological factors that are responsible for the development of CLP. Also, due to a lack of awareness regarding this, there is an increased prevalence of this defect. In India, due to a lack of knowledge regarding cleft anomaly, poverty, and social stigma, many patients do not report to the hospitals, and hence, there is a need to spread awareness which would encourage people to access the healthcare facilities at an early age and would reduce the complications in later stages.

How to cite this article

Shivlani VI, Niranjane PP, Diagavane PS, et al. Demographic Profile of Patients with Cleft Lip and Palate Anomaly: 15-year Experience from a Tertiary Care Hospital and Teaching Institute in Wardha District of Maharashtra, India. Int J Clin Pediatr Dent 2023;16(S-3):S278-S282.

Cleft lip and palate risk factors among otorhinolaryngology: Head and neck surgery patients in two hospitals

Cleft lip and/or palate is the most prevalent type of head and neck deformity, accounting for 65% of cases. The occurrence of this condition is influenced by both genetic and environmental factors. Cleft defects are classified into 2 types: syndromic cleft lip and palate syndrome and non-syndromic cleft lip and palate syndrome. Cleft lip with or without cleft palate is the most common type of cleft defect, and the surgical repair is the primary treatment option for patients. Our study was a retrospective case-control study that included 132 cases of patients with cleft defects and 132 healthy babies without cleft defects serving as controls. Personal information, including the name, age, and origin of the participants, was collected. Additionally, we collected information on all potential risk factors, including medical history, daily habits, consanguinity between parents, and family history. Information was collected in Excel and analyzed using the Statistical Package for Social Sciences and a Chi-Square test was performed to determine the results and their relationship to cleft lip and palate. Our study identified various risk factors that have a significant association with cleft lip and palate with a P-value <5% in addition to factors that are not considered risk factors. Using relative risk analysis, we were able to rank the top 5 most significant and influential risk factors. The most impactful factor was not taking folic acid during pregnancy. The primary risk factors associated with cleft lip and palate include a family history of the condition, lack of folic acid supplementation, maternal age over 35 years, and high temperatures exceeding 39 °C. Consequently, we recommend that mothers who intend to conceive should take folic acid supplements at a dose of 0.4 to 0.8 mg during the initial trimester of pregnancy. Additionally, we advise careful monitoring of all risk factors, particularly during the first trimester of pregnancy.

Virtual Reality as parent education tool in pre-surgical management of cleft lip and palate affected infants-A pilot study

AIM

To assess the influence of virtual reality (VR) in parent acceptance of the pre-surgical nasoalveolar molding (PNAM) as a pre surgical care to the cleft lip and palate affected infants.

MATERIAL AND METHODS

Descriptive Cross sectional pilot study design was planned to assess the pre surgical management of the cleft lip and palate. Twenty parents/caregivers of the infants were randomly divided into two groups. Twelve participants received education through conventional education module (Group I) using verbal explanation supported by the photographs. Another 12 participants received education through customized VR based educational video (Group II). After the education, the parents were provided with questionnaire to assess the acceptance of the treatment procedure. The survey response rate was represented in percentage.

RESULTS

The results of the study indicated that most of the parents were aware of the feeding plate or obturators as an aid in assisting feeding practices among cleft lip and palate affected infants. However, only 33% of participants in Group I were able to understand the doctor's explanation regarding the PNAM whereas 100% of participants in Group II were able to visualize the benefits of PNAM. These participants were willingly accepting PNAM as essential pre-surgical care.

CONCLUSION

Innovative approaches are essential in patient education modalities as the success of any treatment outcome largely depends on the patient acceptance. Within the limits of this study, VR has been successful in the educating the parents and caregivers regarding the acceptance of PNAM therapy in cleft affected infants.