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Larsson A, Miniscalco C, Mark H, Jönsson R, Persson C. Persisting speech difficulties at 7-8 years of age - a longitudinal study of speech production in internationally adopted children with cleft lip and palate. LOGOP PHONIATR VOCO 2024; 49:1-10. [PMID: 35833222 DOI: 10.1080/14015439.2022.2083673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Revised: 05/18/2022] [Accepted: 05/24/2022] [Indexed: 10/17/2022]
Abstract
AIM To longitudinally investigate speech production (consonant proficiency, consonant errors and perceived velopharyngeal competence) in 17 internationally adopted (IA) children with unilateral cleft lip and palate (UCLP) at three time points. METHOD Consonant proficiency (percent consonants correct, consonant inventory) and number and type of consonant errors were calculated based on blind phonetic transcriptions of words from the Swedish Test of Articulation and Nasality (SVANTE). Velopharyngeal competence was perceptually rated by three blinded experienced speech-language pathologists at the ages of 3, 5 and 7-8 years. RESULTS A significant positive development of speech production was found, although most children still scored very low for consonant proficiency at the age of 7-8 compared with normative values: the median for percent consonants correct was 79.7 and many children still had persisting cleft-related and developmental consonant errors. At the age of 7-8, almost half of the children were rated as having a competent velopharyngeal function and only three as having an incompetent velopharyngeal function. CONCLUSION Persisting speech difficulties at school age in IA children with UCLP were found in the present study, which is one of the very few longitudinal studies. Our results highlight the need for detailed follow-up of speech production in clinical settings. Speech disorders may have a severe impact on a child's intelligibility and participation with peers, and there is a need for more studies investigating the actual everyday effect of the difficulties found.
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Affiliation(s)
- AnnaKarin Larsson
- Institute of Neuroscience and Physiology, Speech and Language Pathology Unit, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Child Health Unit Gothenburg & Södra Bohuslän, Regionhälsan, Region Västra Götaland, Göteborg, Sweden
| | - Carmela Miniscalco
- Institute of Neuroscience and Physiology, Gillberg Neuropsychiatry Centre, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Queen Silvia Children's Hospital, Department of Child Neuropsychiatry and Paediatric Speech and Language Pathology, Gothenburg, Sweden
| | - Hans Mark
- Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Plastic Surgery, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Radoslava Jönsson
- Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Otorhinolaryngology and Audiology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Christina Persson
- Institute of Neuroscience and Physiology, Speech and Language Pathology Unit, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Otorhinolaryngology, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden
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Klintö K, Hagberg E, Havstam C, Nelli C, Okhiria Å, Brunnegård K. Reliability of data on percent consonants correct and its associated quality indicator in the Swedish cleft lip and palate registry. LOGOP PHONIATR VOCO 2024; 49:27-33. [PMID: 35786207 DOI: 10.1080/14015439.2022.2095017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 06/18/2022] [Accepted: 06/21/2022] [Indexed: 10/17/2022]
Abstract
BACKGROUND Data in national health care quality registries must be valid and reliable in order to enable open comparisons of results. AIM To assess the reliability of data on percent consonants correct (PCC) and its associated quality indicator ≥86% correct consonants in the Swedish quality registry for patients born with cleft lip and palate (CLP) registry. METHODS Six independent speech-language pathologists re-assessed the audio recordings of 96 five-year-olds with PCC data in the CLP registry. Target consonants of a single-word picture-naming test were phonetically transcribed, and PCC was calculated. The reliability of PCC data was assessed with the intraclass correlation coefficient (ICC). The reliability of the quality indicator ≥86% correct consonants was assessed with point-by-point percentage agreement and Cohen's kappa. RESULTS Intra- and inter-judge agreement for PCC was excellent with ICCs above 0.9, and so was the agreement of data from the CLP registry and the six judges' re-assessments. The percentage agreement between all judges and the CLP registry for the quality indicator ≥86% correct consonants was poor (67%). However, in 88% of the cases, results from four judges and the CLP registry agreed, corresponding to good agreement. The mean of all kappa values for six judges and the CLP registry corresponded to good agreement (0.72). CONCLUSIONS The results indicate the PCC data in the CLP registry and the quality indicator ≥86% correct consonants to be reliable. When differences in outcome between treatment centres are detected, the raw data collected should always be re-examined before drawing definitive conclusions.
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Affiliation(s)
- Kristina Klintö
- Department of Clinical Sciences in Lund, Lund University, Lund, Sweden
- Department of Otorhinolaryngology, Division of Speech and Language Pathology, Skåne University Hospital, Malmö, Sweden
| | - Emilie Hagberg
- Medical Unit Speech Therapy and Stockholm Craniofacial Team, Karolinska University Hospital, Stockholm, Sweden
| | - Christina Havstam
- Department of Otorhinolaryngology, Division of Speech and Language Pathology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Cecilia Nelli
- Speech and Language Therapy Unit, Linköping University Hospital, Linköping, Sweden
| | - Åsa Okhiria
- Department of Speech-Language Pathology, Uppsala University Hospital, Uppsala, Sweden
| | - Karin Brunnegård
- Department of Clinical Sciences/Speech and Language Pathology, Umeå University, Umeå, Sweden
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Gantugs AE, Imura H, Chimedtseren I, Kitagawa K, Sakuma C, Natsume N, Kawana T, Badamnyambuu B, Kurose M, Niimi T, Furukawa H, Natsume N. Questionnaire survey on public awareness of cleft lip with/without palate in Mongolia. Congenit Anom (Kyoto) 2024; 64:40-46. [PMID: 38308585 DOI: 10.1111/cga.12552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Revised: 12/26/2023] [Accepted: 01/22/2024] [Indexed: 02/05/2024]
Abstract
The frequency of cleft lip with/without palate (CL/P) in the Mongolian population is approximately 1 in 1314 live births. This research aims to disseminate information about this congenital disability to the public to better understand CL/P, and people's fissures, and review administrative measures, as there is a lack of research in this area. A questionnaire survey was conducted using Google Forms, with 1000 Mongolian participants. Most participants (86.7%) said they had knowledge of the word, whereas 86.2% said they had knowledge of the condition. Most participants' answers were question-related disadvantages of CL/P patients, including statements such as "It's uncomfortable in human relationships" and "It makes an uncomfortable impression on the person you meet the first time." The results of this study revealed that most Mongolians were aware of CL/P and are concerned about patients. However, the causes of CL/P in the general population remain unknown, and further research is needed in this area.
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Affiliation(s)
- Anar-Erdene Gantugs
- Division of Research and Treatment for Oral and Maxillofacial Congenital Anomalies, Aichi Gakuin University, School of Dentistry, Nagoya, Japan
| | - Hideto Imura
- Division of Research and Treatment for Oral and Maxillofacial Congenital Anomalies, Aichi Gakuin University, School of Dentistry, Nagoya, Japan
- Cleft Lip and Palate Center, Aichi Gakuin University Dental Hospital, Nagoya, Japan
- Division of Speech, Hearing, and Language, Aichi Gakuin University Dental Hospital, Nagoya, Japan
| | - Ichinnorov Chimedtseren
- Division of Research and Treatment for Oral and Maxillofacial Congenital Anomalies, Aichi Gakuin University, School of Dentistry, Nagoya, Japan
| | - Ken Kitagawa
- Division of Research and Treatment for Oral and Maxillofacial Congenital Anomalies, Aichi Gakuin University, School of Dentistry, Nagoya, Japan
- Cleft Lip and Palate Center, Aichi Gakuin University Dental Hospital, Nagoya, Japan
- Division of Speech, Hearing, and Language, Aichi Gakuin University Dental Hospital, Nagoya, Japan
| | - Chisato Sakuma
- Division of Research and Treatment for Oral and Maxillofacial Congenital Anomalies, Aichi Gakuin University, School of Dentistry, Nagoya, Japan
- Cleft Lip and Palate Center, Aichi Gakuin University Dental Hospital, Nagoya, Japan
- Division of Speech, Hearing, and Language, Aichi Gakuin University Dental Hospital, Nagoya, Japan
| | - Nagana Natsume
- Division of Research and Treatment for Oral and Maxillofacial Congenital Anomalies, Aichi Gakuin University, School of Dentistry, Nagoya, Japan
- Cleft Lip and Palate Center, Aichi Gakuin University Dental Hospital, Nagoya, Japan
- Division of Speech, Hearing, and Language, Aichi Gakuin University Dental Hospital, Nagoya, Japan
| | - Takayuki Kawana
- Division of Research and Treatment for Oral and Maxillofacial Congenital Anomalies, Aichi Gakuin University, School of Dentistry, Nagoya, Japan
| | - Byambajargal Badamnyambuu
- Division of Research and Treatment for Oral and Maxillofacial Congenital Anomalies, Aichi Gakuin University, School of Dentistry, Nagoya, Japan
| | - Motohiro Kurose
- Division of Research and Treatment for Oral and Maxillofacial Congenital Anomalies, Aichi Gakuin University, School of Dentistry, Nagoya, Japan
| | - Teruyuki Niimi
- Division of Research and Treatment for Oral and Maxillofacial Congenital Anomalies, Aichi Gakuin University, School of Dentistry, Nagoya, Japan
- Cleft Lip and Palate Center, Aichi Gakuin University Dental Hospital, Nagoya, Japan
- Division of Speech, Hearing, and Language, Aichi Gakuin University Dental Hospital, Nagoya, Japan
| | - Hiroo Furukawa
- Division of Research and Treatment for Oral and Maxillofacial Congenital Anomalies, Aichi Gakuin University, School of Dentistry, Nagoya, Japan
- Cleft Lip and Palate Center, Aichi Gakuin University Dental Hospital, Nagoya, Japan
- Division of Speech, Hearing, and Language, Aichi Gakuin University Dental Hospital, Nagoya, Japan
| | - Nagato Natsume
- Division of Research and Treatment for Oral and Maxillofacial Congenital Anomalies, Aichi Gakuin University, School of Dentistry, Nagoya, Japan
- Cleft Lip and Palate Center, Aichi Gakuin University Dental Hospital, Nagoya, Japan
- Division of Speech, Hearing, and Language, Aichi Gakuin University Dental Hospital, Nagoya, Japan
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Dwivedi S, Thakur A. An extremely rare case of Oro-facial digital syndrome: A case report. Spec Care Dentist 2024; 44:421-427. [PMID: 37095590 DOI: 10.1111/scd.12865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 04/04/2023] [Accepted: 04/07/2023] [Indexed: 04/26/2023]
Abstract
BACKGROUND Oro-facial digital(OFD) syndrome is a rare anomaly which is often missed out as just cleft lip and palate.It is an X-linked dominant condition with lethality in males. It however results from the pleotropic effect of a morphogenetic impairment affecting almost invariably the mouth, face and digits and it also includes lower IQ and mental retardation. 14 different variations of these syndrome can be seen with the majority of cases of type 1 and 2 based on characteristic clinical manifestations. CASE REPORT Present case report describes a 9 year old girl patient who was mis-diagnosed with partial cleft palate and was later diagnosed as orofacial digital syndrome based on the clinical and oral features. CONCLUSION Not much literature is present regarding this topic and with no relevent family history makes this case a one in a million case of OFD. Therefore, this case report is a complete insight on Oro-facial digital syndrome.
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Affiliation(s)
- Shilpy Dwivedi
- Department of Pedodontics and Preventive Dentistry, New Horizon Dental College and Research Institute, Sakri, Bilaspur, India
| | - Arpita Thakur
- Department of Pedodontics and Preventive Dentistry, New Horizon Dental College and Research Institute, Sakri, Bilaspur, India
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Takaichi M, Fujiwara K, Nakamichi N, Ishizaka R, Imaue S, Ikeda A, Noguchi M. Cleft Lip With Ankyloblepharon Filiforme Adnatum: A Case Report. Cleft Palate Craniofac J 2024; 61:155-158. [PMID: 36377243 DOI: 10.1177/10556656221138886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2023] Open
Abstract
Ankyloblepharon filiforme adnatum (AFA) is a rare, benign congenital anomaly. Notably, it is characterized by the adhesion of the ciliary edges of the upper and lower eyelids at the trabecular line. AFA is usually a solitary malformation of sporadic occurrence; however, it can occur in conjunction with other congenital diseases. Herein, we report a case of cleft lip with AFA. A patient was referred to the ophthalmology department of our hospital. The ophthalmic diagnosis was AFA in both the eyes. The left eye was observed to have a fibrous adhesion in the center, and she underwent surgery to excise the fibrous adhesion of tissue with scissors. The right eye was observed to have a fibrous adhesion in the external canthus and was excised during lip plasty. After surgery, her eyes were able to fully open, and no other apparent disease was diagnosed. AFA is thought to be caused by an ectodermal-derived developmental abnormality. Notably, cases of AFA with a cleft lip are rare. Diagnosis and surgery should be performed promptly to minimize any risk of amblyopia and for the early detection of congenital diseases, including glaucoma.
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Affiliation(s)
- Mayu Takaichi
- Department of Oral and Maxillofacial Surgery, Graduate School of Medicine, University of Toyama, Toyama, Japan
| | - Kumiko Fujiwara
- Department of Oral and Maxillofacial Surgery, Osaka Medical and Pharmaceutical University, Osaka, Japan
| | - Naomi Nakamichi
- Department of Oral and Maxillofacial Surgery, Graduate School of Medicine, University of Toyama, Toyama, Japan
| | - Risa Ishizaka
- Department of Oral and Maxillofacial Surgery, Graduate School of Medicine, University of Toyama, Toyama, Japan
| | - Shuichi Imaue
- Department of Oral and Maxillofacial Surgery, Graduate School of Medicine, University of Toyama, Toyama, Japan
| | - Atsushi Ikeda
- Department of Oral and Maxillofacial Surgery, Graduate School of Medicine, University of Toyama, Toyama, Japan
| | - Makoto Noguchi
- Department of Oral and Maxillofacial Surgery, Graduate School of Medicine, University of Toyama, Toyama, Japan
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Sorrentino U, Fedrigo M, Calò AP, Perin M, Veronese P, Salviati L. ZFHX4 truncating variant and orofacial clefting. Am J Med Genet A 2024; 194:115-116. [PMID: 37434517 DOI: 10.1002/ajmg.a.63353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 06/27/2023] [Accepted: 07/01/2023] [Indexed: 07/13/2023]
Affiliation(s)
- Ugo Sorrentino
- Clinical Genetics Unit, Department of Women's and Children's Health, University of Padova, Padova, Italy
| | - Marny Fedrigo
- Cardiovascular Pathology and Pathological Anatomy Unit, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Padova, Italy
| | - Anna Paola Calò
- Clinical Genetics Unit, Department of Women's and Children's Health, University of Padova, Padova, Italy
| | - Martina Perin
- Clinical Genetics Unit, Department of Women's and Children's Health, University of Padova, Padova, Italy
| | - Paola Veronese
- Maternal-Fetal Medicine Unit, Department of Women's and Children's Health, Padova, Italy
| | - Leonardo Salviati
- Clinical Genetics Unit, Department of Women's and Children's Health, University of Padova, Padova, Italy
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7
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Bartalis K, Kálmán B, Kisely M. [Ectrodactyly-ectodermal dysplasia-clefting (EEC) syndrome]. Orv Hetil 2023; 164:1831-1837. [PMID: 37980600 DOI: 10.1556/650.2023.32913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Accepted: 08/29/2023] [Indexed: 11/21/2023]
Abstract
The ectrodactyly-ectodermal dysplasia-clefting syndrome is an extremely rare genetic disorder that is inherited as an autosomal dominant trait, but can also occur sporadically. It is characterized by the triad of ectrodactyly (absence of fingers), ectodermal dysplasia and cleft lip and palate along with variable involvement of other organs. Both the ectodermal and mesodermal tissues may be affected resulting in a spectrum of phenotypes. Early diagnosis and treatment signify a unique challenge for those involved in the clinical management, while enable counseling and preparation of parents for the tasks ahead of them. In our report, we describe the case of a patient with sporadic EEC syndrome. In addition to the presentation of the complex phenotype along with the medical interventions, we summarize the most important characteristics of the disease, the diagnostic and therapeutic possibilities as well as the clinical significance of the accurate genetic verification. Using whole exome sequencing, we identified in the 3q28 chromosomal region a pathogenic mutation within the TP63 gene previously linked to the EEC3 phenotypes. The knowledge of pathogenic mutation provides the means to prenatal diagnostics or in vitro fertilization methods that allows us to minimize the possibility of inheriting the syndrome in the patient's offspring. By presenting our case, we aim to draw attention to this rare and disabling disease that requires the high quality works of a multidisciplinary team capable of ensuring good quality of life for the patient. Orv Hetil. 2023; 164(46): 1831-1837.
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Affiliation(s)
- Krisztina Bartalis
- 1 Vas Vármegyei Markusovszky Egyetemi Oktatókórház, Fül-Orr-Gégészeti és Fej-Nyaksebészeti Osztály Szombathely, Markusovszky u. 5., 9700 Magyarország
| | - Bernadette Kálmán
- 2 Vas Vármegyei Markusovszky Egyetemi Oktatókórház, Molekuláris Orvoslás Szombathely Magyarország
- 3 Pécsi Tudományegyetem, Általános Orvostudományi Kar, Szentágothai Kutatóközpont, Laboratóriumi Medicina Intézet Pécs Magyarország
| | - Mihály Kisely
- 1 Vas Vármegyei Markusovszky Egyetemi Oktatókórház, Fül-Orr-Gégészeti és Fej-Nyaksebészeti Osztály Szombathely, Markusovszky u. 5., 9700 Magyarország
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Pereira VJ, So JYT, Tsang JMK, Choi WS, Tong MCF, Lee KYS. Speech Telepractice and Treatment Intensity in a Cantonese-Speaking Case with 22q11.2 Deletion Syndrome Following Late Diagnosis and Management of Velopharyngeal Dysfunction. Cleft Palate Craniofac J 2023; 60:1505-1512. [PMID: 35678611 DOI: 10.1177/10556656221106042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
This case report explores clinical treatment efficacy in a Cantonese-speaking child with 22q11.2 Deletion Syndrome where diagnosis and management of velopharyngeal dysfunction can be considered late. All treatment sessions were undertaken via telepractice during the peak of the COVID-19 pandemic in Hong Kong. A hybrid of specialized cleft palate speech treatment techniques and traditional treatment approaches in Speech Sound Disorders were utilized. Treatment intensity components including dose, dose form, session duration, and total intervention duration were documented.
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Affiliation(s)
- Valerie J Pereira
- Department of Otorhinolaryngology, Head & Neck Surgery, Faculty of Medicine, The Chinese University of Hong Kong, New Territories, Hong Kong SAR, China
- Institute of Human Communicative Research, The Chinese University of Hong Kong, New Territories, Hong Kong SAR, China
| | - Janet Y T So
- Department of Otorhinolaryngology, Head & Neck Surgery, Faculty of Medicine, The Chinese University of Hong Kong, New Territories, Hong Kong SAR, China
| | - Joy M K Tsang
- Department of Otorhinolaryngology, Head & Neck Surgery, Faculty of Medicine, The Chinese University of Hong Kong, New Territories, Hong Kong SAR, China
| | - Wing S Choi
- Division of Oral and Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - Michael C F Tong
- Department of Otorhinolaryngology, Head & Neck Surgery, Faculty of Medicine, The Chinese University of Hong Kong, New Territories, Hong Kong SAR, China
- Institute of Human Communicative Research, The Chinese University of Hong Kong, New Territories, Hong Kong SAR, China
| | - Kathy Y S Lee
- Department of Otorhinolaryngology, Head & Neck Surgery, Faculty of Medicine, The Chinese University of Hong Kong, New Territories, Hong Kong SAR, China
- Institute of Human Communicative Research, The Chinese University of Hong Kong, New Territories, Hong Kong SAR, China
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Diaz Perez KK, Curtis SW, Sanchis-Juan A, Zhao X, Head T, Ho S, Carter B, McHenry T, Bishop MR, Valencia-Ramirez LC, Restrepo C, Hecht JT, Uribe LM, Wehby G, Weinberg SM, Beaty TH, Murray JC, Feingold E, Marazita ML, Cutler DJ, Epstein MP, Brand H, Leslie EJ. Rare variants found in clinical gene panels illuminate the genetic and allelic architecture of orofacial clefting. Genet Med 2023; 25:100918. [PMID: 37330696 PMCID: PMC10592535 DOI: 10.1016/j.gim.2023.100918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 05/12/2023] [Accepted: 06/10/2023] [Indexed: 06/19/2023] Open
Abstract
PURPOSE Orofacial clefts (OFCs) are common birth defects including cleft lip, cleft lip and palate, and cleft palate. OFCs have heterogeneous etiologies, complicating clinical diagnostics because it is not always apparent if the cause is Mendelian, environmental, or multifactorial. Sequencing is not currently performed for isolated or sporadic OFCs; therefore, we estimated the diagnostic yield for 418 genes in 841 cases and 294 controls. METHODS We evaluated 418 genes using genome sequencing and curated variants to assess their pathogenicity using American College of Medical Genetics criteria. RESULTS 9.04% of cases and 1.02% of controls had "likely pathogenic" variants (P < .0001), which was almost exclusively driven by heterozygous variants in autosomal genes. Cleft palate (17.6%) and cleft lip and palate (9.09%) cases had the highest yield, whereas cleft lip cases had a 2.80% yield. Out of 39 genes with likely pathogenic variants, 9 genes, including CTNND1 and IRF6, accounted for more than half of the yield (4.64% of cases). Most variants (61.8%) were "variants of uncertain significance", occurring more frequently in cases (P = .004), but no individual gene showed a significant excess of variants of uncertain significance. CONCLUSION These results underscore the etiological heterogeneity of OFCs and suggest sequencing could reduce the diagnostic gap in OFCs.
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Affiliation(s)
| | - Sarah W Curtis
- Department of Human Genetics, Emory University School of Medicine, Atlanta, GA
| | - Alba Sanchis-Juan
- Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, Program in Medical and Population Genetics, Broad Institute, Cambridge, MA, Department of Neurology and Surgery, Massachusetts General Hospital and Harvard Medical School, Boston, MA
| | - Xuefang Zhao
- Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, Program in Medical and Population Genetics, Broad Institute, Cambridge, MA, Department of Neurology and Surgery, Massachusetts General Hospital and Harvard Medical School, Boston, MA
| | - Taylor Head
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, GA
| | - Samantha Ho
- Department of Human Genetics, Emory University School of Medicine, Atlanta, GA
| | - Bridget Carter
- Department of Human Genetics, Emory University School of Medicine, Atlanta, GA; Agnes Scott College, Decatur, GA
| | - Toby McHenry
- Center for Craniofacial and Dental Genetics, Department of Oral and Craniofacial Sciences, University of Pittsburgh School of Dental Medicine, Pittsburgh, PA
| | - Madison R Bishop
- Department of Human Genetics, Emory University School of Medicine, Atlanta, GA
| | | | | | - Jacqueline T Hecht
- Department of Pediatrics, McGovern Medical, School and School of Dentistry, UT Health at Houston, Houston, TX
| | - Lina M Uribe
- Department of Orthodontics, University of Iowa, Iowa City, IA
| | - George Wehby
- Department of Health Management and Policy, University of Iowa, Iowa City, IA
| | - Seth M Weinberg
- Center for Craniofacial and Dental Genetics, Department of Oral and Craniofacial Sciences, University of Pittsburgh School of Dental Medicine, Pittsburgh, PA
| | - Terri H Beaty
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | | | - Eleanor Feingold
- Department of Human Genetics, University of Pittsburgh School of Public Health, Pittsburgh, PA
| | - Mary L Marazita
- Center for Craniofacial and Dental Genetics, Department of Oral and Craniofacial Sciences, University of Pittsburgh School of Dental Medicine, Pittsburgh, PA; Department of Human Genetics, University of Pittsburgh School of Public Health, Pittsburgh, PA
| | - David J Cutler
- Department of Human Genetics, Emory University School of Medicine, Atlanta, GA
| | - Michael P Epstein
- Department of Human Genetics, Emory University School of Medicine, Atlanta, GA
| | - Harrison Brand
- Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, Program in Medical and Population Genetics, Broad Institute, Cambridge, MA, Department of Neurology and Surgery, Massachusetts General Hospital and Harvard Medical School, Boston, MA
| | - Elizabeth J Leslie
- Department of Human Genetics, Emory University School of Medicine, Atlanta, GA.
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10
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Pekar-Zlotin M, Zilberman Sharon N, Melcer Y, Tal-Bliman Y, Ezratty J, Feingold-Zadok M, Svirsky R, Maymon R. Pregnancy with Facial Cleft: 20 Years of Experience at a Single Center. Isr Med Assoc J 2023; 25:678-682. [PMID: 37846996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 10/18/2023]
Abstract
BACKGROUND Fetal facial clefts are among the most common congenital anomalies detected prenatally. This finding may lead to termination of pregnancy in some cases. OBJECTIVES To compare a cohort of fetuses with facial clefts in which the pregnancy was terminated to the cohort of cases that were born with facial clefts. To investigate risk factors for facial clefts. METHODS We conducted a retrospective chart review of all women with prenatal and postnatal diagnosis of facial cleft that were managed in our institute. A telephone questionnaire was conducted regarding a positive family history and/or genetic predisposition for facial clefts abnormalities. RESULTS The final cohort consisted of two group. One group included 54 cases of termination of pregnancy (TOP) that were performed due to cleft lip (CL) or cleft palate (CLP); 27 women answered the telephone questionnaire. The second group comprised 99 women who delivered children with facial cleft during the same period; 60 answered the questionnaire. Only seven cases were diagnosed prenatal. Among the two groups, no correlation to family history was discovered. Of note, there was one case of three consecutive fetuses with CL in one woman, without any significant genetic findings. CONCLUSIONS To the best of our knowledge, this is the first study to describe an anatomical malformation posing an ethical dilemma before TOP. Primary prevention with folic acid and early sonographic detection of CL/CLP with multidisciplinary consultation should be considered.
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Affiliation(s)
- Marina Pekar-Zlotin
- Department of Obstetrics and Gynecology, Shamir Medical Center (Assaf Harofeh), Zerifin, Israel, affiliated with Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Natali Zilberman Sharon
- Department of Obstetrics and Gynecology, Shamir Medical Center (Assaf Harofeh), Zerifin, Israel, affiliated with Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Yaakov Melcer
- Department of Obstetrics and Gynecology, Shamir Medical Center (Assaf Harofeh), Zerifin, Israel, affiliated with Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Yael Tal-Bliman
- Department of Obstetrics and Gynecology, Shamir Medical Center (Assaf Harofeh), Zerifin, Israel, affiliated with Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Jodi Ezratty
- Department of Obstetrics and Gynecology, Shamir Medical Center (Assaf Harofeh), Zerifin, Israel, affiliated with Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Michal Feingold-Zadok
- Department of Obstetrics and Gynecology, Shamir Medical Center (Assaf Harofeh), Zerifin, Israel, affiliated with Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Ran Svirsky
- Department of Obstetrics and Gynecology, Shamir Medical Center (Assaf Harofeh), Zerifin, Israel, affiliated with Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Ron Maymon
- Department of Obstetrics and Gynecology, Shamir Medical Center (Assaf Harofeh), Zerifin, Israel, affiliated with Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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11
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Álvarez Carvajal DC, Inostroza-Allende F, Geldres Meneses MB, Giugliano Villarroel C. Speech Outcomes and Velopharyngeal Function in Children Undergoing Submucous Cleft Palate Repair. J Craniofac Surg 2023; 34:1766-1771. [PMID: 37526200 DOI: 10.1097/scs.0000000000009570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Accepted: 06/27/2023] [Indexed: 08/02/2023] Open
Abstract
OBJECTIVE Describe and compare the results of speech and velopharyngeal function in children with classic and occult submucous cleft palate undergoing interdisciplinary treatment at the Gantz Foundation. METHODS The clinical history of all patients born between 2012 and 2017 with a diagnosis of classic or occult submucous cleft palate was retrospectively reviewed. Preoperative and postoperative medical, surgical, and speech and language history were collected. RESULTS Twenty-eight cases diagnosed at the age of 44.8±23.9 months were included. Of these, 71.4% presented classic submucous cleft, and 28.6% occult. Before primary surgery, 7.1% had a diagnosis of the syndrome, and 21.4% were under study. A total of 39.3% had hearing difficulties and 21.4% used tympanic ventilation tubes. A total of 60.7% had language problems, 39.3% had compensatory articulation, 17.9% had absent hypernasality, and 21.4% had absent nasal emission. The team indicated primary palate surgery in 71.4%, of which 85% performed the surgery at the mean age of 61.7±24.7 months. The surgical technique was Furlow in 88.2% of the cases and intravelar veloplasty in the remaining 11.8%. Then, 3 cases underwent velopharyngeal insufficiency surgery; 2 of them eliminated hypernasality and reduced nasal emission. The age of diagnosis ( P =0.021) and the performance of velopharyngeal insufficiency surgery ( P =0029) of the occult submucous cleft palate group was significatively later than the classic cleft palate group. CONCLUSIONS Language, hearing, compensatory articulation, hypernasality, and nasal emission problems were recorded. A high percentage required primary surgery. Of these, a low proportion also required a velopharyngeal insufficiency surgery, which improved the velopharyngeal function of the children but did not completely adapt it. In this regard, early diagnosis is essential, as well as an analysis of each center primary closure protocol.
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Affiliation(s)
| | - Felipe Inostroza-Allende
- Speech Therapy Unit, Gantz Foundation-Cleft Children's Hospital
- Speech Therapy Department, University of Chile
| | | | - Carlos Giugliano Villarroel
- Department of Plastic Surgery, Gantz Foundation-Cleft Children's Hospital
- Department of Plastic Surgery, Surgery Service, Clínica Alemana de
- Smile Train-South American Medical Advisory Council-SAMAC, Santiago, Chile
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12
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Wilkes C, Graetz M, Downie L, Bethune M, Chong D. Prenatal diagnosis of cleft lip and/or palate: What do we tell prospective parents? Prenat Diagn 2023; 43:1310-1319. [PMID: 37552068 DOI: 10.1002/pd.6418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Revised: 07/22/2023] [Accepted: 07/24/2023] [Indexed: 08/09/2023]
Abstract
Cleft lip and/or palate (CL/CP) is the most common congenital craniofacial anomaly and parents often ask, "how did this happen?" Patients and families may benefit from access to a multidisciplinary team (MDT) from prenatal diagnosis into early adulthood. Multiple factors can contribute to the development of a cleft. We discuss the epidemiology and risk factors that increase the likelihood of having a newborn with a cleft. The purpose of this article is to review the prenatal investigations involved in the diagnosis and workup of these patients in addition to postpartum treatment, prognostic factors, and counseling families regarding future recurrence risk.
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Affiliation(s)
- Courtney Wilkes
- Department of Plastic and Maxillofacial Surgery, The Royal Children's Hospital, Melbourne, Victoria, Australia
| | - Melissa Graetz
- Department of Genetics, Mercy Hospital for Women, Melbourne, Victoria, Australia
| | - Lilian Downie
- Department of Genetics, Mercy Hospital for Women, Melbourne, Victoria, Australia
| | - Michael Bethune
- Department of Medical Imaging and Perinatal Medicine, The Mercy Hospital for Women, Melbourne, Victoria, Australia
- Specialist Women's Ultrasound, Melbourne, Victoria, Australia
| | - David Chong
- Department of Plastic and Maxillofacial Surgery, The Royal Children's Hospital, Melbourne, Victoria, Australia
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13
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Labunski A, Carrasquillo KG, Brocks D. Treatment and Management of Ectrodactyly-Ectodermal Dysplasia-Clefting Syndrome With Scleral Prosthetic Devices. Eye Contact Lens 2023; 49:262-265. [PMID: 37053073 DOI: 10.1097/icl.0000000000000987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/14/2023]
Abstract
ABSTRACT This case report highlights the unique application and long-term benefits of customized scleral devices in a patient with ocular complications from ectrodactyly-ectodermal dysplasia-clefting (EEC) syndrome over the span of 10 years. A 13-year-old girl with a history of EEC syndrome and ocular manifestations, including severe bilateral dry eye disease, corneal neovascularization and scarring, progressive fibrous pannus, and limbal stem cell deficiency, was examined and fitted with scleral devices. The goal of treatment was to stabilize the ocular surface, enhance vision, and improve ocular comfort. Throughout the course of treatment, there was minimal progression in ocular signs, despite interruptions in scleral device wear from application and removal challenges secondary to ectrodactyly. Customized scleral devices provided an optimal environment to support the ocular surface, improve comfort, and improve visual acuity. Further studies are required to demonstrate the benefits of scleral devices in larger populations of patients with EEC syndrome.
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Affiliation(s)
- Andrea Labunski
- New England College of Optometry (A.L., K.G.C.), Cornea and Contact Lens Department, Boston, MA; and BostonSight (K.G.C., D.B.), BostonSight Clinic, Needham, MA
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14
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Houb-Dine A, Jalila H, Zaoui F, Benkaddour A. Oral and dental abnormalities in Coffin Siris syndrome : A new case report. Tunis Med 2023; 101:456-459. [PMID: 38372531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Accepted: 08/10/2023] [Indexed: 02/20/2024]
Abstract
INTRODUCTION Coffin-Siris Syndrome (CSS) is a rare genetic disorder of unknown etiology. It combines digital-ungual abnormalities, facial dysmorphism, developmental and intellectual delay, and other organ-system abnormalities. Oral and dental anomalies are rarer. CASE REPORT 8-year-old boy with clinical diagnosis of CSS presented facial dysmorphism, sparse hair, a flat and wide nose, absence of nails on 3rd and 5th fingers of the right hand and 3rd and 4th fingers of the left hand, malformation of the feet, toes with nail hypoplasia. Oral and dental anomalies included : bilateral complete cleft lip and palate, delayed eruption of permanent teeth, presence of supernumerary tooth and taurodontism in the first permanent molars. CONCLUSION Early diagnosis of oral problems and regular follow-up in dentist are necessary to promote good oral health and improve the patient's quality of life.
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Affiliation(s)
- Afaf Houb-Dine
- Dentofacial Orthopedics Department, Faculty of Dental Medicine of Rabat, Mohammed V University in Rabat, Morocco
| | - Hammouti Jalila
- Pediatric Dentistry Department, Faculty of Dental Medicine of Rabat, Mohammed V University in Rabat, Morocco
| | - Fatima Zaoui
- Dentofacial Orthopedics Department, Faculty of Dental Medicine of Rabat, Mohammed V University in Rabat, Morocco
| | - Asmae Benkaddour
- Dentofacial Orthopedics Department, Faculty of Dental Medicine of Rabat, Mohammed V University in Rabat, Morocco
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Zenteno D, Cancino-Mella M, Torres-Puebla G, Barrientos G, Islas C, Tapia J, Elso MJ, Brockmann P. [Studies of sleep and therapeutic actions in children and adolescents with craniofacial anomalies]. Andes Pediatr 2023; 94:37-44. [PMID: 37906869 DOI: 10.32641/andespediatr.v94i1.4179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Accepted: 07/04/2022] [Indexed: 11/02/2023]
Abstract
OBJECTIVE To describe the presence of obstructive sleep apnea syndrome (OSAS) in children with craniofacial anomalies (CFA), associate biodemographic characteristics and polygraph variables, and analyze the therapeutic management decided after the sleep study and the evaluation by a multidisciplinary team. PATIENTS AND METHOD Retrospective study. Polygraphs were performed on patients aged between 1 month and 19 years with CFA. An initial and projected management was established categorized into ventilatory support, tracheostomy, surgery, dental, and medical treatment. Descrip tive and inferential statistics were performed, evaluating the association between demographic and polygraph variables and therapeutic management. RESULTS 34 patients were included with a median age of 4.0 years (IQR 0.9 - 6.5). Diagnosis was 41.2% cleft lip and palate, 35.3% craniosynostosis, and 23.5% micrognathia. Polygraphs were altered in 70.6% of the cases; of these, 26.5% were diagnosed as mild, 5.9% moderate, and 38.2% severe OSAS. There was an association between minimum satu ration and diagnosis of OSAS (p = 0.0036), and in the presence of OSAS with the initial management applied (p=0.0013). There was no significant relationship between the different types of CFA with the initial therapeutic management (p = 0.6565). Initial and projected managements, respectively: Venti latory support (11.8% and 2.9%), tracheostomy (11.8% and 0%), surgery (35.2% and 26.5%), dental (20.6% and 53%), and medical treatment (20.6% and 17.6 %). CONCLUSIONS 70% of the patients with CFA presented OSAS. The greatest severity was found in Cleft Lip and Palatine and Craniosynostosis. Therapeutic management was mainly oriented towards initial surgical and planned dental treatments based on the diagnosis of OSAS and not on the type of CFA.
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Affiliation(s)
| | | | | | | | | | - Jaime Tapia
- Hospital Guillermo Grant Benavente, Concepción, Chile
| | - María José Elso
- Departamento de Especialidades Médicas, Facultad de Medicina, Universidad de Concepción, Concepción, Chile
| | - Pablo Brockmann
- Departamento de Cardiología y Respiratorio Pediátrico, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
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Abstract
Children who have cleft and craniofacial diagnoses require coordinated, interdisciplinary treatment planning from birth to young adulthood. Teams that adhere to the Parameters of Care and maintain annual review by the American Cleft Palate Craniofacial Association Commission on Approval of Teams are published at www.acpa-cpf.org to assist families in obtaining that care. The six critical components to this interdisciplinary care focus on the team's composition, the team's management and responsibilities, the inclusion of patient and family/caregiver communication, an ongoing commitment to cultural competence, the importance of psychosocial and social services provided for the child and family, and the dedication to outcomes assessment. Primary care physicians are in a unique position to help direct families to this online directory for the best possible outcomes. [Pediatr Ann. 2023;52(1):e18-e22.].
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17
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Sanquer E, Hennocq Q, Picard A, Bucur-Girard A, Kadlub N, Neiva-Vaz C. Criteria for early and late velopharyngoplasty in 61 children with cleft palate. J Stomatol Oral Maxillofac Surg 2022; 123:e521-e525. [PMID: 35272091 DOI: 10.1016/j.jormas.2022.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Accepted: 03/02/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Velopharyngeal insufficiency persists in 15 to 30% of children with cleft palate, despite early velar surgery. Pharyngoplasty using a superior pedicle flap is the most common secondary surgery to treat velopharyngeal insufficiency. This study aims to identify the criteria leading to indicate velopharyngoplasty in 3 groups of age. MATERIALS AND METHODS we conducted a retrospective single center study in the reference center for cleft palate in Paris from 2013 to 2016. We included 61 children with non-syndromic cleft operated on with a velopharyngoplasty for velopharyngeal insufficiency. Pre-operative speech and surgical assessments, as well as the operative reports of the children, were analyzed retrospectively using multivariate models. RESULTS We included 61 patients. The only criteria factor for an early velopharyngoplasty was the Pittsburgh Weighted Speech Scale (PWSS) score (OR 1.20, CI 95% 1.07 to 1.4 ; P=.006). Criteria for a late velopharyngoplasty were a degradation of the velopharyngeal function (OR 16.07, CI 95% 1.7 to 518.7 ; P=.041) and lost of follow-up (OR 5.78, CI 95% 3.9 to 4320 ; P=.017). CONCLUSION Criteria for early and late velopharyngoplasty were identified, and we demonstrated the insufficiency of Borel-Maisonny classification for scientific clinical study.
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Affiliation(s)
- Estelle Sanquer
- Department of Maxillo-facial and Plastic Surgery, Necker-Enfants Malades Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France; facial cleft and malformation national network, Paris, France
| | - Quentin Hennocq
- Department of Maxillo-facial and Plastic Surgery, Necker-Enfants Malades Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France; facial cleft and malformation national network, Paris, France
| | - Arnaud Picard
- Department of Maxillo-facial and Plastic Surgery, Necker-Enfants Malades Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France; facial cleft and malformation national network, Paris, France; University of Paris, France
| | - Alexandra Bucur-Girard
- Department of Maxillo-facial and Plastic Surgery, Necker-Enfants Malades Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France; facial cleft and malformation national network, Paris, France
| | - Natacha Kadlub
- Department of Maxillo-facial and Plastic Surgery, Necker-Enfants Malades Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France; facial cleft and malformation national network, Paris, France; University of Paris, France.
| | - Cécilia Neiva-Vaz
- Department of Maxillo-facial and Plastic Surgery, Necker-Enfants Malades Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France; facial cleft and malformation national network, Paris, France
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18
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Huqh MZU, Abdullah JY, Wong LS, Jamayet NB, Alam MK, Rashid QF, Husein A, Ahmad WMAW, Eusufzai SZ, Prasadh S, Subramaniyan V, Fuloria NK, Fuloria S, Sekar M, Selvaraj S. Clinical Applications of Artificial Intelligence and Machine Learning in Children with Cleft Lip and Palate-A Systematic Review. Int J Environ Res Public Health 2022; 19:ijerph191710860. [PMID: 36078576 PMCID: PMC9518587 DOI: 10.3390/ijerph191710860] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/30/2022] [Accepted: 08/22/2022] [Indexed: 05/03/2023]
Abstract
OBJECTIVE The objective of this systematic review was (a) to explore the current clinical applications of AI/ML (Artificial intelligence and Machine learning) techniques in diagnosis and treatment prediction in children with CLP (Cleft lip and palate), (b) to create a qualitative summary of results of the studies retrieved. MATERIALS AND METHODS An electronic search was carried out using databases such as PubMed, Scopus, and the Web of Science Core Collection. Two reviewers searched the databases separately and concurrently. The initial search was conducted on 6 July 2021. The publishing period was unrestricted; however, the search was limited to articles involving human participants and published in English. Combinations of Medical Subject Headings (MeSH) phrases and free text terms were used as search keywords in each database. The following data was taken from the methods and results sections of the selected papers: The amount of AI training datasets utilized to train the intelligent system, as well as their conditional properties; Unilateral CLP, Bilateral CLP, Unilateral Cleft lip and alveolus, Unilateral cleft lip, Hypernasality, Dental characteristics, and sagittal jaw relationship in children with CLP are among the problems studied. RESULTS Based on the predefined search strings with accompanying database keywords, a total of 44 articles were found in Scopus, PubMed, and Web of Science search results. After reading the full articles, 12 papers were included for systematic analysis. CONCLUSIONS Artificial intelligence provides an advanced technology that can be employed in AI-enabled computerized programming software for accurate landmark detection, rapid digital cephalometric analysis, clinical decision-making, and treatment prediction. In children with corrected unilateral cleft lip and palate, ML can help detect cephalometric predictors of future need for orthognathic surgery.
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Affiliation(s)
- Mohamed Zahoor Ul Huqh
- Orthodontic Unit, School of Dental Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian, Kota Bharu 16150, Malaysia
| | - Johari Yap Abdullah
- Craniofacial Imaging Lab, School of Dental Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian, Kota Bharu 16150, Malaysia
- Correspondence: (J.Y.A.); (L.S.W.); (S.S.)
| | - Ling Shing Wong
- Faculty of Health and Life Sciences, INTI International University, Nilai 71800, Malaysia
- Correspondence: (J.Y.A.); (L.S.W.); (S.S.)
| | - Nafij Bin Jamayet
- Division of Clinical Dentistry (Prosthodontics), School of Dentistry, International Medical University, Bukit Jalil, Kuala Lumpur 57000, Malaysia
| | - Mohammad Khursheed Alam
- Orthodontic Division, Preventive Dentistry Department, College of Dentistry, Jouf University, Sakaka 72345, Saudi Arabia
| | - Qazi Farah Rashid
- Prosthodontic Unit, School of Dental Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian, Kota Bharu 16150, Malaysia
| | - Adam Husein
- Prosthodontic Unit, School of Dental Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian, Kota Bharu 16150, Malaysia
| | - Wan Muhamad Amir W. Ahmad
- Department of Biostatistics, School of Dental Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian, Kota Bharu 16150, Malaysia
| | - Sumaiya Zabin Eusufzai
- Department of Biostatistics, School of Dental Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian, Kota Bharu 16150, Malaysia
| | - Somasundaram Prasadh
- National Dental Center Singapore, 5 Second Hospital Avenue, Singapore 168938, Singapore
| | | | | | | | - Mahendran Sekar
- Department of Pharmaceutical Chemistry, Faculty of Pharmacy and Health Sciences, Royal College of Medicine Perak, Universiti Kuala Lumpur, Ipoh 30450, Malaysia
| | - Siddharthan Selvaraj
- Faculty of Dentistry, AIMST University, Bedong 08100, Malaysia
- Correspondence: (J.Y.A.); (L.S.W.); (S.S.)
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19
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Weiss NM, Bennöhr F, Lenz JH, Mlynski R, Rettschlag S. [Eustachian tube dysfunction after cleft palate surgery : Use of the latest diagnostics]. HNO 2022; 70:557-563. [PMID: 35318498 PMCID: PMC9242949 DOI: 10.1007/s00106-022-01147-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/05/2022] [Indexed: 11/15/2022]
Abstract
OBJECTIVE In patients with cleft palate, a high incidence of chronic obstructive Eustachian tube dysfunction (ETD) is assumed after surgery. Consequently, an increased rate of retracted eardrum or cholesteatoma is expected. Even though no common standard for investigating ETD is available, the development of objective tests has increased during the past 10 years. This study aimed to investigate the incidence of persisting chronic obstructive ETD in adult patients with cleft palate surgically treated in early childhood by using a combination of diagnostic tools. METHODS Adult participants with cleft palate repair in early childhood were invited for a follow-up examination and compared to a control group. Examination included tympanometry, tubomanometry, the Eustachian Tube Dysfunction Questionnaire (ETDQ-7), and the Eustachian Tube Score 7 (ETS-7). RESULTS A total of 16 adult patients were re-examined after cleft palate surgery and compared to a control group of 40 healthy individuals. Significant differences were found in the median ETS‑7 (p < 0.0001) score but not in the median ETDQ‑7 (p = 0.09) score. Only 2 of the 32 investigated ears (6%) had pathologic scores in ETS‑7 and ETDQ‑7 (p = 0.09), whereas 5 (31%) cleft palate patients showed symptoms of chronic obstructive ETD according to ETS‑7. No patient had examination findings indicating a requirement for further treatment. CONCLUSION By combining diagnostic tools for ETD, a lower rate of persisting obstructive ETD in adults after cleft palate surgery was found than previously reported. Successful surgical treatment of cleft palate seems to lead to physiological Eustachian tube function in long-term follow up.
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Affiliation(s)
- Nora M Weiss
- Klinik für Hals-Nasen-Ohrenheilkunde, Kopf- und Halschirurgie "Otto Körner", Universitätsmedizin Rostock, Doberaner Str. 137-139, 18057, Rostock, Deutschland.
| | - Franziska Bennöhr
- Klinik für Hals-Nasen-Ohrenheilkunde, Kopf- und Halschirurgie "Otto Körner", Universitätsmedizin Rostock, Doberaner Str. 137-139, 18057, Rostock, Deutschland
| | - Jan-Hendrik Lenz
- Klinik und Poliklinik für Mund‑, Kiefer- und Plastische Gesichtschirurgie, Klinik und Polikliniken für Zahn‑, Mund- und Kieferheilkunde, Universitätsmedizin Rostock, Rostock, Deutschland
| | - Robert Mlynski
- Klinik für Hals-Nasen-Ohrenheilkunde, Kopf- und Halschirurgie "Otto Körner", Universitätsmedizin Rostock, Doberaner Str. 137-139, 18057, Rostock, Deutschland
| | - Stefanie Rettschlag
- Klinik für Hals-Nasen-Ohrenheilkunde, Kopf- und Halschirurgie "Otto Körner", Universitätsmedizin Rostock, Doberaner Str. 137-139, 18057, Rostock, Deutschland
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20
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Chiquet B, Holguin L. The Prenatal Diagnosis and Consultation for Cleft Lip and Palate Prior to Presurgical Infant Orthopedics and Early Dental Care. Dent Clin North Am 2022; 66:277-281. [PMID: 35365278 DOI: 10.1016/j.cden.2022.01.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Children born with cleft lip and/or cleft palate (CL/P) have unique treatment needs and benefit from a team of health care providers, including surgeons, dentists, and allied health professionals. Presurgical infant orthopedic appliances can reduce the severity of the birth defect and can be provided to patients by a dental health care professional starting at birth. The dental needs of patients with CL/P are multifaceted and having an established dental home to monitor growth and development and help with disease prevention is key to improve oral health.
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Affiliation(s)
- Brett Chiquet
- Department of Pediatric Dentistry, UTHealth, The University of Texas Health Science Center at Houston, School of Dentistry
| | - Lizbeth Holguin
- Division Chief of Pediatric/Hospital Dentistry, El Paso Children's Hospital.
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21
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Alighieri C, Bettens K, Verhaeghe S, Van Lierde K. Speech diagnosis and intervention in children with a repaired cleft palate: A qualitative study of Flemish private community speech-language pathologists' practices. Int J Speech Lang Pathol 2022; 24:53-66. [PMID: 34229538 DOI: 10.1080/17549507.2021.1946153] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Purpose: This study investigated the practice patterns of private community speech-language pathologists (SLPs) when treating children with a repaired cleft of the palate with or without a cleft of the lip (CP ± L). Practices were explored in terms of diagnostics and treatment focus, treatment dosage and experienced difficulties when treating children with a CP ± L.Method: Eleven female private community SLPs, who lived in Flanders (i.e. the northern part of Belgium) and were aged between 23 and 62 years participated in this study. Data were collected from semi-structured face-to-face interviews. The qualitative software program NVivo 12 was used for data analysis. The interviews were analysed using an inductive thematic approach.Result: SLPs reported a lack of available information on speech-related cleft care. SLPs expressed the need to receive a referral letter from the hospital in order to make an adequate speech diagnosis. Most therapists reported that they performed an articulatory assessment combined with a language assessment. Most SLPs used a hybrid treatment model including a variety of intervention techniques. These techniques were not always in line with available scientific evidence. SLPs reported the desire to receive practical step-by-step guidelines on how to provide speech intervention to children with a CP ± L. In contrast, there was a strong consensus among the therapists that an individualised treatment plan is necessary.Conclusion: The results of this study have revealed gaps in the dissemination and implementation of scientific evidence relevant to speech services for children with a CP ± L (i.e. a research-practice gap) in Flanders. Research evidence needs to be adequately translated into clinical practice by providing concrete and practical guidelines.
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Affiliation(s)
| | - Kim Bettens
- Department of Rehabilitation Sciences, Ghent University, Gent, Belgium
| | - Sofie Verhaeghe
- Department of Public Health and Primary Care, Ghent University, Gent, Belgium
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22
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Pyakurel B, Lamichhane A, Bhandari B, Oli N, Lamichhane S. Occipital Encephalocele with Multiple Birth Defects: A Case Report. JNMA J Nepal Med Assoc 2021; 59:1040-1043. [PMID: 35199698 PMCID: PMC9107817 DOI: 10.31729/jnma.6542] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Indexed: 11/25/2022] Open
Abstract
A full-term female baby presented at 24 hours of life at the emergency department with occipital encephalocele, bilateral cleft lip, and cleft palate. She was born to a second gravida mother with no consanguinity between the parents. On examination, encephalocele was 10centimeters x 7centimeters in size with bilateral cleft lip and palate. It presents the opportunity for healthcare professionals to learn about a group of congenital neurological disorders in the content of a rare case presentation and highlights the importance of ultrasonography in the antenatal period for the detection of neural tube defects in the early stage for proper counselling and management. A compulsory prenatal diagnosis of the suspected family should be done by the intervention of the public sector of any country so that we can prevent and avoid abnormal birth.
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Affiliation(s)
- Bikash Pyakurel
- Department of Pediatrics, Lumblnl Medical College, Palpa, Nepal
| | - Anita Lamichhane
- Department of Pediatrics, Lumblnl Medical College, Palpa, Nepal
- Correspondence: Dr. Anita Lamichhane, Department of Pediatrics, Lumbini Medical College, Palpa, Nepal. , Phone: +977-9843359884
| | - Bikash Bhandari
- Department of Pediatrics, Lumblnl Medical College, Palpa, Nepal
| | - Navachandra Oli
- Department of Pediatrics, Lumblnl Medical College, Palpa, Nepal
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Mathad VC, Scherer N, Chapman K, Liss JM, Berisha V. A Deep Learning Algorithm for Objective Assessment of Hypernasality in Children With Cleft Palate. IEEE Trans Biomed Eng 2021; 68:2986-2996. [PMID: 33566756 PMCID: PMC9023650 DOI: 10.1109/tbme.2021.3058424] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVES Evaluation of hypernasality requires extensive perceptual training by clinicians and extending this training on a large scale internationally is untenable; this compounds the health disparities that already exist among children with cleft. In this work, we present the objective hypernasality measure (OHM), a speech-based algorithm that automatically measures hypernasality in speech, and validate it relative to a group of trained clinicians. METHODS We trained a deep neural network (DNN) on approximately 100 hours of a publicly-available healthy speech corpus to detect the presence of nasal acoustic cues generated through the production of nasal consonants and nasalized phonemes in speech. Importantly, this model does not require any clinical data for training. The posterior probabilities of the deep learning model were aggregated at the sentence and speaker-levels to compute the OHM. RESULTS The results showed that the OHM was significantly correlated with perceptual hypernasality ratings from the Americleft database (r = 0.797, p < 0.001) and the New Mexico Cleft Palate Center (NMCPC) database (r = 0.713, p < 0.001). In addition, we evaluated the relationship between the OHM and articulation errors; the sensitivity of the OHM in detecting the presence of very mild hypernasality; and established the internal reliability of the metric. Further, the performance of the OHM was compared with a DNN regression algorithm directly trained on the hypernasal speech samples. SIGNIFICANCE The results indicate that the OHM is able to measure the severity of hypernasality on par with Americleft-trained clinicians on thisdataset.
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Blake N, Edeling H, Bekker D, Kotzé PJ, du Plessis R, Steyn JJF, Joubert G, Jooste JF. The spectrum of orofacial clefts and treatment logistics at Universitas Academic Hospital, Bloemfontein, South Africa. S AFR J SURG 2021; 59:57-61. [PMID: 34212572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
BACKGROUND Cleft lips and/or palates should be identified early and be operated on at specific ages according to international recommendations. In African countries, however, cleft lip and palate surgeries are often delayed. METHODS A retrospective, descriptive study was done to determine the distribution, specific time delays, demographics and loss to follow-up of patients with cleft lip and/or palates treated at Universitas Academic Hospital over a 10-year period. Data was obtained from outpatient files from the Plastic and Reconstructive Surgery Department at Universitas Academic Hospital. Two hundred and three of 318 records (63.8%) had the defined variables documented. RESULTS The median time from first presentation to specialist consultation was 1.9 months. The median ages for first presentation was 2.2 months and for specialist consultation 5.2 months. Patients mainly had isolated cleft palates (42.4%), followed by both cleft lip and palate (31%) and isolated cleft lips (24.6%). A quarter of patients (25.6%) were lost to follow-up. More than a third (36.5%) of patients were referred from the local Motheo district and 12.8% were referred from Lesotho. CONCLUSION In our setting, patients with cleft lip and/or palate are generally diagnosed and referred late. These patients also have delayed access to specialist consultation. Often patients are only evaluated by specialists at ages whereby they should have already undergone their first surgeries. Too many patients are lost to follow-up.
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Affiliation(s)
- N Blake
- Department of Plastic and Reconstructive Surgery, Universitas Hospital, University of the Free State, South Africa
| | - H Edeling
- School of Clinical Medicine, Faculty of Health Sciences, University of the Free State, South Africa
| | - D Bekker
- School of Clinical Medicine, Faculty of Health Sciences, University of the Free State, South Africa
| | - P J Kotzé
- School of Clinical Medicine, Faculty of Health Sciences, University of the Free State, South Africa
| | - R du Plessis
- School of Clinical Medicine, Faculty of Health Sciences, University of the Free State, South Africa
| | - J J F Steyn
- School of Clinical Medicine, Faculty of Health Sciences, University of the Free State, South Africa
| | - G Joubert
- Department of Biostatistics, School of Biomedical Sciences, University of the Free State, South Africa
| | - J F Jooste
- Department of Plastic and Reconstructive Surgery, Universitas Hospital, University of the Free State, South Africa and School of Clinical Medicine, Faculty of Health Sciences, University of the Free State, South Africa
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Schleif EP, Mason K, Perry JL. English-Only Treatment of Compensatory Speech Errors in a Bilingual Adoptee With Repaired Cleft Palate: A Descriptive Case Study. Am J Speech Lang Pathol 2021; 30:993-1007. [PMID: 33784192 DOI: 10.1044/2021_ajslp-20-00072] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Purpose The purpose of this clinical focus article is to provide a descriptive case study of a late-adopted, bilingual adolescent with cleft palate speech errors. Specifically, we examined the cross-linguistic generalization of remediated compensatory cleft errors, following treatment in English (second language) only. The overarching goal of this study is to gain insights into the complexity of speech intervention for the adopted population with delayed cleft palate repair. Method A 14-year-old female adopted from China with a repaired unilateral cleft lip and palate and maladaptive articulation errors underwent 55 one-hour sessions of a motor-based, speech therapy approach over a 15-month span, targeting English phonemes only. Pre-, mid-, and posttreatment evaluation included perceptual and instrumental assessment of speech and resonance. Outcome measures at each time point included perceptual speech and resonance ratings, nasometry scores, and percent consonants correct (PCC) in both English and Mandarin. Results PCC in English improved from 60% in single words and 35% in sentences pretreatment to 100% in single words and sentences during posttreatment assessment. Without direct treatment in Mandarin, PCC in Mandarin improved from 56% in single words and 50% in sentences pretreatment to 100% in single words and 99% in sentences during posttreatment assessment. Posttreatment nasometry scores decreased by 20% for the nasal sample and 17% for the oral sample compared to pretreatment. Conclusions This descriptive case study demonstrated successful remediation of cleft palate speech errors, following 15 months of treatment in a late-adopted bilingual adolescent using a motor-based therapy approach. Treatment of errors in English (second language) led to generalization of correct productions in Mandarin (first language). This study presents the potential for bilingual late adoptees to achieve intelligible speech in both languages when motor-based therapy principles are applied to intervention.
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Affiliation(s)
- Eshan Pua Schleif
- Department of Communication Sciences and Disorders, East Carolina University, Greenville, NC
| | - Kazlin Mason
- Department of Human Services, University of Virginia, Charlottesville
| | - Jamie L Perry
- Department of Communication Sciences and Disorders, East Carolina University, Greenville, NC
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Frisova V, Cojocaru L, Turan S. A new two-dimensional sonographic approach to the assessment of the fetal hard and soft palates. J Clin Ultrasound 2021; 49:8-11. [PMID: 32989822 DOI: 10.1002/jcu.22928] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Revised: 08/15/2020] [Accepted: 09/07/2020] [Indexed: 06/11/2023]
Abstract
Facial clefts are among the most common congenital defects. Ultrasound (US) imaging of secondary fetal palate, especially the detection of isolated defects, remains challenging. Currently described two-dimensional (2D) and three-dimensional methods are technically demanding and impractical for application during routine fetal anatomy evaluation. As an adjunct method, magnetic resonance imaging can provide additional information but has its limitations. We present a novel 2D US approach using axial and sagittal planes to evaluate the fetal palate and demonstrate the main differences between an intact palate, isolated cleft palate, and a cleft lip with cleft palate.
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Affiliation(s)
- Veronika Frisova
- Profema-Fetal Medicine Centre, Prague, Czech Republic
- Department of Obstetrics and Gynaecology, Faculty Hospital, Faculty of Medicine and Dentistry, Palacky University Olomouc, Olomouc, Czech Republic
| | - Liviu Cojocaru
- Department of Obstetrics, Gynaecology & Reproductive Sciences, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Shifa Turan
- Department of Obstetrics, Gynaecology & Reproductive Sciences, University of Maryland School of Medicine, Baltimore, Maryland, USA
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Tessier A, Boutaud L, Bruel AL, Thauvin-Robinet C, Roth P, Malan V, Beaujard MP, Achaiaa A, de Oliveira J, Steffann J, Encha-Razavi F, Faivre L, Bessières B, Attié-Bitach T. Hydrothorax in fetal cases of Opitz G/BBB diagnosis: Extending the phenotype? Clin Genet 2020; 98:620-621. [PMID: 32926417 DOI: 10.1111/cge.13840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2020] [Revised: 08/25/2020] [Accepted: 08/27/2020] [Indexed: 11/30/2022]
Abstract
We report two fetal cases carrying a de novo MID1 mutation and presenting with severe hydrothorax, suggesting the expansion of the phenotype of Opitz GBBB syndrome.
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Affiliation(s)
- Aude Tessier
- Service d'Histologie-Embryologie-Cytogénétique, Hôpital Necker-Enfants Malades, Assistance Publique - Hôpitaux de Paris, Paris, France
- INSERM UMR 1163, Université de Paris, Imagine Institute, Paris, France, Paris, France
| | - Lucile Boutaud
- Service d'Histologie-Embryologie-Cytogénétique, Hôpital Necker-Enfants Malades, Assistance Publique - Hôpitaux de Paris, Paris, France
- INSERM UMR 1163, Université de Paris, Imagine Institute, Paris, France, Paris, France
| | - Ange-Line Bruel
- UMR1231, Université Bourgogne, Dijon, France
- Centre de Génétique, CHU Dijon Bourgogne, Dijon, France
| | - Christel Thauvin-Robinet
- UMR1231, Université Bourgogne, Dijon, France
- Centre de Génétique, CHU Dijon Bourgogne, Dijon, France
| | - Philippe Roth
- Département d'obstétrique et de médecine fœtale, Hôpital Necker-Enfants Malades, APHP, Paris, France
| | - Valérie Malan
- Service d'Histologie-Embryologie-Cytogénétique, Hôpital Necker-Enfants Malades, Assistance Publique - Hôpitaux de Paris, Paris, France
- INSERM UMR 1163, Université de Paris, Imagine Institute, Paris, France, Paris, France
| | - Marie-Paule Beaujard
- Service d'Histologie-Embryologie-Cytogénétique, Hôpital Necker-Enfants Malades, Assistance Publique - Hôpitaux de Paris, Paris, France
| | - Amale Achaiaa
- Service d'Histologie-Embryologie-Cytogénétique, Hôpital Necker-Enfants Malades, Assistance Publique - Hôpitaux de Paris, Paris, France
| | - Judite de Oliveira
- Service de génétique moléculaire, Hôpital Necker-Enfants Malades, APHP, Paris, France
| | - Julie Steffann
- INSERM UMR 1163, Université de Paris, Imagine Institute, Paris, France, Paris, France
- Service de génétique moléculaire, Hôpital Necker-Enfants Malades, APHP, Paris, France
| | - Ferechte Encha-Razavi
- Service d'Histologie-Embryologie-Cytogénétique, Hôpital Necker-Enfants Malades, Assistance Publique - Hôpitaux de Paris, Paris, France
| | - Laurence Faivre
- UMR1231, Université Bourgogne, Dijon, France
- Centre de Génétique, CHU Dijon Bourgogne, Dijon, France
| | - Bettina Bessières
- Service d'Histologie-Embryologie-Cytogénétique, Hôpital Necker-Enfants Malades, Assistance Publique - Hôpitaux de Paris, Paris, France
- INSERM UMR 1163, Université de Paris, Imagine Institute, Paris, France, Paris, France
| | - Tania Attié-Bitach
- Service d'Histologie-Embryologie-Cytogénétique, Hôpital Necker-Enfants Malades, Assistance Publique - Hôpitaux de Paris, Paris, France
- INSERM UMR 1163, Université de Paris, Imagine Institute, Paris, France, Paris, France
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Ruscello DM, Vallino LD. The Use of Nonspeech Oral Motor Exercises in the Treatment of Children With Cleft Palate: A Re-Examination of Available Evidence. Am J Speech Lang Pathol 2020; 29:1811-1820. [PMID: 32755484 DOI: 10.1044/2020_ajslp-20-00087] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Purpose The purpose of this tutorial is to re-examine the current literature on nonspeech oral motor exercise (NSOME) in general and its use in the treatment of children with cleft palate specifically and provide a best practice recommendation. Method The Population Intervention Comparison Outcome process was used to investigate the clinical question. This systematic framework identifies the clinical population, evaluates the intervention(s) applied to the population, assesses the results of interventions, and delineates the outcome. A literature search, which examined developmental research, applied clinical research, and systematic treatment reviews, was conducted for this purpose. Results The literature reviewed herein suggests that, on a number of different levels, the implementation of NSOMEs does not result in positive communication outcomes for children with cleft palate who present with velopharyngeal dysfunction or compensatory speech errors. Conclusion Based on the current review, there is no empirical support for the use of NSOME as a direct or adjunct treatment for velopharyngeal dysfunction or compensatory speech errors. Appropriate treatments for these communication disorders include surgical, dental, and speech-based interventions.
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Affiliation(s)
- Dennis M Ruscello
- Department of Communication Sciences and Disorders, West Virginia University, Morgantown
| | - Linda D Vallino
- Head, Craniofacial Outcomes Research Laboratory, Nemours/Alfred I. duPont Hospital for Children, Wilmington, DE
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Kaczorowska N, Markulak P, Mikulewicz M. Assessment of orofacial dysfunction in a group of Polish children with unilateral cleft lip and palate: A preliminary report. ADV CLIN EXP MED 2020; 29:1331-1336. [PMID: 33269820 DOI: 10.17219/acem/128187] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
BACKGROUND Cleft lip and palate (CLP) is a genetic and environmental malformation of the face. The resulting interruption of the tissue in the mouth and nasal cavity undoubtedly impairs basic physiological functions, which impacts the quality of life (Qol) of such patients. OBJECTIVES To assess orofacial dysfunction using the Nordic Orofacial Test-Screening (NOT-S) in a group of Polish children with unilateral CLP (UCLP). The following hypotheses were presented: 1) orofacial dysfunction is more common in children with UCLP and 2) patients with UCLP have a worse QoL than the control group. MATERIAL AND METHODS Seventy children at the age of 7-13 years took part in the study. The inclusion criterion was a diagnosis of UCLP. The control group (non-UCLP) was matched by gender and age to the cleft group. The research used the NOT-S questionnaire. RESULTS In the cleft group, there were statistically significantly more disorders of functions, such as breathing, chewing and swallowing, and drooling; in the NOT-S examination, there were more disorders of the face at rest, facial expression and speech in the cleft group. Comparing the NOT-S total scores, it was found that in the cleft group, there a disorder of at least 1 function was statistically significantly more prevalent than in the control group. Likewise, the median results in the cleft group were 3 points higher than in the control group. CONCLUSIONS Using the NOT-S survey, it was possible to confirm both hypotheses. Orofacial dysfunction is more common in children with UCLP and this contributes to a worse QoL for them than for children without UCLP.
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Affiliation(s)
- Natalia Kaczorowska
- Department of Dentofacial Orthopedics and Orthodontics, Division of Facial Abnormalities, Wroclaw Medical University, Poland
| | - Patrycja Markulak
- Department of Dentofacial Orthopedics and Orthodontics, Division of Dentofacial Orthopedics and Orthodontics, Wroclaw Medical University, Poland
| | - Marcin Mikulewicz
- Department of Dentofacial Orthopedics and Orthodontics, Division of Facial Abnormalities, Wroclaw Medical University, Poland
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Scheiba N, Hartschuh W. Van der Woude Syndrome. Dtsch Arztebl Int 2020; 117:751. [PMID: 33439825 PMCID: PMC7878721 DOI: 10.3238/arztebl.2020.0751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Affiliation(s)
| | - Wolfgang Hartschuh
- **Haut- und Laserzentrum Heidelberg und Hautklinik, Universitätsklinikum Heidelberg
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Grollemund B, Dissaux C, Gavelle P, Martínez CP, Mullaert J, Alfaiate T, Guedeney A. The impact of having a baby with cleft lip and palate on parents and on parent-baby relationship: the first French prospective multicentre study. BMC Pediatr 2020; 20:230. [PMID: 32423402 PMCID: PMC7236125 DOI: 10.1186/s12887-020-02118-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2020] [Accepted: 05/04/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The objective of this prospective, multidisciplinary and multicenter study was to explore the effect of a cleft lip, associated or not with a cleft palate, on parents, on parent-infant relationship, and on the baby's relational development. It also highlighted how the type of cleft and the timing of the surgery could impact this effect. METHOD 158 infants, with Cleft lip with or without Palate, and their parents participated in this multicenter prospective cohort. Clinical evaluations were performed at 4 and 12 months postpartum. The impact on the parents and on the parent-infant relationship was evaluated by the Parenting Stress Index (PSI), the Edinburgh Post-partum Depression Scale (EPDS) and the Impact-on-Family Scale (IOFS). The relational development of the infant was assessed using the Alarm Distress Baby Scale (ADBB). The main criteria used to compare the infants were the severity of cleft and the time of surgery. RESULTS The timing of surgery, the type of malformation or the care structure had no effect on social withdrawal behaviors of the child at 4 and 12 months postpartum (ADBB). Furthermore, early intervention significantly decreased maternal stress assessed with the PSI at 4 months. Parents for whom it had been possible to give a prenatal diagnosis were much better prepared to accept the waiting time between birth and the first surgical intervention (IOFS). Higher postpartum depression scores (EPDS) were found for both parents compared to the general population. CONCLUSION A joint assessment of the mental health of both infants and parents is required in the follow-up of cleft lip and palate. Even if most families are remarkably resilient faced with this major cause of stress, a significant proportion of them could require help to deal with the situation, especially during this first year of follow-up. An assessment of the child's social withdrawal behaviour and of the parental stress and depression appears useful, in order to adapt care to infant and parent's needs. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT00993993. Registered 10/14/2009 <.
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Affiliation(s)
- Bruno Grollemund
- Département d’Orthopédie Dento-Faciale, Pôle de médecine et chirurgie buccodentaires, Cleft Competence Center, Strasbourg University Hospital, Place de l’Hôpital 1, 67000 Strasbourg, France
| | - Caroline Dissaux
- Maxillofacial and Plastic Surgery Department (Head: Prof. C. Bruant-Rodier), Cleft Competence Center, Strasbourg University Hospital, 1 place de l’Hôpital Civil, 67091 Strasbourg, France
| | - Pascale Gavelle
- Hôpital Necker Enfants malades, Paris France. Service de chirurgie maxillo-faciale et plastique. Centre de référence des fentes et malformations faciales, Hôpital Necker Enfants Malades, Paris, France
| | | | - Jimmy Mullaert
- Département d’Epidémiologie, Biostatistique et Recherche Clinique, Unité de Recherche Clinique HUPNVS Hôpital Bichat - Claude-Bernard, Paris, France
| | - Toni Alfaiate
- Département d’Epidémiologie, Biostatistique et Recherche Clinique, Unité de Recherche Clinique HUPNVS; INSERM CIC-EC, 1425 Paris, France
| | - Antoine Guedeney
- HUPNVS Hôpital Bichat - Claude-Bernard, Univ Paris Denis Diderot, CESP Inserm U 1178 et LPPS, 4057 Paris, EA France
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Neiswanger K, Mukhopadhyay N, Rajagopalan S, Leslie EJ, Sanchez CA, Hecht JT, Orioli IM, Poletta FA, de Salamanca JE, Weinberg SM, Marazita ML. Individuals with nonsyndromic orofacial clefts have increased asymmetry of fingerprint patterns. PLoS One 2020; 15:e0230534. [PMID: 32196525 PMCID: PMC7083315 DOI: 10.1371/journal.pone.0230534] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2019] [Accepted: 03/02/2020] [Indexed: 01/10/2023] Open
Abstract
Dermatoglyphic patterns on the fingers often differ in syndromes and other conditions with a developmental component, compared to the general population. Previous literature on the relationship between orofacial clefts–the most common craniofacial birth defect in humans–and dermatoglyphics is inconsistent, with some studies reporting altered pattern frequencies and/or increased asymmetry and others failing to find differences. To investigate dermatoglyphics in orofacial clefting, we obtained dermatoglyphic patterns in a large multiethnic cohort of orofacial cleft cases (N = 367), their unaffected family members (N = 836), and controls (N = 299). We categorized fingerprint pattern types from males and females who participated at five sites of the Pittsburgh Orofacial Cleft study (Hungary, United States of America (Pennsylvania, Texas), Spain, and Argentina). We also calculated a pattern dissimilarity score for each individual as a measure of left-right asymmetry. We tested for group differences in the number of arches, ulnar and radial loops, and whorls on each individual’s hands, and in the pattern dissimilarity scores using ANOVA. After taking sex and site differences into account, we did not find any significant pattern count differences between cleft and non-cleft individuals. Notably, we did observe increased pattern dissimilarity in individuals with clefts, compared to both their unaffected relatives and controls. Increased dermatoglyphic pattern dissimilarity in individuals with nonsyndromic orofacial clefts may reflect a generalized developmental instability.
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Affiliation(s)
- Katherine Neiswanger
- Center for Craniofacial and Dental Genetics, Department of Oral Biology, School of Dental Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
- * E-mail:
| | - Nandita Mukhopadhyay
- Center for Craniofacial and Dental Genetics, Department of Oral Biology, School of Dental Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
| | - Shwetha Rajagopalan
- Center for Craniofacial and Dental Genetics, Department of Oral Biology, School of Dental Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
| | - Elizabeth J. Leslie
- Center for Craniofacial and Dental Genetics, Department of Oral Biology, School of Dental Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
| | - Carla A. Sanchez
- Center for Craniofacial and Dental Genetics, Department of Oral Biology, School of Dental Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
| | - Jacqueline T. Hecht
- Department of Pediatrics, University of Texas McGovern Medical Center, Houston, Texas, United States of America
| | - Iêda M. Orioli
- Laboratory of Congenital Malformation Epidemiology, Oswaldo Cruz Institute, Rio de Janeiro, Brazil
| | - Fernando A. Poletta
- Center for Medical Education and Clinical Research, Estudio Collaborativo Latino Americano de Malformaciones Congénitas, Buenos Aires, Argentina
| | | | - Seth M. Weinberg
- Center for Craniofacial and Dental Genetics, Department of Oral Biology, School of Dental Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
- Department of Human Genetics, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
- Department of Anthropology, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
| | - Mary L. Marazita
- Center for Craniofacial and Dental Genetics, Department of Oral Biology, School of Dental Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
- Department of Human Genetics, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
- Clinical and Translational Science, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
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Suzuki T, Yamamoto Y, Nakamura H, Sei-Okawa K, Maruyama Y, Takeda J, Makino S, Yamataka A, Itakura A. Fetal umbilical cord cyst may evolve to omphalocele during pregnancy. J Clin Ultrasound 2020; 48:181-183. [PMID: 31724176 DOI: 10.1002/jcu.22786] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Revised: 08/26/2019] [Accepted: 10/02/2019] [Indexed: 06/10/2023]
Abstract
Omphalocele is rarely complicated by umbilical cord cysts. In our case, an umbilical cord cyst and fetal ascites were detected at 26 weeks' gestation in a fetus with trisomy 13. This changed to omphalocele with subsequently absorbed fetal ascites at 35 weeks' gestation. We propose two hypotheses. The abdominal wall may have been physically pierced or an omphalocele might have preexisted, and the intestinal tract in the hernia sac was pushed by fetal ascites.
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Affiliation(s)
- Toshifumi Suzuki
- Department of Obstetrics and Gynecology, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - Yuka Yamamoto
- Department of Obstetrics and Gynecology, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - Hiroki Nakamura
- Department of Pediatric General and Urogenital Surgery, Juntendo University School of Medicine, Tokyo, Japan
| | - Kiguna Sei-Okawa
- Department of Obstetrics and Gynecology, National Defense Medical College, Tokorozawa, Saitama, Japan
| | - Yojiro Maruyama
- Department of Obstetrics and Gynecology, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - Jun Takeda
- Department of Obstetrics and Gynecology, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - Shintaro Makino
- Department of Obstetrics and Gynecology, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - Atsuyuki Yamataka
- Department of Pediatric General and Urogenital Surgery, Juntendo University School of Medicine, Tokyo, Japan
| | - Atsuo Itakura
- Department of Obstetrics and Gynecology, Juntendo University Faculty of Medicine, Tokyo, Japan
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Fitzpatrick B, Coad J, Sell D, Rihtman T. Assessing speech at three years of age in the cleft palate population: a scoping review of assessment practices. Int J Lang Commun Disord 2020; 55:165-187. [PMID: 32077212 DOI: 10.1111/1460-6984.12517] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Revised: 10/11/2019] [Accepted: 11/21/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND There is no consensus in the UK regarding the types of speech samples or parameters of speech that should be assessed at 3 years of age in children with cleft palate ± cleft lip (CP±L), despite cleft units routinely assessing speech at this age. The standardization of assessment practices would facilitate comparisons of outcomes across UK cleft units; earlier identification of speech impairments-which could support more timely treatments; and more reliable recording of therapy impacts and surgical interventions. AIMS To explore assessment practices used to assess speech in 3-year-old children with CP±L, including speech parameters, methods of assessment and the nature of the speech sample used. METHODS & PROCEDURES A broad examination of the literature was undertaken through the use of a scoping review conducted in accordance with Joanna Briggs Institute guidelines. Search terms were generated from a preliminary search and then used in the main search (Medline, CINAHL, Embase, AMED and PsycINFO). MAIN CONTRIBUTION A combination of approaches (medical, linguistic, developmental and functional) is required to assess CP±L speech at age 3. A developmental approach is recommended at this age, considering the complexity of speech profiles at age 3, in which typically developing speech processes may occur alongside cleft speech characteristics. A combined measure for both nasal emission and turbulence, and an overall measure for velopharyngeal function for speech, show potential for assessment at this age. Categorical ordinal scales are frequently used; the use of continuous scales has yet to be fully explored at age 3. Although single-word assessments, including a subset of words developed for cross-linguistic comparisons, are frequently used, more than one type of speech sample may be needed to assess speech at this age validly. The lack of consensus regarding speech samples highlights a need for further research into the types of speech samples 3-year-olds can complete; the impact of incomplete speech samples on outcome measures (particularly relevant at this age when children may be less able to complete a full sample); the impact of different speech samples on the validity of assessments; and the reliability of listener judgements. CONCLUSIONS & IMPLICATIONS Whilst a medical model and linguistic approaches are often central in assessments of age-3 cleft speech, this review highlights the importance of developmental and functional approaches to assessment. Cross-linguistic single-word assessments show potential, and would facilitate the comparison of UK speech outcomes with other countries. Further research should explore the impact of different speech samples and rating scales on assessment validity and listener reliability.
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Affiliation(s)
- Beth Fitzpatrick
- Faculty of Health and Life Sciences, Coventry University, Coventry, UK
- Speech and Language Therapy, Birmingham Children's Hospital, Birmingham, UK
| | - Jane Coad
- Faculty of Health and Life Sciences, Coventry University, Coventry, UK
- School of Health Sciences Nottingham University, Nottingham, UK
| | - Debbie Sell
- Centre for Outcomes and Experience Research in Children's Health, Illness and Disability, Great Ormond Street Hospital NHS Foundation Trust, London, UK
| | - Tanya Rihtman
- Faculty of Health and Life Sciences, Coventry University, Coventry, UK
- Faculty of Health and Life Sciences, Oxford Brookes University, Oxford, UK
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Abstract
RATIONALE Micrognathia is a subtle facial malformation characterized by a small mandible and receding chin. Fetal micrognathia is often associated with chromosomal abnormalities, skeletal dysplasia, and various syndromes. Once it is dignosised, detailed fetal malformation screening and chromosome examination should be carried out. PATIENT CONCERN One pregnant woman with suspicion of fetal micrognathia was referred from her local hospital to our hospital for detailed fetal malformation screening and fetal echocardiography. Examination of the fetus was performed using a two-dimensional and three-dimensional ultrasound probe in multiple planes. The fetus showed micrognathia without glossoptosis with features of the inferior facial angle (IFA) ≤50° and his tongue reached anterior mandibular border box during normal movement. DIAGNOSES The fetus was diagnosed as isolated micrognathia prenatally without multisystem abnormalities. INTERVENTIONS Amniocentesis was performed and the fetus was found to carry 46XN with 6q14.1 duplication, the significance of which was unclear. OUTCOMES The fetus was labored through vagina at 38 weeks gestation. A small soft cleft palate was diagnosed after delivery. LESSONS This case suggests that once prenatal diagnosis of the fetal micrognathia has been made, we should carefully examine the presence of fetus's multisystem developmental abnormalities and due consideration should be given for associated soft cleft palate.
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Thakur S, Singh A, Diwana VK, Rani A, Thakur NS. Dynamic changes in nasal symmetry after presurgical nasoalveolar molding in infants with complete unilateral cleft lip and palate. Afr J Paediatr Surg 2020; 17:1-4. [PMID: 33106444 PMCID: PMC7818664 DOI: 10.4103/ajps.ajps_5_18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2018] [Revised: 02/26/2018] [Accepted: 05/28/2020] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Presurgical nasoalveolar molding (PNAM) technique gave a new perspective to presurgical infant orthopedics. Nasal reconstruction presents a challenge for the plastic surgeons in case of patients with unilateral cleft lip and palate (UCLP). PNAM facilitates the reshaping of the nasal cartilage and molding of maxillary arch preoperatively. This therapy not only aids the surgical repair of lip but also enhances the overall postsurgical results with negligible postoperative scar. AIM The aim of the study was to analyze nasal changes before and after PNAM in patients with complete UCLP. MATERIALS AND METHODS This was a retrospective review of 22 ULCP patients who underwent PNAM before lip surgeries. A series of standard basilar view photographs in 1:1 ratio were taken, and linear measurements were done directly on the photographs. RESULTS After PNAM therapy, there was highly significant increase in the nostril height, nostril dome height, and columella length (P < 0.001*) and highly significant reduction in the nostril width and nasal basal width (P < 0.001*). CONCLUSION Significant improvement in the nasal symmetry was found after PNAM therapy in patients with complete UCLP.
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Affiliation(s)
- Seema Thakur
- Department of Peditric and Preventive Dentistry, H. P. Government Dental College and Hospital, Shimla, Himachal Pradesh, India
| | - Anjali Singh
- Department of Peditric and Preventive Dentistry, H. P. Government Dental College and Hospital, Shimla, Himachal Pradesh, India
| | - Vijay Kumar Diwana
- Department of Plastic Surgery, H. P. Government Dental College and Hospital, Shimla, Himachal Pradesh, India
| | - Alka Rani
- Department of Oral Pathology, H. P. Government Dental College and Hospital, Shimla, Himachal Pradesh, India
| | - Narbir Singh Thakur
- Department of Oral Pathology, H. P. Government Dental College and Hospital, Shimla, Himachal Pradesh, India
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Jain D, Bandyopadhyay T, Tomar V, Sharma V, Rai R. Ankyloblephron Filiform Adnatum: A Case Report. Nepal J Ophthalmol 2019; 11. [PMID: 31523076 DOI: 10.3126/nepjoph.v11i1.25445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Ankyloblephron filiform adnatum (AFA) is a rare benign congenital anomaly that can arise either in isolation or associated with a syndrome. It should be treated as early as possible due to its ambylogenic potential. We report a case of a successfully managed newborn that had sporadic AFA detected at birth. Our case is unique in the sense that sporadic AFA with Atrial septal defect has not been reported in the literature.
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Prabakaran S, Thilagam KK, Reddy GMM. Profile of Cleft Lip and Cleft Palate at a Public Hospital in Southern India. Indian Pediatr 2019; 56:753-755. [PMID: 31638008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
OBJECTIVES To analyze the pattern of cleft lip and cleft palate cases and their operative management at a tertiary-care hospital. METHODS Data of all patients (<18 year) with cleft lip and cleft palate operated between 2011 and 2016 were extracted from the records and analyzed. RESULTS The final analysis included 1643 cases (60.9% males). Mean (SD) age at the time of surgery was 8.9 (10.17) years. Left-sided cleft clip was more common. Complete hard palate type of cleft palate on left was present in 787 (47.90%). Primary Cleft Palate repair was most common procedure (492, 29.9% children, followed by primary lip nose unilateral in 458 (27.9%) and lip nose revision in 298 (21.1%). CONCLUSIONS Data on age at presentation and procedures used for correction of cleft lip and cleft palate are presented.
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Affiliation(s)
- S Prabakaran
- Department of Pediatric Surgery, Govt Mohan Kumaramangalam Medical College and Hospital, Salem, Tamil Nadu, India. Correspondence to: Dr S Prabakaran, Govt.Mohan Kumaramangalam Medical College and Hospital, Salem, Tamil Nadu, India.
| | - K Kasthuri Thilagam
- Department of Pathology, Govt Mohan Kumaramangalam Medical College and Hospital, Salem, Tamil Nadu, India
| | - G Murali Mohan Reddy
- Department of Community Medicine, Evidencian Research Associates; Salem, Tamil Nadu, India
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New Causal Candidate Genes and Enhancers Linked to Orofacial Clefting Identified. Am J Med Genet A 2019; 179:1409-10. [PMID: 31355538 DOI: 10.1002/ajmg.a.61278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Malek I, Mekni M, Sayadi J, Bezzine A, Zghal I, Nacef L. Ankyloblepharon Filiform Adnatum: Beyond the eye. Tunis Med 2019; 97:826-829. [PMID: 31872416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
The ankyloblepharon filiform adnatum (AFA) is a rare congenital palpebral abnormality characterized by a partial non disjunction of the gray lines of upper and lower eyelids. We report two cases of newborns presenting with ankyloblepharon and highlight its potentially amblyogenic impact and the possible ocular and systemic associations.
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Shaffer JR, LeClair J, Carlson JC, Feingold E, Buxó CJ, Christensen K, Deleyiannis FW, Field LL, Hecht JT, Moreno L, Orioli IM, Padilla C, Vieira AR, Wehby GL, Murray JC, Weinberg SM, Marazita ML, Leslie EJ. Association of low-frequency genetic variants in regulatory regions with nonsyndromic orofacial clefts. Am J Med Genet A 2019; 179:467-474. [PMID: 30582786 PMCID: PMC6374160 DOI: 10.1002/ajmg.a.61002] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2018] [Revised: 08/06/2018] [Accepted: 11/01/2018] [Indexed: 01/24/2023]
Abstract
Genome-wide scans have shown that common risk alleles for orofacial clefts (OFC) tend to be located in noncoding regulatory elements and cumulatively explain only part of the heritability of OFCs. Low-frequency variants may account for some of the "missing" heritability. Therefore, we scanned low-frequency variants located within putative craniofacial enhancers to identify novel OFC risk variants and implicate new regulatory elements in OFC pathogenesis. Analyses were performed in a multiethnic sample of 1,995 cases of cleft lip with or without cleft palate (CL/P), 221 cases with cleft palate (CP) only, and 1,576 unaffected controls. One hundred and nineteen putative craniofacial enhancers identified from ChIP-Seq studies in craniofacial tissues or cell lines contained multiple low-frequency (0.01-1%) variants, which we genotyped in participants using a custom Illumina panel. Two complementary statistical approaches, sequence kernel association test and combined multivariate and collapsing, were used to test association of the aggregated low-frequency variants across each enhancer region with CL/P and CP. We discovered a significant association between CP and a branchial arch enhancer near FOXP1 (mm60; p-value = .0002). Additionally, we observed a suggestive association between CL/P and a forebrain enhancer near FOXE1 (hs1717; p-value = .001). These findings suggest that low-frequency variants in craniofacial enhancer regions contribute to the complex etiology of nonsyndromic OFCs.
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Affiliation(s)
- John R. Shaffer
- Center for Craniofacial and Dental Genetics, Department of Oral Biology, School of Dental Medicine, University of Pittsburgh, Pittsburgh, PA, 15219 USA
- Department of Human Genetics, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, 15261 USA
| | - Jessica LeClair
- formerly of Department of Computational and Systems Biology, School of Medicine, University of Pittsburgh, Pittsburgh, PA, 15261, USA
- Department of Biostatistics, School of Public Health, Boston University, Boston, MA 02118, USA
| | - Jenna C. Carlson
- Center for Craniofacial and Dental Genetics, Department of Oral Biology, School of Dental Medicine, University of Pittsburgh, Pittsburgh, PA, 15219 USA
- Department of Human Genetics, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, 15261 USA
- Department of Biostatistics, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA 15261, USA
| | - Eleanor Feingold
- Department of Human Genetics, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, 15261 USA
- Department of Biostatistics, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA 15261, USA
| | - Carmen J. Buxó
- Dental and Craniofacial Genomics Core, School of Dental Medicine, University of Puerto Rico, San Juan, Puerto Rico, 00936, USA
| | - Kaare Christensen
- Department of Epidemiology, Institute of Public Health, University of Southern Denmark, Odense, DK-5000, Denmark
| | - Frederic W.B. Deleyiannis
- Department of Surgery, Plastic and Reconstructive Surgery, University of Colorado School of Medicine, Denver, CO, 80045, USA
| | - L. Leigh Field
- Department of Medical Genetics, University of British Columbia, Vancouver, V6H 3N1, Canada
| | - Jacqueline T. Hecht
- Department of Pediatrics, McGovern Medical School and School of Dentistry UT Health at Houston, Houston, TX, 77030, USA
| | - Lina Moreno
- Department of Orthodontics, College of Dentistry, University of Iowa, Iowa City, IA, 52242, USA
| | - Ieda M. Orioli
- Department of Genetics, Institute of Biology, Federal University of Rio de Janeiro, Rio de Janeiro, 21941-617, Brazil
- ECLAMC (Latin American Collaborative Study of Congenital Malformations) at INAGEMP (National Institute of Population Medical Genetics), Rio de Janeiro, 21941-617, Brazil
| | - Carmencita Padilla
- Department of Pediatrics, College of Medicine; and Institute of Human Genetics, National Institutes of Health; University of the Philippines Manila, Manila, The Philippines, 1000; and Philippine Genome Center, University of the Philippines System, Manila, The Philippines 1101
| | - Alexandre R. Vieira
- Center for Craniofacial and Dental Genetics, Department of Oral Biology, School of Dental Medicine, University of Pittsburgh, Pittsburgh, PA, 15219 USA
- Department of Human Genetics, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, 15261 USA
| | - George L. Wehby
- Department of Health Management and Policy, College of Public Health, University of Iowa, Iowa City, IA, 52246, USA
| | - Jeffrey C. Murray
- Department of Pediatrics, Carver College of Medicine, University of Iowa, Iowa City, Iowa, 52242, USA
| | - Seth M. Weinberg
- Center for Craniofacial and Dental Genetics, Department of Oral Biology, School of Dental Medicine, University of Pittsburgh, Pittsburgh, PA, 15219 USA
- Department of Human Genetics, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, 15261 USA
- Department of Anthropology, Dietrich School of Arts and Sciences, University of Pittsburgh, Pittsburgh, PA, 15261, USA
| | - Mary L. Marazita
- Center for Craniofacial and Dental Genetics, Department of Oral Biology, School of Dental Medicine, University of Pittsburgh, Pittsburgh, PA, 15219 USA
- Department of Human Genetics, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, 15261 USA
- Clinical and Translational Science, School of Medicine, University of Pittsburgh, Pittsburgh, PA, 15213, USA
| | - Elizabeth J. Leslie
- Department of Human Genetics, Emory University School of Medicine, Emory University, Atlanta, GA, 30322
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Niculescu L, Wagner M, Westphal DS, Fischer M, Mihatsch W, Prothmann A, Ruzicka T, Wollenberg A, Wolff H, Schmidt H, Giehl KA. A Case of Ankyloblepharon-ectodermal Defects-cleft Lip/Palate-syndrome with Choanal Atresia and Skin Erosions: Phenotypic Variability of TP63-related Disorders. Acta Derm Venereol 2019; 99:111-112. [PMID: 29956718 DOI: 10.2340/00015555-2997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Luana Niculescu
- Department of Dermatology and Allergy, Ludwig Maximilian University, Munich, Germany
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Tiwari P, Pandey V, Tapadar J. Coexisting Congenital Subglosso-palatal Membrane and Tongue Dermoid in a Neonate. Indian Pediatr 2018; 55:1087-1088. [PMID: 30745483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
BACKGROUND Neonatal respiratory distress due to coexisting subglosso-palatal membrane and tongue dermoid has not been reported yet. CASE CHARACTERISTICS A newborn with respiratory distress having a membrane in the oral cavity. Excision of membrane revealed a tongue mass with cleft palate, obstructing the nasopharynx completely. Elective ventilation was followed by excision of mass. OUTCOME The child was cured with uneventful course at follow-up of six months. MESSAGE Co-existing congenital anomalies causing airway obstruction may be missed in presence of subglosso-palatal membrane.
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Affiliation(s)
- Preeti Tiwari
- Department of Oral and Maxillofacial Surgery, Institute of Medical Sciences - Banaras Hindu University, Varanasi, Uttar Pradesh, India. Correspondence to: Dr Preeti Tiwari, Department of Oral and Maxillofacial Surgery, IMS - BHU, Varanasi 221 005, UP, India.
| | - Vaibhav Pandey
- Department of Paediatric Surgery, Institute of Medical Sciences - Banaras Hindu University, Varanasi, Uttar Pradesh, India
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Abstract
INTRODUCTION A choristoma formed by heterotopic tissue rarely occurs in the throat, especially one accompanied with cleft palate in a new-born baby. PATIENT CONCERNS An 18-month-old female patient was admitted to the hospital for apparent snoring symptoms accompanied by mouth breathing and sleep apnea. In addition, the patient presented with weak aspiration and nasal leakage during fluid intake. DIAGNOSIS The patient received routine physical examination and endoscopy showing that there was a wide fissure which split from the palate vertical anterior cleft to 1/3 of the hard palate. Meanwhile, we found an unclear-bordered uplift in the left palate and a soft mass. The radiographs revealed a mass with inhomogeneous density convex to the pharyngeal cavity. INTERVENTIONS The patient was subsequently referred for surgical resection and tissue diagnosis of choristoma was confirmed by pathological examination. H&E staining showed well demarcated mature brain tissue with scattered sand-like calcification. OUTCOMES According to the diagnosis, the patient suffered from pharyngeal glial choristoma and incomplete cleft palate. The surgical resection and repair were performed together. The postoperative recovery was very good. LESSONS Choristoma rarely occurs in the head and neck, especially if accompanied by cleft palate. Early diagnosis for choristoma relies heavily on clinical examination and radiological imaging. Complete resection of choristoma remains the gold standard for treatment of these patients.
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Jin H, Yingqiu C, Zequn L, Yanjun H, Yunyan Z, Shufan Z, Yiyang C, Ru L, Li Z, Yongling Z, Hongtao W, Can L. Chromosomal microarray analysis in the prenatal diagnosis of orofacial clefts: Experience from a single medical center in mainland China. Medicine (Baltimore) 2018; 97:e12057. [PMID: 30142861 PMCID: PMC6112896 DOI: 10.1097/md.0000000000012057] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
The aim of this study was to investigate the value of chromosomal microarray analysis (CMA) for the prenatal diagnosis of orofacial clefts.A total of 143 fetuses with oral clefts were detected by ultrasound during prenatal exam between 2012 and 2017 in our center. We categorized the cases into 4 groups: isolated cleft lip (CL) (CL only), isolated cleft palate (CP only), isolated cleft lip and palate (CLP) (CLP only), and syndromic CLP (combined with other malformations). The CMA was performed in all cases, while 139 fetuses were referred for G-banded chromosome analysis.There were 42 male and 10 female fetuses were born, with a sex ratio of 4.2:1. The isolated CLP group accounted for 74.1% (106/143) of cases, while the isolated CL, isolated CP, and syndromic CP groups accounted for 13.9% (20/143), 2% (3/143), and 10% (14/143), respectively. A total of 11 fetuses had pathogenic copy number variants (CNVs, 7.7%), including isolated CP (1/143, 0.7%), isolated CLP (5/143, 3.5%), and syndromic CLP (5/143, 3.5%). Compared with the CMA results, 5 fetuses were found to have an abnormal karyotype (5/139, 3.6%). However, no abnormalities were found in either karyotype analysis or CMA in the isolated CL group.CMA is a valuable tool for identifying submicroscopic chromosomal abnormalities in the prenatal diagnosis of oral clefts. An excellent outcome can be expected for fetuses with isolated CL that are negative for chromosomal abnormalities.
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Affiliation(s)
- Han Jin
- Department of Prenatal Diagnostic Center
| | - Cui Yingqiu
- Department of Oral and Maxillofacial Surgery, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Liu Zequn
- Department of Prenatal Diagnostic Center
| | | | - Zhang Yunyan
- Department of Oral and Maxillofacial Surgery, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Zhao Shufan
- Department of Oral and Maxillofacial Surgery, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Chen Yiyang
- Department of Oral and Maxillofacial Surgery, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Li Ru
- Department of Prenatal Diagnostic Center
| | - Zhen Li
- Department of Prenatal Diagnostic Center
| | | | - Wang Hongtao
- Department of Oral and Maxillofacial Surgery, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Liao Can
- Department of Prenatal Diagnostic Center
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Chen CP, Chen CY, Chern SR, Wu PS, Chen SW, Lai ST, Chuang TY, Yang CW, Chen LF, Wang W. Prenatal diagnosis of a 1.6-Mb 4p16.3 interstitial microdeletion encompassing FGFRL1 and TACC3 associated with bilateral cleft lip and palate of Wolf-Hirschhorn syndrome facial dysmorphism and short long bones. Taiwan J Obstet Gynecol 2018; 56:821-826. [PMID: 29241927 DOI: 10.1016/j.tjog.2017.10.021] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/17/2017] [Indexed: 01/30/2023] Open
Abstract
OBJECTIVE We present prenatal diagnosis of a 4p16.3 interstitial microdeletion associated with bilateral cleft lip and palate and short long bones on prenatal ultrasound, and we discuss the genotype-phenotype correlation. MATERIALS AND METHODS A 32-year-old woman underwent amniocentesis at 22 weeks of gestation because of bilateral cleft lip and palate and short limbs on prenatal ultrasound. Conventional cytogenetic analysis was performed on cultured amniocytes and parental bloods. Oligonucleotide array comparative genomic hybridization (aCGH) was performed on the DNAs extracted from uncultured amniocytes, parental bloods and umbilical cord. Metaphase fluorescence in situ hybridization (FISH) was performed on cultured amniocytes. RESULTS Amniocentesis revealed a karyotype of 46,XY. The parental karyotypes were normal. aCGH analysis on uncultured amniocytes revealed a 1.66-Mb interstitial microdeletion at 4p16.3 encompassing 23 Online Mendelian Inheritance of in Man (OMIM) genes including FGFRL1 and TACC3. The parents did not have such a deletion. The pregnancy was subsequently terminated, and a malformed fetus was delivered with typical Wolf-Hirschhorn syndrome (WHS) facial appearance and bilateral cleft lip and palate. aCGH analysis of the umbilical cord confirmed the prenatal diagnosis with a result of arr 4p16.3 (72,447-1,742,649) × 1.0 [GRCh37 (hg19)]. Metaphase FISH analysis of cultured amniocytes confirmed a 4p16.3 microdeletion. CONCLUSION Haploinsufficiency of FGFRL1 and TACC3 at 4p16.3 can be associated with bilateral cleft lip and palate of WHS facial dysmorphism and short long bones. Prenatal diagnosis of facial cleft with short long bones should raise a suspicion of chromosome microdeletion syndromes.
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Affiliation(s)
- Chih-Ping Chen
- Department of Obstetrics and Gynecology, MacKay Memorial Hospital, Taipei, Taiwan; Department of Medical Research, MacKay Memorial Hospital, Taipei, Taiwan; Department of Biotechnology, Asia University, Taichung, Taiwan; School of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung, Taiwan; Institute of Clinical and Community Health Nursing, National Yang-Ming University, Taipei, Taiwan; Department of Obstetrics and Gynecology, School of Medicine, National Yang-Ming University, Taipei, Taiwan.
| | - Chen-Yu Chen
- Department of Obstetrics and Gynecology, MacKay Memorial Hospital, Taipei, Taiwan; Department of Medicine, MacKay Medical College, New Taipei, Taiwan; MacKay Junior College of Medicine, Nursing and Management, Taipei, Taiwan
| | - Schu-Rern Chern
- Department of Medical Research, MacKay Memorial Hospital, Taipei, Taiwan
| | | | - Shin-Wen Chen
- Department of Obstetrics and Gynecology, MacKay Memorial Hospital, Taipei, Taiwan
| | - Shih-Ting Lai
- Department of Obstetrics and Gynecology, MacKay Memorial Hospital, Taipei, Taiwan
| | - Tzu-Yun Chuang
- Department of Obstetrics and Gynecology, MacKay Memorial Hospital, Taipei, Taiwan
| | - Chien-Wen Yang
- Department of Medical Research, MacKay Memorial Hospital, Taipei, Taiwan
| | - Li-Feng Chen
- Department of Obstetrics and Gynecology, MacKay Memorial Hospital, Taipei, Taiwan
| | - Wayseen Wang
- Department of Medical Research, MacKay Memorial Hospital, Taipei, Taiwan; Department of Bioengineering, Tatung University, Taipei, Taiwan
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Vikram CM, Macha SK, Kalita S, Mahadeva Prasanna SR. Acoustic analysis of misarticulated trills in cleft lip and palate children. J Acoust Soc Am 2018; 143:EL474. [PMID: 29960457 DOI: 10.1121/1.5042339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
In this paper, acoustic analysis of misarticulated trills in cleft lip and palate speakers is carried out using excitation source based features: strength of excitation and fundamental frequency, derived from zero-frequency filtered signal, and vocal tract system features: first formant frequency (F1) and trill frequency, derived from the linear prediction analysis and autocorrelation approach, respectively. These features are found to be statistically significant while discriminating normal from misarticulated trills. Using acoustic features, dynamic time warping based trill misarticulation detection system is demonstrated. The performance of the proposed system in terms of the F1-score is 73.44%, whereas that for conventional Mel-frequency cepstral coefficients is 66.11%.
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Affiliation(s)
- C M Vikram
- Electronics and Electrical Engineering, Indian Institute of Technology Guwahati, Guwahati, Assam 781039, India
| | - Sashank Kumar Macha
- Department of Electronics and Communication Engineering, National Institute of Technology, Tiruchirappalli, Tamilu Nadu 620015, India , , ,
| | - Sishir Kalita
- Electronics and Electrical Engineering, Indian Institute of Technology Guwahati, Guwahati, Assam 781039, India
| | - S R Mahadeva Prasanna
- Electronics and Electrical Engineering, Indian Institute of Technology Guwahati, Guwahati, Assam 781039, India
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48
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Abstract
The features of Abruzzo-Erickson syndrome are described. A case report of an adult female suspected to have this condition is described and illustrated. The possible link to Abruzzo-Erickson syndrome and differential diagnosis of CHARGE is discussed.
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Affiliation(s)
- Giles Kidner
- Orthodontic Department, Stoke Mandeville Hospital, Aylesbury, Bucks, HP17 8UG, UK.
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49
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Eshghi M, Preisser JS, Bijankhan M, Zajac DJ. Acoustic-temporal aspects of stop-plosives in the speech of Persian-speaking children with cleft lip and palate. Int J Speech Lang Pathol 2017; 19:578-586. [PMID: 27666091 DOI: 10.1080/17549507.2016.1221458] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/08/2015] [Accepted: 07/29/2016] [Indexed: 06/06/2023]
Abstract
PURPOSE The main objective was to examine temporal parameters of stop-plosives in Persian-speaking children with repaired cleft lip and palate (CLP). METHOD Eleven children with repaired bilateral CLP and 20 typically-developing children participated in the study. Stop-gap duration (SGD) and voice-onset time (VOT) were measured based on digital waveform and spectrographic displays. RESULT Separate linear mixed model analyses showed significantly longer SGDs for children with CLP for all plosives in word-mid and final positions. Furthermore, children with CLP tend to produce longer VOTs for all voiceless plosives. CONCLUSION Persian-speaking children with repaired CLP prolong stop-gap segments, similar to findings reported for English-speaking children with CLP. Prolonged segments may be due to an active strategy to increase oral air pressure and/or improve perceptual accuracy of speech segments.
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Affiliation(s)
- Marziye Eshghi
- a Department of Allied Health Sciences, Division of Speech and Hearing Sciences, School of Medicine , University of North Carolina at Chapel Hill , NC , USA
| | - John S Preisser
- b Department of Biostatistics, Gillings School of Global Public Health , University of North Carolina at Chapel Hill , NC , USA
| | - Mahmood Bijankhan
- c Department of Linguistics, School of Literature and Human Sciences , University of Tehran, Tehran , Iran , and
| | - David J Zajac
- d Craniofacial Centre, Department of Dental Ecology, School of Dentistry , University of North Carolina at Chapel Hill , NC , USA
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50
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Abstract
The impact of in-utero isotretinoin exposure has been widely reported, with many affected pregnancies failing to reach term.1 2 Due to the low numbers of in-utero isotretinoin exposed pregnancies, the interactions between this drug and rare genetic defects such as microduplication 1q21.1 are unclear, particularly how they might manifest phenotypically. We present this case of in-utero isotretinoin exposure occurring in a child with microduplication 1q21.1. The child was born with congenital abnormalities which did not fit into a single syndrome. Regrettably in-utero exposure to isotretinoin continues to occur. We hope this case will trigger further discussion on the dangers of dispensing Isotretinoin without ensuring stringent pregnancy testing and its potential interaction with genetic abnormalities, in particular with microduplication 1q21.1.
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Affiliation(s)
- Sarah Kirsten Taylor
- Sheffield Medical School, University of Sheffield, Sheffield, South Yorkshire, UK
| | - Remy Toko
- Department of Paediatrics, Hull and East Yorkshire Hospitals NHS Trust, Hull, UK
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