The Continuing Multidisciplinary Needs of Adult Patients with Cleft Lip and/or Palate

Chuo, C.B.; Searle, Y.; Jeremy, Alison; Richard, Bruce; Sharp, I.; Slator, Rona

doi:10.1597/07-048.1

Cited by 47 publications

(44 citation statements)

References 22 publications

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“…There is a need for multidisciplinary care for these patients during many stages of their lives 9–11 . This study is typical of complete cleft care, involving multidisciplinary treatment and analyses of their treatment outcomes.…”

Section: Discussionmentioning

confidence: 99%

Airway Changes after Cleft Orthognathic Surgery Evaluated by Three-Dimensional Computed Tomography and Overnight Polysomnographic Study

Chang

Wallace

Hsiao

et al. 2017

Sci Rep

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Cleft lip and palate is the most common congenital craniofacial anomaly. Up to 60% of these patients will benefit from cleft orthognathic surgery, which consists primarily of maxillary advancement and mandibular setback to address midface retrusion and relative mandibular protrusion, respectively. It is believed that maxillary advancement can enlarge the airway whilst mandibular setback can reduce the airway, but this has not previously been quantified for cleft patients undergoing orthognathic surgery. This unique longitudinal prospective study of 18 patients was conducted between April 2013 and July 2016. No significant changes occurred by six months postoperatively in body mass index, apnoea-hypopnoea index or lowest oxygen saturation (LSAT). There was a mean increase of 0.73 cm3 in velopharyngeal volume, a mean decrease of 0.79 cm3 in oropharyngeal volume, an improvement in snoring index, and no statistically significant change in hypopharyngeal volume. In conclusion, cleft orthognathic surgery that produced anterior advancement of the maxilla, setback of the mandible and clockwise rotation of the maxillo-mandibular complex resulted in increased velopharyngeal, decreased oropharyngeal and unchanged hypopharyngeal airways, and improved snoring, but did not significantly alter objective sleep-related breathing function.

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Section: Discussionmentioning

confidence: 99%

Airway Changes after Cleft Orthognathic Surgery Evaluated by Three-Dimensional Computed Tomography and Overnight Polysomnographic Study

Chang

Wallace

Hsiao

et al. 2017

Sci Rep

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“…Many patients request secondary surgical treatment, and several studies have indicated that the greatest concern for the patient is correction of appearance and function of the nose. 1–5 Earlier studies on nasal airway function among patients treated for UCLP indicate that objectively measured nasal function is extensively impaired; the patients have lower values regarding nasal volume, higher resistance to breathing, and lower results regarding olfaction compared with controls. 6,7 …”

mentioning

confidence: 99%

Photographic Measurements Partially Correlate to Nasal Function and Appearance among Adult Cleft Patients

Keijser

Nowinski

Mani

2016

Plastic and Reconstructive Surgery - Global Open

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Background:Unilateral cleft lip and palate (UCLP) affects nasal function and appearance. There is a lack of objective measurements to evaluate these features. This study analyzes whether objective measurements on photographs correlate with nasal function and/or appearance among adults treated for UCLP.Methods:All patients with UCLP born from 1960 to 1987 treated at the Uppsala University Hospital were invited (n = 109). Participation rate was 68% (n = 74); mean follow-up was 35 years. An age-matched control group (n = 61) underwent the same tests. Nostril area, nasal tip deviation angle, and width of the nostril were measured on photographs and were compared with functional tests and with appearance as assessed by self-assessment questionnaire, professional panel, or laymen panel.Results:The photographically measured nostril area correlated with nasal volume (acoustic rhinometry) among UCLP patients, both cleft side and noncleft side, and controls (0.331, P = 0.005; 0.338, P = 0.004; and 0.420, P < 0.001, respectively). For the patients’ noncleft side and controls, the area correlated inversely with airflow resistance at inspiration (noncleft side: −0.245, P = 0.043; controls: −0.226, P = 0.013). Laymen assessment of nasal appearance correlated with width ratio of the patients (0.27, P = 0.022) and with nasal tip deviation angle and area ratio of the controls (0.26, P = 0.041, and 0.31, P = 0.015, respectively).Conclusions:Photographic measurements correlate partially with both functional tests of the nose and panel ratings of appearance. No correlation was found with self-assessment of appearance. Evaluation of photographs needs to be combined with patient-reported outcome measures to be a valuable endpoint of nasal appearance.

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“…Secondly, our findings will help advocate for greater involvement of psychological professionals in the preoperative and postoperative treatment of patients in order to help maximize positive surgical outcomes. 14,15 The development of an identity devoid of self-confidence and independence occurred over many years and requires much more than surgical correction to be reversed; therefore, psychological intervention may be greatly beneficial.…”

Section: Discussionmentioning

confidence: 99%

A Qualitative Analysis of Identity and Goals in Patients With Deformities

Tapia

Chang

Ramírez

et al. 2013

Annals of Plastic Surgery

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The Continuing Multidisciplinary Needs of Adult Patients with Cleft Lip and/or Palate

Cited by 47 publications

References 22 publications

Airway Changes after Cleft Orthognathic Surgery Evaluated by Three-Dimensional Computed Tomography and Overnight Polysomnographic Study

Airway Changes after Cleft Orthognathic Surgery Evaluated by Three-Dimensional Computed Tomography and Overnight Polysomnographic Study

Photographic Measurements Partially Correlate to Nasal Function and Appearance among Adult Cleft Patients

A Qualitative Analysis of Identity and Goals in Patients With Deformities

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