The Eurocleft Study: Intercenter Study of Treatment Outcome in Patients with Complete Cleft Lip and Palate. Part 2: Craniofacial Form and Nasolabial Appearance

Brattström, Viveca; Mølsted, Kirsten; Prahl-Andersen, Birte; Semb, Gunvor; Shaw, William C.

doi:10.1597/02-119.2.1

Cited by 163 publications

(117 citation statements)

References 24 publications

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“…When searching the literature it was seen that the results of the intercenter studies were in accordance with the RCTs. The centers that practice PSIO did not show demonstrable advantages in terms of the facial growth and the occlusion in patients with UCLP treated with different types of PSIO appliances (Ross, 1987;Mars et al, 1992;Mølsted et al, 1992;Brattströ m et al, 2005;Mølsted et al, 2005). Although specific causal factors cannot be identified with this type of study and it does not give strong evidence regarding the relationships of the treatment outcomes and the use of PSIO, the results should be taken into consideration.…”

Section: Facial Growth Maxillary Arch and Occlusionmentioning

confidence: 92%

Long-Term Effects of Presurgical Infant Orthopedics in Patients with Cleft Lip and Palate: A Systematic Review

Uzel¹,

Alparslan

2011

The Cleft Palate-Craniofacial Journal

107

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Objective: This study aimed to assess the scientific evidence on the efficiency of presurgical infant orthopedic appliances in patients with cleft lip and palate to shed light on a specific, contemporary discussion of whether the appliances have long-term advantages with respect to treatment outcomes.Design: A systematic review. Methods: Two literature surveys from the five electronic databases were performed with a 1-month interval. Randomized controlled trials and controlled clinical trials (controls had no presurgical infant orthopedics) that had followup periods of a minimum of 6 years were included in the study. The exceptions to the follow-up limit were studies related to feeding and parent satisfaction.Results: Of the 319 articles retrieved in the literature surveys, 12 were qualified for the final analysis. The level of evidence of these articles ranged from 1b to 4. Eight randomized controlled trials and four controlled clinical trials were available on eight treatment outcomes. The longest follow-up period of the randomized controlled trials was 6 years. No randomized controlled trials were found on active presurgical infant orthopedic appliances and on nasoalveolar molding appliances.Conclusions: Based on the results, presurgical infant orthopedic appliances have no long-term positive effects on seven of the eight studied treatment outcomes in patients with cleft lip and palate. More randomized controlled trials need to be done to have evidence regarding the effects of presurgical infant orthopedics in different surgical protocols. Also, the encouraging results about the effect of nasolaveolar molding appliances on nasal symmetry have to be supported by future randomized controlled trials.

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Section: Facial Growth Maxillary Arch and Occlusionmentioning

confidence: 92%

Long-Term Effects of Presurgical Infant Orthopedics in Patients with Cleft Lip and Palate: A Systematic Review

Uzel¹,

Alparslan

2011

The Cleft Palate-Craniofacial Journal

107

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“…10,12,14,18 The retrusive mandible might occur as the result of large gonial angle and clockwise rotation of the mandible (gonial angle, lower gonial angle, SN-GoMe, FMA; Table 3), as noted in previous cleft studies. 10,12,[18][19][20][21] The finding that IMPA was decreased from UCLA to UCLP to CP (P , .001; Table 3) means that differences in the amount of dental compensation could be the result of differences in the sagittal relationship according to cleft type. a One-way analysis of variance (ANOVA) and Duncan's multiple comparison tests were performed.…”

Section: Sagittal and Dental Relationshipsmentioning

confidence: 98%

Initial growth pattern of children with cleft before alveolar bone graft stage according to cleft type

Seo¹,

Park²,

Kim³

et al. 2011

The Angle Orthodontist

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“…As a result, the findings may not be generalizable to a broad population; however, should the quantitative approaches used in this study be sufficiently sensitive to detect effects related to lip revision surgery, then these methodologies could be used to compare the effects of different surgical techniques on function in future randomized clinical trials and/or in clinical settings. In support of our approach to the assessment of perioral function are the results of the Eurocleft Intercenter studies, in which the findings of subjective ratings of nasolabial appearance in patients with cleft lip and palate, based on static photographic images, were found to be invalid as surgical outcome measures (Brattström et al, 2005). These researchers noted that "the rating of nasolabial outcome is a key area for further research."…”

Section: Discussionmentioning

confidence: 94%

Functional Outcomes of Cleft Lip Surgery. Part I: Study Design and Surgeon Ratings of Lip Disability and Need for Lip Revision

Trotman

Phillips

Essick

et al. 2007

The Cleft Palate-Craniofacial Journal

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Objective-Children with a cleft of the upper lip exhibit obvious facial disfigurement. Many require multiple lip surgeries for an optimal esthetic result. However, because the decision for lip revision is based on subjective clinical criteria, clinicians may disagree on whether these surgeries should be performed. To establish more reliable, functionally relevant outcome criteria for evaluation and treatment planning, a clinical trial currently is in progress. In this article, the design of the clinical trial is described and results of a study on subjective evaluations of facial form by surgeons for or against the need for lip revision surgery are presented.Design-Parallel, three-group, nonrandomized clinical trial and subjective evaluations/ratings of facial views by surgeons.Subjects-For the clinical trial, children with repaired cleft lip and palate scheduled for a secondary lip revision, children with repaired cleft lip and palate who did not have lip revision, and noncleft children. For the subjective evaluations, surgeons' facial ratings of 21 children with repaired cleft lip.Address correspondence to: Dr. Carroll-Ann Trotman, CB #7450, 275 Brauer Hall, Chapel Hill, NC 27599-7450. carrollann_trotman@dentistry.unc.edu.. NIH Public Access Author ManuscriptCleft Palate Craniofac J. Author manuscript; available in PMC 2013 May 07. NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author ManuscriptAnalysis-Descriptive and Kappa statistics assessing the concordance of surgeons' ratings of (a) repeated facial views and (b) a recommendation of revision on viewing the prerevision and postrevision views.Results-The surgeons' consistency in rating repeated views was moderate to excellent; however, agreement among the surgeons when rating individual participants was low to moderate.Conclusions-The findings suggest that the agreement among surgeons was poor and support the need for more objective measures to assess the need for revision surgery. Keywords clinical trial; functional outcomes; lip revision surgeryFor a child with a cleft of the lip with or without a cleft palate, the decision to surgically revise the lip is based on a subjective evaluation of lip form and function that is made by the surgeon either independently or in conjunction with the patient and parents (Marsh, 1990). Subjective evaluation defines the current standard of care for patients who are candidates for lip revision; however, recent research has demonstrated many limitations with the use of subjective assessments. Of particular concern are the lack of agreement among clinicians (Asher-McDade et al., 1991;Tobiason et al., 1991;Ritter et al., 2002;Morrant and Shaw, 1996) and a tendency for the assessment of lip form to confound the assessment of lip function (Ritter et al., 2002). For example, when the severity of the deformity of static faces (i.e., faces at rest) was rated subjectively by clinicians, interexaminer agreement ranged from low (Asher-McDade et al., 1991) to good (Tobiason et al., 1991;Ritter et al., 2002), whi...

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The Eurocleft Study: Intercenter Study of Treatment Outcome in Patients with Complete Cleft Lip and Palate. Part 2: Craniofacial Form and Nasolabial Appearance

Abstract: The results confirm that systematic differences in craniofacial morphology and nasolabial appearance may occur between different cleft centers, but do not allow specific caused factors to be identified.

Cited by 163 publications

References 24 publications

Long-Term Effects of Presurgical Infant Orthopedics in Patients with Cleft Lip and Palate: A Systematic Review

Long-Term Effects of Presurgical Infant Orthopedics in Patients with Cleft Lip and Palate: A Systematic Review

Initial growth pattern of children with cleft before alveolar bone graft stage according to cleft type

Functional Outcomes of Cleft Lip Surgery. Part I: Study Design and Surgeon Ratings of Lip Disability and Need for Lip Revision

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