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At least 379 records · Page 21Linked to original sources
PubMed1998

Diphenylhydantoin affects glycosaminoglycans and collagen production by human fibroblasts from cleft palate patients.

During embryonic development, the proper production of extracellular matrix molecules mediates morphogenetic processes involved in palatogenesis. In the present study, we investigated whether any differences exist in glycosaminoglycan (GAG) and collagen synthesis between palate fibroblasts from infants, with or without cleft palate, in two age ranges. Subsequently, the effects of diphenylhydantoin (PHT), a teratogen known to induce cleft palate in human and mammalian newborns, on extracellular matrix (ECM) production were studied. We found that cleft palate fibroblasts (CPFs) synthesize greater amounts of GAG and collagen than normal fibroblasts (NFs). CPFs produced less cellular hyaluronic acid (HA) and more sulphated GAG. HA was the principal GAG species in the medium, and its percentage was lower in one- to three-year-old CPFs. Cleft palate fibroblasts produced more extracellular chondroitin 4- and 6-sulphate (CS) and dermatan sulphate (DS). Associated with a higher production of sulphated GAG, we observed a higher synthesis of type III and type I collagen with a normal ratio of alpha2(I) to alpha1(I) chains. PHT treatment of NFs reduced collagen and GAG synthesis, with a marked effect on sulphated GAG. The drug changed collagen synthesis, whereas it did not affect GAG production in CPFs whose phenotype may already be impaired. These findings indicate that, in CPFs, modifications in the pattern of ECM components, which are most likely responsible for the anomalous development, persist in infants. In addition, NFs and CPFs with a different phenotype respond differently to PHT treatment.

Cells, Cultured↗
PubMed1980

Cleft palate in domestic animals: epidemiologic features.

Among 331 animals with cleft palate in a veterinary clinic-hospital population, cats, mixed breed dogs and German Shepherd Dogs had low risk for cleft palate; high rates were seen in English Bulldogs, some small purebred dogs and Charolais cattle, where cleft palate occurred as part of a syndrome of multiple malformations. Many of the epidemiologic characteristics resemble features of cleft palate in humans and suggest animal breeds suitable for exploration as animal models for use by experimental teratologists, developmental biologists, and clinicians.

Abnormalities, Multiple↗
PubMed2001

Incidence of cleft palate fistula: an institutional experience with two-stage palatal repair.

The purpose of this study was to determine the incidence of cleft palatal fistula in a series of nonsyndromic children treated at the authors' institution. This retrospective analysis of 103 patients with cleft palate treated by five surgeons between 1982 and 1995 includes 60 boys and 33 girls, whose median age was 18.4 months at the time of surgery. The median length of follow-up was 4.9 years after primary palatoplasty. Cleft palatal fistula was defined as a failure of healing or a breakdown in the primary surgical repair of the palate. Intentionally unrepaired fistulas of the primary and secondary palate were excluded. Extent of clefting was described according to the Veau classification. Statistical examination of multiple variables was performed using contingency table analysis, multivariate logistic regression, and the Wilcoxon rank sum test. The incidence of cleft palatal fistula in this series was 8.7 percent. All of these fistulas were clinically significant. The rate of fistula recurrence was 33 percent. The incidence of cleft palatal fistula when compared by Veau classification was statistically significant, with nine fistulas occurring in patients with Veau 3 and 4 clefts and no fistulas occurring in patients with Veau 1 and 2 clefts (p = 0.0441). No significant differences between patients with and without fistulas were identified with respect to operating surgeon, patient sex, patient age at palatoplasty, type of palatoplasty, and use of presurgical orthopedics or palatal expansion. All three recurrent fistulas occurred in the anterior palate, two in patients with Veau class 3 clefts and one in a patient with a Veau class 4 cleft. The low rate of clinically significant fistula was attributed to early delayed primary closure, with smaller secondary clefts allowing repair with a minimum of dissection and disruption of vascularity.

Cleft Palate↗
PubMed1995

[Using buccal mucosal muscle flap to repair the cleft palate.].

This paper introduced a new method applied to repair cleft palate,in which,the bilateral buccal mucosal muscle flaps were shaped T forms and turned over to cover the fissure of palate,instead of common mucopriostrum excision and of retro-pushing method.It may push the soft palate back.The advantage is avoiding wide tearing of the mucoperiosteum of the palate,which results in the disformation of maxilla.Also we can reconstruct the suspension of levetor veli palatini,so as to repair the palate cleft functionally.

English Abstract↗
PubMed2003

A bilateral musculomucosal buccal flap method for cleft palate surgery.

PURPOSE: This article introduces a new technique for the repair of cleft palate with a bilateral musculomucosal buccal flap. PATIENTS AND METHODS: From 1990 to 2001, 26 patients with cleft palate of different types were treated for the repair of cleft palate with the bilateral musculomucosal buccal flaps. Their age ranged from 3 to 12 years (mean age, 6.4 years). They were followed up from 2 to 8 years. The velopharyngeal closure was examined by nasopharyngoscopy. RESULTS: The postoperative results of all the patients who could be followed up were clearly satisfactory without any postoperative complications such as dehiscence or perforation or maxillary deformity. The velopharyngeal closure was satisfactory. CONCLUSION: Repair of cleft palate with bilateral musculomucosal buccal flaps is a very useful method for repairing cleft palate and possibly reduces postoperative complications of dehiscence, perforation, and growth retardation.

Child↗
PubMed2002

Frequency of pharyngoplasty after primary repair of cleft palate.

BACKGROUND: The frequency of pharyngoplasty after initial repair of cleft palate is a direct measure of the success or failure of the primary palatal repair with respect to velopharyngeal function. The optimal timing and surgical technique for the repair of cleft palate remain subjects of debate. PURPOSE: To assess the outcome of various techniques for primary palatal repair, specifically the frequency of secondary pharyngoplasty, and to determine the significance, if any, of certain variables to this outcome. METHODS: A pool of 114 patients with cleft lip and palate was compiled from a retrospective analysis of medical records for more than 300 consecutive patients treated over a 15-year period (1980-1995). The review included only patients who had been treated by the same surgeon or by his resident. A 1-stage palatal repair was performed on all patients, in which the hard and the soft palate were closed simultaneously. The following data were collected: patient's sex, patient's date of birth, type of cleft, technique used for initial repair, age at initial repair and date of secondary pharyngoplasty surgery, if performed. RESULTS: The overall frequency of subsequent pharyngoplasty was 25% (28 patients). The rate of secondary surgery was significantly higher for boys (21/63 or 33%) than for girls (7/51 or 14%). There were also significant differences in the rate of secondary pharyngoplasty according to type of cleft: 50% (6/12) for patients with bilateral cleft lip and palate, 44% (7/16) for those with hard and soft cleft palate, 21% (8/38) for those with unilateral cleft lip and palate, 20% (3/15) for those with submucous cleft palate and 12% (4/33) for those with soft cleft palate. Surgical technique for the primary repair (V-Y pushback or von Langenbeck procedure) was not a significant factor in determining the rate of subsequent pharyngoplasty, nor was age at primary repair, although those who underwent primary repair at age 12-14 months were least likely to require pharyngoplasty. CONCLUSION: In this study the frequency of velopharyngeal insufficiency after 1-stage palatoplasty was consistent with previously reported results. Of interest would be a comparison of 1-stage and 2-stage approaches to primary palate repair in young patients.

Age Factors↗
PubMed1994

Implant prosthodontic procedures for a completely edentulous patient with cleft palate.

Prosthodontic treatment of the edentulous cleft palate patient presents the dentist with numerous challenges for achieving a satisfactory result for the patient. A technique is described for prosthodontic rehabilitation of a completely edentulous cleft palate patient using bone augmentation procedures, root-form dental implants, and a removable maxillofacial prosthesis. Dental implants may improve prosthesis retention, stability, and occlusal function when used in carefully selected cases.

Adult↗
PubMed2001

Physical and transcriptional mapping of the X-linked cleft palate and ankyloglossia (CPX) critical region.

Cleft palate most commonly occurs as a sporadic multifactorial disorder with a clear but difficult to define genetic component. As a semi-dominant disorder, X-linked cleft palate (CPX) provides a useful model to investigate a congenital defect that is little influenced by non-genetic factors. By using an Icelandic kindred, CPX has been localised between DXS1196 and DXS1217 and mapped, in a 3-Mb yeast artificial chromosome contig, at Xq21.3. Markers generated from this physical map have now been used to construct a contig of P1 and bacterial artificial chromosome clones for genomic DNA sequencing. Genomic DNA sequence analysis has revealed two novel expressed genes and two pseudogenes in the order Cen-KLHL4-LAMRL5-CAPZA1P-CPXCR1-Tel. KLHL4 and CPXCR1 are widely expressed in fetal tissues, including the tongue, mandible and palate. DNA mutation screening of CPXCR1 has revealed several sequence variants present on all affected CPX chromosomes. However, these variants have also been detected at a lower frequency on unaffected chromosomes, indicating that they are polymorphisms that are unlikely to cause the CPX phenotype.

Amino Acid Sequence↗
PubMed2000

Teratological effect of 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD): induction of cleft palate in the ddY and C57BL/6 mouse.

2,3,7,8-Tetrachlorodibenzo-p-dioxin (TCDD), a highly toxic halogenated aromatic hydrocarbon, is a teratogen to induce cleft palate when exposed during the pregnancy. There are inter-strain differences in the sensitivity to cleft palate induced by TCDD and other chemicals including polychlorinated terphenyls (PCTs). The C57BL/6 mouse and the ddY mouse had been shown to be different in the induction of cleft palate following the treatment of PCTs, which attempts us to evaluate the TCDD-induced cleft palate in two mouse strains to understand the mechanism through which TCDD and PCTs induce cleft palate. This study evaluated the induction of cleft palate in the fetuses of ddY and C57BL/6 mice after subcutaneous treatment of TCDD on gestation day (GD) 10.5-14.5 or oral treatment on GD 8.5-13.5. Our results clearly showed that ddY mice, a susceptible strain to PCTs-induced cleft palate, are resistant to the induction of cleft palate by TCDD comparably to the high susceptibility of C57BL/6 mice, suggesting a different teratological mechanism between TCDD and PCTs. In addition, at the low doses, our study supported the concept of "window effect" of TCDD on around GD 12 for the induction of cleft palate in C57BL/6 and ddY mice.

Administration, Oral↗
PubMed1992

[Repair of residual cleft palates in older adult patients].

Residual cleft palates in adult patients are hard to repair. A prosthesis may cause patients to complain of loss of fluid through the nose when they drink. Furthermore, there may be problems with the retention of the prosthesis. In sixteen adult patients the residual cleft palate was successfully closed. In three patients a second surgical procedure was required.

Adult↗
PubMed1992

Medical students' knowledge of and exposure to cleft palate.

To compare the knowledge and experience of medical students in 1989 with that of those surveyed in 1973, a questionnaire about the various aspects of cleft palate was completed by 209 medical students from West Virginia University and the Louisiana State University Medical Center at Shreveport and New Orleans. Results revealed that 1989 students were more familiar with the embryology of cleft palate, racial and gender differences, and intellectual and psychologic issues (p less than .05). In contrast, the 1973 students were more able to define cleft palate, submucous cleft palate, and pharyngeal flap. There was no difference between the two groups of students in the amount of clinical exposure to cleft palate. These findings support the need for greater emphasis on cleft palate at the pre- and postdoctoral levels, as well as within continuing education programs. As part of current programs, the standard of practice of multidisciplinary team management for an individual with cleft palate should be underscored.

Cleft Palate↗
PubMed1988

Minimal standards for reporting the results of surgery on patients with cleft lip, cleft palate, or both: a proposal.

This article proposes a set of minimal standards for reporting the results of surgery on patients with cleft lip with or without cleft palate and cleft palate only. These standards do not represent what is technically possible, only what is considered minimally acceptable for presentation in a public forum. They have a clinical focus and should be attainable by any well-constituted cleft palate team. As the title indicates, this document is a proposal. It is hoped that the readership will respond to the recommendations presented so that some set of standards can be adopted in the near future. Once adopted, these standards should be reviewed and updated periodically.

Cleft Lip↗
PubMed1973

Submucous cleft palate and the general practitioner.

Submucous cleft palate refers to a situation where the soft palate is largely composed of mucosa with little or no muscle. The defect is often not obvious on inspection of the mouth and pharynx. There is considerable clinical variation, with speech ranging from normal or minimal nasality to severe nasality and defective articulation. Many patients who have latent submucous cleft palate have the condition unmasked by an adenoidectomy because the adenoid pad had served as a compensatory factor in effecting palatopharyngeal closure. All physicians who perform tonsillectomy and adenoidectomy should be aware of the signs and symptoms which may suggest the diagnosis.

Adenoidectomy↗
PubMed1995

The arterial supply of the palate: implications for closure of cleft palates.

Little is known of the arterial anatomy of the palate. Injection studies and dissection of a total of 49 cadavers have shown the principal arterial supply of the soft palate to be the ascending pharyngeal artery, which anastomoses with the greater palatine artery at the junction of the hard and soft palates. The position and relations of the branches of the ascending palatine artery put it at risk during palate repair.

Aged↗
PubMed1980

A glucocorticoid receptor in fetal mouse: its relationship to cleft palate formation.

Fetal mouse tissue was investigated for a glucocorticoid binding receptor which might be responsible for cleft palate formation. Fetal mouse heads contain a soluble component which binds the glucocorticoid triamcinolone acetonide in vitro with high affinity. This binding component is present in small finite amounts. Other glucocorticoids compete with triamcinolone acetonide for the binding site in a manner consistent with their potency ranking as cleft palate teratogens. Several mineralocorticoids and progestins also compete when administered in vitro but not when administered in vivo. Triamcinolone acetonide binding was determined in three mouse strains, A/J, C3H, and C57BL, which are listed in decreasing order of cleft palate susceptibility to cortisone. No positive correlation was found between cortisone cleft palate susceptibility and either triamcinolone acetonide binding affinity or binding amount in fetuses from these strains. Cleft palate dose response curves for triamcinolone acetonide were determined in these strains, but they were not parallel to each other as they were for cortisone. This suggests that triamcinolone acetonide may cause cleft palate by different mechanisms in these strains. Thus, fetal mouse tissue contains an apparent glucocorticoid receptors, but its relationship to cleft palate formation in mice is not clear.

Animals↗
PubMed2000

[Nonsyndromic cleft lip with or without cleft palate in Chinese population: analysis of 3766 cases].

A retrospective study was conducted to evaluate the variation trend in the incidence and epidemiological characteristics of nonsyndromic cleft lip with or without cleft palate in Chinese population. From 1988 to 1992, data were collected from more than 500 hospital-based units involved in a monitoring program and were analyzed by the National Center for Birth Defects Monitoring. The monitored subjects were the hospitalized births from 28 weeks gestation to a period within 7 days after delivery, which included 3246 408 perinatals and 3766 cases. The total incidence of nonsyndromic cleft lip with or without cleft palate was 11.6/10,000; the total incidence of celft lip alone was 3.8/10,000 and that of cleft lip with cleft palate was 7.8/10,000; no significant variation was noted in the annual incidence from 1988 to 1992. The incidence in males was 13.3/10,000, and 9.5/10,000 in females; there was a significant difference (P < 0.01). Of all the 3766 cases, cleft lip with cleft palate accounted for 67%, unilateral cleft lip 28% and unilateral cleft lip with cleft palate 43%. Left cleft lip and left cleft lip with cleft palate constituted 21% and 29% respectively. The sex-ratio was 1.6:1 for nonsyndromic cleft lip with or without cleft palate. It could be concluded that the incidence of nonsyndromic cleft lip with or without cleft palate showed no variation trend in China. Although no difference was found between urban and rural areas, the susceptibility to the defect was higher in males than in females. Cleft lip with cleft palate was more common than other types. There was a predominance of unilateral defects, of which most were on the left side.

China↗