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Initial size of cleft does not correlate with size and function of nasal airway in adults with unilateral cleft lip and palate
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Oral and Maxillofacial Surgery.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Oral and Maxillofacial Surgery.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Plastic Surgery.
2011 (English)In: Journal of plastic surgery and hand surgery, ISSN 2000-656X, Vol. 45, no 3, 129-135 p.Article in journal (Refereed) Published
Abstract [en]

The noses of patients with clefts are often functionally inadequate. The aim of the present study was to evaluate the correlation between size of the maxillary cleft in infancy and size and function of the nasal airway in adults with unilateral cleft lip and palate (UCLP). This is a long-term follow up study including 53 patients with UCLP born between 1960 and 1987 and treated at the Cleft Lip and Palate Centre, Uppsala University Hospital, Sweden. Lip repair was performed at 3--4 months of age followed by either a one-stage or a two-stage palatal closure. The size of the cleft was measured on infant maxillary dental casts. Nasal minimum cross-sectional area (cm<SU2</SU) and volume (cm<SU3</SU) (acoustic rhinometry), air flow resistance (Pa s/cm<SU3</SU) (rhinomanometry), peak inspiratory flow (l/min) (peak nasal inspiratory flow) and number of identified odours (Scandinavian odor-identification test) were assessed in adulthood. The size of the maxillary cleft varied considerably at infancy. The size of the nasal airway and its function on the cleft side in adulthood were reduced compared with the non-cleft side, but no correlations were found between size of the initial cleft in infancy and size and function of the nasal airway in adulthood. In adults born with UCLP, therefore, size of the maxillary cleft in infancy does not seem to affect size and function of the nasal airway in adulthood.

Place, publisher, year, edition, pages
2011. Vol. 45, no 3, 129-135 p.
Keyword [en]
Unilateral cleft lip and palate, cleft size, acoustic rhinometry, rhinomanometry, nasal resistance, odour identification
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:uu:diva-155931DOI: 10.3109/2000656X.2011.576839ISI: 000291815000002OAI: oai:DiVA.org:uu-155931DiVA: diva2:429498
Available from: 2011-07-04 Created: 2011-07-04 Last updated: 2011-11-23Bibliographically approved
In thesis
1. Cleft Size and Maxillary Arch Dimensions in Unilateral Cleft Lip and Palate and Cleft Palate
Open this publication in new window or tab >>Cleft Size and Maxillary Arch Dimensions in Unilateral Cleft Lip and Palate and Cleft Palate
2011 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The wide variation in infant maxillary morphology and cleft size of children with unilateral cleft lip and palate (UCLP) and isolated cleft palate (CP) raise concerns about their possible influences on treatment outcome. The studies in this thesis aimed to investigate the relation between cleft size in infancy and crossbite at 5 years of age (Paper I); the impact of primary surgery on cleft size and maxillary arch dimensions from infancy to 5 years of age (Paper II); associations between cleft size, maxillary arch dimensions and facial growth in both UCLP and CP children (Paper III); and, to evaluate the relation between infant cleft size and nasal airway size and function in adults treated for UCLP (Paper IV).

In homogenously treated groups of children with UCLP and CP, dental casts were used to measure cleft size and maxillary arch dimensions from infancy up to 5 years of age, and for crossbite recording at 5 years. Serial lateral cephalometric radiographs taken between 5 and 19 years of age in the same groups were used to study facial growth. Nasal airway size and function were evaluated by acoustic rhinometry, rhinomanometry, peak nasal inspiratory flow and odour test in a group of adults treated for UCLP.

The main findings were: crossbite was a frequent malocclusion at 5 years of age in children with UCLP and large cleft widths at the level of the cuspid points in infancy were associated with less anterior and posterior crossbite in this group (Paper I). Cleft widths decreased after lip closure and/or soft palate closure in both UCLP and CP children. Initially, UCLP children had wider maxillary arch dimensions, but after hard palate closure, the transverse growth was reduced, and at 5 years, they had smaller maxillary arch widths than CP children had (Paper II). Maxillary arch depths and cleft widths in infancy were correlated with maxillary protrusion and sagittal jaw relationships in both UCLP and CP children (Paper III), but cleft width in infancy was not correlated with nasal airway size and function in adults treated for UCLP (Paper IV).

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2011. 74 p.
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 722
Keyword
Unilateral cleft lip and palate, cleft palate, cleft size, maxillary arch dimensions, crossbite, facial growth, nasal function
National Category
Dentistry
Research subject
Oral and Maxillofacial Surgery
Identifiers
urn:nbn:se:uu:diva-160178 (URN)978-91-554-8213-8 (ISBN)
Public defence
2011-12-09, Skoogsalen, Uppsala University Hospital, entrance 79, Uppsala, 09:15 (English)
Opponent
Supervisors
Available from: 2011-11-18 Created: 2011-10-17 Last updated: 2011-11-23Bibliographically approved

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