Displaying publications 41 - 60 of 84 in total

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  1. Lokman S, Loh T, Said H, Omar I
    Med J Malaysia, 1992 Mar;47(1):51-5.
    PMID: 1387450
    For a complete overall rehabilitation of cleft palate patients a multi-disciplinary approach should be adopted. Plastic and Head and Neck Surgeons in whom most of the treatment are entrusted should be concerned not only at achieving palatal function and cosmetic acceptability but also the various other problems associated with cleft palate especially hearing loss. In this study, 66 patients with repaired and unrepaired cleft palates were examined for the presence of hearing loss due to middle ear effusion. The incidence of middle ear effusion was high (57.6%). It was also found that only eight of these patients (12.1%) ever complained of hearing loss or any associated symptoms and repair of the cleft palate did not influence the incidence of middle ear effusion. As such, screening should be done in all cleft palates and otolaryngologists should therefore play an important role in the multi-disciplinary team which should comprise the paediatrician, plastic surgeon, speech therapist, orthodontist and dental specialist.
    Matched MeSH terms: Cleft Palate/complications*
  2. Fong PH, Yeap CL, Lee ST
    Ann Acad Med Singap, 1983 Apr;12(2 Suppl):363-5.
    PMID: 6625521
    Cleft lip and palate is the most common congenital abnormality seen in the Department of Plastic Surgery, Singapore General Hospital. A total of 461 operative cases seen over a period of 5 years (1977 to 1981) is analysed. There is a relatively high incidence in the Singapore population of 2.0 per 1000 live births. In both cleft lip and cleft palate deformities, there is no significant difference in the sex distribution. The cleft patterns show that 78% of the cases are unilateral clefts, 53% are left sided, 25% are right sided and 22% of the cases are bilateral clefts.
    Matched MeSH terms: Cleft Palate/epidemiology*
  3. Trott JA, Mohan N
    Br J Plast Surg, 1993 Jul;46(5):363-70.
    PMID: 8369872
    A method of open-tip rhinoplasty using nostril and columella rim incisions at the time of unilateral cleft lip repair is described. This preliminary report details experience gained using this technique in the Malaysian centre of Alor Setar following its introduction in September, 1991.
    Matched MeSH terms: Cleft Palate/surgery*
  4. Arshad AI, Alam MK, Khamis MF
    Cleft Palate Craniofac J, 2018 05;55(5):682-687.
    PMID: 29518343 DOI: 10.1177/1055665618758278
    OBJECTIVES: The aim of this study is to assess the treatment outcome of complete unilateral cleft lip and palate (CUCLP) patients using modified Huddart/Bodenham scoring system (MHB). To determine whether there is an association of congenital and postnatal factors with the treatment outcome.

    DESIGN: Retrospective observational study.

    SETTING: Two regional cleft-referral centers.

    MAIN OUTCOME MEASURES: In the current study, 101 pairs of dental models of non-syndromic CUCLP patients were retrieved from hospital archives. Each occlusal relationship from central incisor till the first permanent molars were scored except the lateral incisor. Sum of 10 occlusal relationships in each study sample gave a total occlusion score. The primary outcome was the mean total occlusion score.

    RESULTS: According to MHB, a mean (standard deviation) total occlusion score of -8.92 (6.89) was determined. Based on treatment outcome, 66 cases were favorable (grades 1, 2, and 3) and 35 cases were unfavorable (grades 4 and 5). Chi-square tests indicated, difference of cheiloplasty ( P = .001) and palatoplasty ( P < .001) statistically significant. Five variables-gender, family history of cleft, cleft side, cheiloplasty, and palatoplasty-were analyzed with a logistic regression model.

    CONCLUSIONS: Final model indicated that cases treated with modified Millard technique (cheiloplasty) and Veau-Wardill-Kilner method (palatoplasty) had higher odds of unfavorable treatment outcome.

    Matched MeSH terms: Cleft Palate/surgery*
  5. Rahman RA, Ahmad A, Rahman ZA, Mokhtar KI, Lah NA, Zilfalil BA, et al.
    Cleft Palate Craniofac J, 2008 Nov;45(6):583-6.
    PMID: 18956930 DOI: 10.1597/07-020.1
    To determine the frequency of the transforming growth factor-alpha (TGFalpha) Taq1 polymorphism in nonsyndromic cleft lip with or without cleft palate (CL+/-P) and cleft palate only (CP) in Kelantan, Malaysia.
    Matched MeSH terms: Cleft Palate/genetics*
  6. Rajion ZA, Townsend GC, Netherway DJ, Anderson PJ, Yusof A, Hughes T, et al.
    Cleft Palate Craniofac J, 2006 Sep;43(5):513-8.
    PMID: 16986980
    To investigate anatomical variations and abnormalities of cervical spine morphology in unoperated infants with cleft lip and palate.
    Matched MeSH terms: Cleft Palate/radiography*
  7. Haque S, Alam MK, Khamis MF
    Cleft Palate Craniofac J, 2018 08;55(7):966-973.
    PMID: 27479096 DOI: 10.1597/15-293
    OBJECTIVE: To evaluate the dental arch relationship (DAR) of nonsyndromic unilateral cleft lip and palate (UCLP) and to explore the various phenotype and postnatal treatment factors that are responsible for poor DAR.

    DESIGN: Retrospective study.

    SETTING: School of Dental Science, Universiti Sains Malaysia.

    SUBJECTS: Eighty-four Bangladeshi children with nonsyndromic UCLP who received cheiloplasty and palatoplasty.

    MAIN OUTCOME MEASURES: Dental models were taken at 5 to 12 years of age (man: 7.69), and dental arch relationships were assessed using modified Huddart/Bodenham index (mHB) by two raters. Kappa statistics was used to evaluate the intra- and interexaminer agreements, chi-square was used to assess the associations, and logistic regression analysis was used to explore the responsible factors that affect DAR.

    RESULTS: The total mHB score (mean [SD]) was -8.261 (7.115). Intra- and interagreement was very good. Using crude and stepwise backward regression analysis, significant association was found between positive history of class III (P = .025, P = .030, respectively) and unfavorable DAR. Complete UCLP (P = .003) was also significantly correlated with unfavorable DAR.

    CONCLUSION: This multivariate study suggested complete type of UCLP and positive history of class III had a significantly unfavorable effect on the DAR.

    Matched MeSH terms: Cleft Palate/surgery*
  8. Yew CC, Alam MK, Rahman SA
    PMID: 27619027 DOI: 10.1016/j.ijporl.2016.07.026
    OBJECTIVES: This study is to evaluate the dental arch relationship and palatal morphology of unilateral cleft lip and palate patients by using EUROCRAN index, and to assess the factors that affect them using multivariate statistical analysis.

    METHOD: A total of one hundred and seven patients from age five to twelve years old with non-syndromic unilateral cleft lip and palate were included in the study. These patients have received cheiloplasty and one stage palatoplasty surgery but yet to receive alveolar bone grafting procedure. Five assessors trained in the use of the EUROCRAN index underwent calibration exercise and ranked the dental arch relationships and palatal morphology of the patients' study models. For intra-rater agreement, the examiners scored the models twice, with two weeks interval in between sessions. Variable factors of the patients were collected and they included gender, site, type and, family history of unilateral cleft lip and palate; absence of lateral incisor on cleft side, cheiloplasty and palatoplasty technique used. Associations between various factors and dental arch relationships were assessed using logistic regression analysis.

    RESULT: Dental arch relationship among unilateral cleft lip and palate in local population had relatively worse scoring than other parts of the world. Crude logistics regression analysis did not demonstrate any significant associations among the various socio-demographic factors, cheiloplasty and palatoplasty techniques used with the dental arch relationship outcome.

    CONCLUSIONS: This study has limitations that might have affected the results, example: having multiple operators performing the surgeries and the inability to access the influence of underlying genetic predisposed cranio-facial variability. These may have substantial influence on the treatment outcome. The factors that can affect unilateral cleft lip and palate treatment outcome is multifactorial in nature and remained controversial in general.

    Matched MeSH terms: Cleft Palate/surgery*
  9. Arshad AI, Alam MK, Khamis MF
    Int J Pediatr Otorhinolaryngol, 2017 Jan;92:70-74.
    PMID: 28012538 DOI: 10.1016/j.ijporl.2016.11.006
    OBJECTIVES: The purpose of the current study was to assess the treatment outcome of non-syndromic patients having complete unilateral cleft lip and palate (CUCLP) by using GOSLON index and to determine any association of pre and/or postnatal factors with the treatment outcome.

    MATERIALS AND METHODS: One hundred and one sets of dental models of patients having CUCLP were assessed in this retrospective study. Five examiners that were blinded to case-specific information scored the dental models at two instances with an interval of two weeks to ensure memory bias elimination (5 × 101 × 2 = 1010 observations). Calibration courses were conducted prior to scoring and each examiner was provided with scoring sheets, pictures of GOSLON reference models and flowcharts explaining the scoring method.

    RESULTS: According to GOSLON index, a mean (SD) GOSLON score of 3.04 (1.25) was determined. Based on treatment outcome groups, 62 patients had favorable (grade 1, 2, and 3) and 39 cases had unfavorable (grade 4 and 5) treatment outcome. Chi-square tests revealed a significant association of gender (P = 0.002), cheiloplasty (P = 0.001) and palatoplasty (P 

    Matched MeSH terms: Cleft Palate/surgery*
  10. Arshad AI, Alam MK, Khamis MF
    Int J Pediatr Otorhinolaryngol, 2017 Sep;100:91-95.
    PMID: 28802394 DOI: 10.1016/j.ijporl.2017.06.025
    OBJECTIVES: Assessment of treatment outcome is the only non-invasive approach to identify the effects of cleft lip and palate repair and modify management accordingly. Here the aim is to assess the outcome of complete unilateral cleft lip and palate (CUCLP) patients using EUROCRAN index and to check whether there are any factors associated with the treatment outcome.

    MATERIALS AND METHODS: It is a retrospective cross sectional study. Dental models were collected from archives of two cleft referral centers in Pakistan. Five blinded examiners scored 101 models twice at two week interval. The primary outcome was mean EUROCRAN scores based on dental arch relationships and palatal surface morphology.

    RESULTS: A mean(SD) score of 2.72 (0.76) and 2.20 (0.73) was determined based on dental arch relationships and palatal surface morphology, respectively. According to the final logistic regression model, modified Millard technique (cheiloplasty) and Veau-Wardill-Kilners' method (palatoplasty) had higher odds of producing unfavorable treatment outcome.

    CONCLUSIONS: Present study determined a fair and a fair to poor treatment outcome based on dental arch relationships and palatal surface morphology, respectively. Our study suggests a significant association between treatment outcome and primary surgical techniques for lip and palate. These findings could warrant a modification of management protocols to ensure improvement in future cleft outcomes.

    Matched MeSH terms: Cleft Palate/surgery*
  11. Ram SP, Noor AR, Ariffin WA, Ariffin NA
    Singapore Med J, 1994 Apr;35(2):205-7.
    PMID: 7939823
    A 37-week gestation male boy was born to a gravida seven para six mother by spontaneous vertex delivery at home. The baby cried at birth. On day 3 of life, he was admitted for respiratory distress. Physical examination revealed ectrodactyly, thin dry skin, anomalous tear duct with cardiomegaly. X-ray revealed absent radii, cardiomegaly and hemivertebra at L1. Echocardiogram revealed perimembranous type of ventricular septal defect. A diagnosis of Ectodermal Dysplasia Ectrodactyly Clefting Syndrome with ventricular septal defect was made. He was managed conservatively in the nursery. However, he expired on day 27 of life following short spell of fever apnoeic episode due to neonatal sepsis.
    Matched MeSH terms: Cleft Palate/genetics*
  12. Salahshourifar I, Halim AS, Sulaiman WA, Zilfalil BA
    J Dent Res, 2011 Mar;90(3):387-91.
    PMID: 21297019 DOI: 10.1177/0022034510391798
    Non-syndromic cleft lip, with or without cleft palate, is a heterogeneous, complex disease with a high incidence in the Asian population. Several association studies have been done on cleft candidate genes, but no reports have been published thus far on the Orofacial Cleft 1 (OFC1) genomic region in an Asian population. This study investigated the association between the OFC1 genomic region and non-syndromic cleft lip with or without cleft palate in 90 Malay father-mother-offspring trios. Results showed a preferential over-transmission of a 101-bp allele of marker D6S470 in the allele- and haplotype-based transmission disequilibrium test (TDT), as well as an excess of maternal transmission. However, no significant p-value was found for a maternal genotype effect in a log-linear model, although single and double doses of the 101-bp allele showed a slightly increased cleft risk (RR = 1.37, 95% CI, 0.527-3.4, p-value = 0.516). Carrying two copies of the 101-bp allele was significantly associated with an increased cleft risk (RR = 2.53, 95% CI, 1.06-6.12, p-value = 0.035). In conclusion, we report evidence of the contribution of the OFC1 genomic region to the etiology of clefts in a Malay population.
    Matched MeSH terms: Cleft Palate/genetics*
  13. Alam MK, Iida J, Sato Y, Kajii TS
    Br J Oral Maxillofac Surg, 2013 Dec;51(8):e205-10.
    PMID: 23099108 DOI: 10.1016/j.bjoms.2012.10.001
    We have evaluated the craniofacial morphology of Japanese patients with unilateral cleft lip and palate (UCLP) and assessed the various postnatal factors that affect it. Lateral cephalograms of 140 subjects (mean (SD) aged 7 (2) years) with UCLP were taken before orthodontic treatment. Surgeons from Hokkaido University Hospital had done the primary operations. The craniofacial morphology was assessed by angular and linear cephalometric measurements. Cheiloplasty, palatoplasty, and preoperative orthopaedic treatment were chosen as postnatal factors. To compare the assessments of the postnatal factors, we made angular and linear cephalometric measurements for each subject and converted them into Z scores in relation to the mean (SD) of the two variables. Subjects treated by the modified Millard cheiloplasty had larger sella-nasion-point A (SNA) and nasion-point A-pogonion (NA-POG) measurements than subjects treated by the modified Millard with a vomer flap cheiloplasty. Two-stage palatoplasty showed consistently better craniofacial morphology than the other palatoplasty. Subjects who had preoperative orthopaedic treatment with a Hotz plate had significantly larger upper incisor/sella-nasion (U1-SN) measurements than who had no preoperative orthopaedic treatment or an active plate. We conclude that in subjects treated by a modified Millard type of cheiloplasty, a two-stage palatoplasty, and a Hotz plate there were fewer adverse effects on craniofacial morphology.
    Matched MeSH terms: Cleft Palate/pathology; Cleft Palate/surgery*
  14. Beaty TH, Fallin MD, Hetmanski JB, McIntosh I, Chong SS, Ingersoll R, et al.
    Genetics, 2005 Sep;171(1):259-67.
    PMID: 15965248
    Analysis of haplotypes based on multiple single-nucleotide polymorphisms (SNP) is becoming common for both candidate gene and fine-mapping studies. Before embarking on studies of haplotypes from genetically distinct populations, however, it is important to consider variation both in linkage disequilibrium (LD) and in haplotype frequencies within and across populations, as both vary. Such diversity will influence the choice of "tagging" SNPs for candidate gene or whole-genome association studies because some markers will not be polymorphic in all samples and some haplotypes will be poorly represented or completely absent. Here we analyze 11 genes, originally chosen as candidate genes for oral clefts, where multiple markers were genotyped on individuals from four populations. Estimated haplotype frequencies, measures of pairwise LD, and genetic diversity were computed for 135 European-Americans, 57 Chinese-Singaporeans, 45 Malay-Singaporeans, and 46 Indian-Singaporeans. Patterns of pairwise LD were compared across these four populations and haplotype frequencies were used to assess genetic variation. Although these populations are fairly similar in allele frequencies and overall patterns of LD, both haplotype frequencies and genetic diversity varied significantly across populations. Such haplotype diversity has implications for designing studies of association involving samples from genetically distinct populations.
    Matched MeSH terms: Cleft Palate/ethnology; Cleft Palate/genetics
  15. Mohd Ibrahim H, Mohamed Yusoff FH, Ahmad K, Van Dort S
    Med J Malaysia, 2015 Dec;70(6):321-5.
    PMID: 26988203 MyJurnal
    INTRODUCTION: Little is known about the treatment outcomes of children with cleft lip and/or palate (CLP) receiving surgical care for primary lip and palate closure in Malaysia.

    OBJECTIVES: This study examined the speech and hearing status of Malay-speaking children with CLP residing in Kuala Lumpur.

    METHODS: Parents whose children were between the age of 5 and 7 years were recruited via the Cleft Lip and Palate Association of Malaysia (CLAPAM) registry. Parents completed a survey and the children completed a speech and hearing assessment at the Audiology and Speech Sciences Clinic, Universiti Kebangsaan Malaysia.

    OUTCOMES: Speech measures include nasality rating, nasalance scores, articulation errors and speech intelligibility rating, while hearing measures include hearing thresholds and tympanometry results for each child.

    RESULTS: Out of 118 registered members who fulfilled the inclusion criteria, 21 agreed to participate in the study. The overall speech and hearing status of children in this sample were poor. Only four (19%) participants had normal speech intelligibility rating and normal hearing bilaterally. In terms of overall cleft management, only four (19%) participants were seen by a cleft team while seven (33%) had never had their hearing tested prior to this study.

    CONCLUSION: Participants in this sample had poor outcomes in speech and hearing and received uncoordinated and fragmented cleft care. This finding calls for further large scale research and collaborative efforts into improving and providing centralised, multidisciplinary care for children born with CLP.

    Matched MeSH terms: Cleft Palate
  16. Ong HY, Ng JJ, Ong HJ, Wong SJ, Gopalan S
    Cureus, 2021 Feb 28;13(2):e13616.
    PMID: 33816015 DOI: 10.7759/cureus.13616
    A tooth in the nasal cavity is an uncommon phenomenon. The exact mechanism is unclear, and patients may present with non-specific nasal symptoms. We encountered a 24-year-old patient with history of cleft palate repair, presenting to us with unilateral nasal discharge not improving with conventional medications. Rigid nasal endoscopy revealed a rhinolith-like foreign body at the floor of the left nasal cavity. Removal of the rhinolith was done under general anesthesia, and it turned out to be an intranasal tooth. Intranasal tooth is often misdiagnosed due to its non-specific symptoms. Detailed dental and oropharyngeal examination as well as imaging studies are essential in diagnosing an intranasal tooth. Early surgical removal is the mainstay of treatment in order to prevent further complications. Patients with unilateral nasal symptoms not responding to conventional treatment require proper ear, nose, and throat (ENT) evaluation to rule out other pathology.
    Matched MeSH terms: Cleft Palate
  17. Yakob M, Hassan YR, Tse KL, Gu M, Yang Y
    PMID: 28092164 DOI: 10.1597/16-191
    Objective To test the reliability of the modified Huddart-Bodenham (MHB) numerical scoring system and its agreement with the GOSLON Yardstick categorization for assessing the dental arch relationships in unilateral cleft lip and palate (UCLP) cases. Design A retrospective study. Setting Faculty of Dentistry, The University of Hong Kong. Patients Forty-one nonsyndromic UCLP consecutive patients attending the Joint Cleft Lip/Palate Clinic at Faculty of Dentistry in the University of Hong Kong were selected. Interventions Study models at 8 to 10 years old (T1) and 10 to 12 years old (T2) were obtained from each patient. Main Outcome Measures Models were rated with the MHB scoring system and GOSLON Yardstick index. The intra- and interexaminer reliabilities as well as correlation of both scoring systems were evaluated. Furthermore, to investigate the outcome measurements consistency, the MHB scoring system and GOSLON Yardstick were independently used to compare the dental arch relationships from T1 to T2, with the samples split into intervention and nonintervention groups. Results The MHB scoring system presented good intra- and interexaminer agreement, which were comparable to those of the GOSLON Yardstick. The correlation between the MHB scoring system and GOSLON Yardstick scores was good. Both scoring systems showed similar results when assessing the change in the dental arch relationships from T1 to T2. Conclusions The MHB scoring system can be used as an alternative method to the commonly used GOSLON Yardstick for assessing dental deformities in UCLP patients. Both scoring systems showed similar results in assessing the improvement in dental arch relationships.
    Matched MeSH terms: Cleft Palate
  18. Rathmawati Ahmad, Normastura Abd Rahman, Ruhaya Hasan, Azizah Yusoff
    Malays J Nutr, 2017;23(2):239-252.
    MyJurnal
    Introduction: Appropriate oral health knowledge is essential to enable parents to be responsible for the oral health care of their children especially those with special needs. This study aimed to determine the oral health knowledge, attitude and practice (KAP) of parents and cariogenic food intake of their non-syndromic cleft lip with or without cleft palate children (NSCLP) compared to non-cleft children.

    Methods: A comparative cross-sectional study was conducted on randomly selected parents with children aged 1 to 6 years at Hospital Universiti Sains Malaysia and Kota Bharu Dental Clinic. A face-to-face interview using a validated questionnaire on oral health KAP and cariogenic food intake of their children was done. Data were analysed by using IBM SPSS version 22.0.

    Results: Sixty-four Malay parents with NSCLP (n=33) and non-cleft (n=31) children were recruited. The mean (SD) percentage score of oral health knowledge of parents in both groups (NSCLP and non-cleft) was fair, 59.5%(11.85) and 62.0%(15.00), P=0.4722; oral health attitude was good, 78.0% (9.30) and 80.2% (15.40), P=0.504; but oral health practice was poor 33.8% (5.94) and 36.1 (8.44), P=0.220. The cariogenic food frequency score was significantly higher in noncleft children; 40.2(10.32) compared to NSCLP children, 34.8(9.46), P=0.032.

    Conclusions: Parents of both groups had fair knowledge and good attitude but poor oral health practice. Cariogenic foods were consumed more by the non-cleft children. Oral health awareness among the parents needs to be strengthened towards good oral health attitude and practice and non-cariogenic food choices for the betterment of oral health status of their children.
    Matched MeSH terms: Cleft Palate
  19. Ghani, S.H.A., Hussain, R., Hassan, S., Tan, K.K., Ahmad, M.H.
    Ann Dent, 1996;3(1):-.
    MyJurnal
    The Combined Cleft Clinic at the University Hospital, Kuala Lumpur was organised in 1992. The team consists of Plastic Surgeon, Orthodontists, Speech therapist, Ear, Nose and Throat Surgeon, Audiologist, medical officers and the nurses. We attend the clinic on a regular basis. Specialists from other medical and dental disciplines as well as the members of the Cleft Lip and Palate Association of Malaysia (CLAPAM) do occasionally participate in this set-up.The team members formulate treatment plans for each cleft patient, monitor the patient's growth and development and manage the patient at different stages according to the individual needs. To date, the idea of team approach and an establishment of a centre towards management of cleft patients seem to be the most ideal as the patients are benefiting total treatment and care from various specialists from only one place. The experience of University Hospital as a centre for cleft patients is discussed.
    Matched MeSH terms: Cleft Palate
  20. Gopinath VK, Samsudin AR, Mohd Noor SNF, Mohamed Sharab HY
    Eur J Dent, 2017 4 25;11(1):76-82.
    PMID: 28435370 DOI: 10.4103/ejd.ejd_238_16
    OBJECTIVES: The aim of this study was to evaluate the vertical and sagittal facial profile and maxillary arch width, depth, and length of patients with unilateral cleft lip and palate (UCLP) and to compare them with healthy noncleft children in the mixed dentition stage (7-13 years).

    MATERIALS AND METHODS: This study is conducted at Hospital Universiti Sains Malaysia. UCLP group comprised 48 patients with nonsyndromic UCLP who have had the lip and palate repaired, whereas the control group comprised 48 healthy noncleft cases. The lateral cephalometrics measurements were used to determine the vertical height, sagittal depth of the face, and cranial base length and angle. Maxillary arch dimensions were measured on the study cast including arch width, depth, and length.

    RESULTS: Vertical facial height and sagittal depth measurements showed a significant decrease (P < 0.05) in the mean growth pattern in UCLP group. The anterior cranial base length (S-N) was shorter in UCLP children (P < 0.001), while Ba-N length had no significant difference (P = 0.639). Nasion-Sella Tursica-Basion angle was significantly higher in the UCLP group (P = 0.016). Dental arch width with reference to canine-to-canine and first premolar-to- first premolar distance was significantly larger in control (P = 0.001).

    CONCLUSION: Mean vertical and sagittal facial dimensions in the UCLP children who do not undergo orthodontic treatment are significantly lesser in all directions of growth than healthy noncleft children. The maxillary dental arch had a normal depth but constricted in width and arch length.

    Matched MeSH terms: Cleft Palate
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