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An exploratory study on speech and hearing outcomes in children with cleft lip and palate

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 Lip
Parameatal Cyst : A report of Two Cases and Review of Literature

Sinha RK, Mukherjee S, Mitra N, Saha B, Kumar J

Malays J Med Sci, 2015 Nov;22(6):71-73.
PMID: 28223890

Cyst formation in the parameatal area is a relatively rare entity and not many cases have been reported in the literature. Two such cases are reported here. First patient was a 46 year old sexually active male who developed a spherical, cystic swelling of 1 cm in size on right lip of external urethral meatus. The second case was a 4 year old boy who presented with asymptomatic recurrent left parameatal swelling. In both the cases, cysts were completely excised and defects were sutured. Histologically, the cyst walls were lined by tall squamous and columnar epithelium. Good cosmetic results were obtained in these two cases without any recurrence at 2 two months follow up.

Matched MeSH terms: Lip
Screening of Transforming Growth Factor Beta 3 and Jagged2 Genes in the Malay Population With Nonsyndromic Cleft Lip With or Without Cleft Palate

Ghazali N, Rahman NA, Kannan TP, Jaafar S

Cleft Palate Craniofac J, 2015 07;52(4):e88-94.
PMID: 26151095 DOI: 10.1597/14-024

OBJECTIVE: To determine the prevalence of mutations in transforming growth factor beta 3 (TGFβ3) and Jagged2 genes and their association with nonsyndromic cleft lip with or without cleft palate (CL±P) patients.

DESIGN: Cross-sectional study on nonsyndromic CL±P and noncleft patients.

SETTING: Reconstructive clinic and outpatient dental clinic, Hospital Universiti Sains Malaysia.

PATIENTS: Blood samples of 96 nonsyndromic CL±P and 96 noncleft subjects.

MAIN OUTCOME MEASURE: Prevalence and association of mutations in TGFβ3 and Jagged2 genes with nonsyndromic CL±P.

RESULTS: Most of the nonsyndromic CL±P patients (53.1%) had left unilateral CLP. There were slightly more females (56.6%) compared with males. The prevalence of the mutations in the TGFβ3 gene was 17.7% (95% confidence interval [CI]: 9.5, 24.5) and in the Jagged2 gene was 12.5% (95% CI: 5.5, 18.5), which was higher compared with the noncleft group. For the TGFβ3 gene, there was no mutation in the coding region in either of the groups. All variants were single nucleotide polymorphisms located within the intronic flanking region. Two variants were identified (g.15812T>G and g.15966A>G) in both nonsyndromic CL±P and noncleft patients. However, the association was not significant (P > .05). Three variants (g.19779C>T, g.19547G>A, and g.19712C>T) were identified in the Jagged2 gene among nonsyndromic CL±P and noncleft patients. Only g.19712C>T showed a significant association with nonsyndromic CL±P patients (P = .039).

CONCLUSION: g.19712C>T might play a crucial role in the development of cleft lip and palate. To the best of our knowledge, this is the first report of the mutation found within intron 13 of the Jagged2 gene among nonsyndromic CL±P Malay patients.

Study site:Reconstructive and outpatient dental clinic, Hospital Universiti Sains Malaysia (HUSM)

Matched MeSH terms: Cleft Lip/genetics*
Cyprinid fishes of the genus Neolissochilus in Peninsular Malaysia

Khaironizam MZ, Akaria-Ismail M, Armbruster JW

Zootaxa, 2015;3962(1):139-57.
PMID: 26249381 DOI: 10.11646/zootaxa.3962.1.7

Meristic, morphometric and distributional patterns of cyprinid fishes of the genus Neolissochilus found in Peninsular Malaysia are presented. Based on the current concept of Neolissochilus, only two species are present: N. soroides and N. hendersoni. Neolissochilus hendersoni differs from N. soroides by having lower scale and gill raker counts. Neolissochilus soroides has three mouth types (normal with a rounded snout, snout with a truncate edge, and lobe with a comparatively thick lower lip). A PCA of log-transformed measurements did not reveal significant differences between N. hendersoni and N. soroides, or between any of the morphotypes of N. soroides; however, a CVA of log-transformed measurements successfully classified 87.1% of all specimens. Removing body size by running a CVA on all of the principal components except PC1 (which was correlated with length) only slightly decreased the successful classification rate to 86.1%. Differences in morphometrics were as great between the three morphotypes of N. soroides as between any of the morphotypes and N. hendersoni suggesting that the morphotypes should be examined in greater detail with genetic tools. The PCA of morphometrics revealed separate clouds for N. hendersoni and N. soroides, but no differences between the N. soroides morphotypes. This study revealed that N. hendersoni is recorded for the first time in the mainland area of Peninsular Malaysia. Other nominal species of Neolissochilus reported to occur in the river systems of Peninsular Malaysia are discussed. Lissochilus tweediei Herre in Herre & Myers 1937 and Tor soro Bishop 1973 are synonyms of Neolissochilus soroides.

Matched MeSH terms: Lip
Fulltext An overview of indices used to measure treatment effectiveness in patients with cleft lip and palate

Haque S, Alam MK, Arshad AI

Malays J Med Sci, 2015 Jan-Feb;22(1):4-11.
PMID: 25892945 MyJurnal

In the contemporary era, the demand for orthodontic treatment is ever rising. Orthodontic treatment duration can range from a year to a few years. Our aim is to assess the available techniques of categorising treatment effectiveness in patients with cleft lip and palate (CLP) and to study their effect on improvement of treatment outcomes. The electronic databases including Medline-PUBMED, Science Direct, and ISI Web of Knowledge were searched from 1987 to 2013, and 40 311 relevant articles were found. Of these, we identified 22 articles including original articles as well as literature reviews. The different parameters and indices that are applied to speed-up orthodontic treatment outcomes in patients with CLP were identified as the GOSLON Yardstick, 5-year-old index, EUROCRAN index, Huddart Bodenham system, modified Huddart Bodenham system, GOAL Yardstick and, Bauru-Bilateral Cleft Lip and Palate Yardstick. This overview can create better awareness regarding the uses, advantages, and disadvantages of the different indices. It can enable better assessment and provide the impetus needed for a sustained upgrade in the standards of care for CLP in daily orthodontics.

Matched MeSH terms: Cleft Lip
Fulltext Common dental anomalies in cleft lip and palate patients

Haque S, Alam MK

Malays J Med Sci, 2015 Mar-Apr;22(2):55-60.
PMID: 26023296 MyJurnal

Cleft lip and palate (CLP) is the most common orofacial congenital malformation in live births. CLP can occur individually or in combination with other congenital deformities. Affected patients experience a number of dental, aesthetic, speech, hearing, and psychological complications and have a higher incidence of severe dental conditions. The purpose of this study is to characterise the different types of dental anomalies that are frequently associated with CLP patients based on a literature survey.

Matched MeSH terms: Cleft Lip
Fulltext Extensive lip ulcers: a case report. Erythema multiforme

Chean KY

Aust Fam Physician, 2014 Jul;43(7):443-4.
PMID: 25006604
Matched MeSH terms: Lip/pathology*; Lip Diseases/diagnosis*; Lip Diseases/etiology
Three-dimensional quantitative evaluation of facial morphology in adults with unilateral cleft lip and palate, and patients without clefts

Othman SA, Ahmad R, Asi SM, Ismail NH, Rahman ZA

Br J Oral Maxillofac Surg, 2014 Mar;52(3):208-13.
PMID: 24342372 DOI: 10.1016/j.bjoms.2013.11.008

The aims of this study were to assess the quantitative values of measurements using proportion indices in the craniofacial region in patients with repaired, non-syndromic, complete unilateral cleft lip and palate (UCLP), and compare them with a control group who did not have clefts using the non-invasive systems of 3-dimensional technology. Three-dimensional measurements of the facial surfaces of 15 Malay patients who had UCLP repaired and 100 Malay control patients aged 18-25 years were analysed. The 3-dimensional images of the respondents' faces were captured using the VECTRA-3D Stereophotogrammetry System. Eleven craniofacial proportions were assessed using a combination of 18 linear measurements obtained from 21 anthropometric soft tissue landmarks. These measurements were used to produce proportion indices to find the differences in the morphological features between the groups, and assessed using the independent sample t test and z scores. There were significant differences between the groups in 7 out of 11 craniofacial proportion indices (p=0.001-0.044). Z scores of 2 indices were disproportionate. They were nasal index (which was severely supernormal) and upper lip index (which was moderately supernormal). Patients with UCLP had higher mean z scores, indicating that patients with UCLP tended to have larger faces than the control group. There were clinically important differences mainly in the nasolabial area, where the nose and the upper lip were wider, larger, or flatter in patients with UCLP.

Matched MeSH terms: Cleft Lip/pathology*; Lip/pathology
Fulltext Anaphylactic shock following the bite of a wild Kayan slow loris (Nycticebus kayan): implications for slow loris conservation

Madani G, Nekaris KA

J Venom Anim Toxins Incl Trop Dis, 2014;20(1):43.
PMID: 25309586 DOI: 10.1186/1678-9199-20-43

BACKGROUND: Asian slow lorises (Nycticebus spp.) are one of few known venomous mammals, yet until now only one published case report has documented the impact of their venomous bite on humans. We describe the reaction of a patient to the bite of a subadult Nycticebus kayan, which occurred in the Mulu District of Sarawak in 2012.

FINDINGS: Within minutes of the bite, the patient experienced paraesthesia in the right side of the jaw, ear and right foot. By 40 minutes, swelling of the face was pronounced. The patient was admitted to Mulu National Park Health Clinic/Klinik Kesihatan Taman Mulu Tarikh, at which time he was experiencing: swollen mouth, chest pain, mild abdominal pain, nausea, numbness of the lips and mouth, shortness of breath, weakness, agitation and the sensation of pressure in the ears due to swelling. The blood pressure was 110/76, the heart ratio was 116 and oxygen saturation was 96%. The patient was treated intramuscularly with adrenaline (0.5 mL), followed by intravenous injection of hydrocortisone (400 mg) and then intravenous fluid therapy of normal saline (500 mg). By 8 h10 the next day, the patient's condition had significantly improved with no nausea, and with blood pressure and pulse rate stable.

CONCLUSIONS: A handful of anecdotes further support the real danger that slow loris bites pose to humans. As the illegal pet trade is a major factor in the decline of these threatened species, we hope that by reporting on the danger of handling these animals it may help to reduce their desirability as a pet.

Matched MeSH terms: Lip
Fulltext Swelling on the inner aspect of the lower lip

Irfan M, Nik Azrizie M, Suzina SAH

Malays Fam Physician, 2014;9(2):64.
PMID: 25893070
Matched MeSH terms: Lip Diseases*
Fulltext Occlusal features of 12 years old Malaysian Malay school-children in Shah Alam

Elfseyie, Majda T.M., Nagham Mohammed Abdullah, Mohamed Ibrahim Abu Hassan

Compendium of Oral Science, 2014;1(1):6-12.
MyJurnal

Objectives: To assess the occlusal features, tongue habits, lip competence and their gender dimorphism in 12 years old Malaysian Malay school-children.

Materials and methods: The method involved cl inical examination of 208 subjects from public schools in Shah Alam, Selangor, Malaysia. Occlusal status was assessed according to Angle classification. The following features were also assessed and recorded: overjet, overbite, traumatic overbite, crowding, spacing, midline diastema, cross bite, scissors bite, dental midline shifts, canine displacement, missing teeth, traumatically fractured teeth, tongue thrust and lip competence. Descriptive statistics were used for all measurements; Chi-square was used to assess gender differences.

Results: Class I malocclusion is most prevalent in boys and girls (44.0% and 43.8% respectively), followed by Class Ill malocclusion (31% in boys and 30 .4% in girls). Anterior crowding was found in 69.7% of the sample while anterior spacing was found in 30.8%. Incompetent lips were more common in boys than gir1s.

Conclusions: The prevalence of malocclusion in this age group may warrant the need for more preventive and interceptive measures in dental and oral health planning.

Matched MeSH terms: Lip
Postnatal treatment factors affecting craniofacial morphology of unilateral cleft lip and palate (UCLP) patients in a Japanese population

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 Lip/pathology; Cleft Lip/surgery*; Lip/surgery
Fulltext Assessment of nutrient intake in cleft lip and palate children after surgical correction

Gopinath VK

Malays J Med Sci, 2013 Oct;20(5):61-6.
PMID: 24643339 MyJurnal

This research aimed to compare the nutrient intake of children with cleft lip and palate (CLP) with that of normal children (without CLP) in the same age groups. The study was conducted at the School of Dental Sciences, Universiti Sains Malaysia, Kelantan, Malaysia. A total of 139 children, of both sexes, from two to six years of age, either with CLP (40 children) or without CLP (99 children), were selected. The CLP and non-CLP children were grouped according to age, which is a key determinant of nutrient intake. Children in subgroup I were between the ages of 2 and 4 years, the group comprising 48 normal children of mean age 39.85 months (SD 7.1), and 20 CLP children of mean age 37.05 months (SD 5.9). Children in subgroup II were those over 4 years and up to 6 years old, and the group comprised 51 normal children, of mean age 64.16 months (SD 7.9), and 20 CLP children of mean age 56.75 months (SD 9.9). A comparative cross-sectional study was conducted to evaluate nutrient intake in subgroups I and II, using a 24 hours diet recall method. The nutrient intake of CLP children was shown to have no significant differences from that of normal children. A comparison of intake per day with Recommended Dietary Allowances (RDA) for Malaysian children showed that the consumption of nutrients was inadequate in both the normal and CLP children, in both age sub-groups.

Matched MeSH terms: Cleft Lip
Fulltext A novel technique for the management of blandin-nuhn mucocele: a case report

Kumaresan R, Karthikeyan P, Mohammed F, Thapasum Fairozekhan A

Int J Clin Pediatr Dent, 2013 Sep;6(3):201-4.
PMID: 25206223 DOI: 10.5005/jp-journals-10005-1219

Mucocele, a common benign cystic lesion of minor salivary gland and associated ducts develops following extravasation or retention of mucous material in the subepithelial tissue. Occurrence of mucocele of tongue is considered less frequent when compared to a higher incidence of mucocele in the lower lip of young patients. Different modalities of treatment, such as conventional surgical excision followed by newer techniques like cryosurgery, electrocautery have been proposed to completely remove the lesion and reduce the chances of recurrence. Herewith, we report a novel treatment technique using alginate impression material to aid in complete excision of mucocele of glands of Blandin-Nuhn. How to cite this article: Kumaresan R, Karthikeyan P, Mohammed F, Fairozekhan TA. A Novel Technique for the Management of Blandin-Nuhn Mucocele: A Case Report. Int J Clin Pediatr Dent 2013;6(3):201-204.

Matched MeSH terms: Lip
Reproducibility of facial soft tissue landmarks on facial images captured on a 3D camera

Othman SA, Ahmad R, Mericant AF, Jamaludin M

Aust Orthod J, 2013 May;29(1):58-65.
PMID: 23785939

Fast and non-invasive systems of the three-dimensional (3D) technology are a recent trend in orthodontics. The reproducibility of facial landmarks is important so that 3D facial measurements are accurate and may-be applied clinically. The aim of this study is to evaluate the reproducibility of facial soft tissue landmarks using a non-invasive stereo-photogrammetry 3D camera.

Matched MeSH terms: Lip/anatomy & histology
OHSAS 18001 and MS 1722 Certification initiatives prove the commitment to sustainability

Wai Onn Hong

Journal of Occupational Safety and Health, 2013;10(2):27-36.
MyJurnal

Malaysia’s palm oil industry is growing in complexity and successively to succeed on the global level by accounts for about 36% of the word production of palm oil [1]. But, Occupational Health and Safety (OHS) issues are still problematic areas that need to be addressed by all parties concerned in this industry. In the olden days, unlike construction or manufacturing industry, palm oil industry was green in OHS management system. However, due to stringent in the legislative enforcement in the past few years, it has lead some of the plantation companies to develop OHS management system, which are based on Occupational Health and Safety Assessment Series (OHSAS), towards corporate sustainability. Sustainability is not about paying lip-service to the latest corporate buzzword; neither is it about superficially meeting minimum requirements for the sake of compliance. Rather, sustainability is a core value that lies at the heart of the companies’ business conduct. In practical terms, this means strive to operate with due consideration for the interest of all stakeholders by making the health and safety of all workers a priority. This paper describes the certification of OHSAS 18001 and MS 1722 in Genting Plantations Berhad (GENP) prove the commitment to sustainability by forming guiding principle on safety management. Further, this paper also demonstrates that the implementation of safety management can help to reduce the accident rate, especially fatal accident.

Matched MeSH terms: Lip
Stereophotogrammetric analysis of nasolabial morphology among Asian Malays: influence of age and sex

Al-Khatib AR, Rajion ZA, Masudi SM, Hassan R, Anderson PJ, Townsend GC

Cleft Palate Craniofac J, 2012 Jul;49(4):463-71.
PMID: 22236217 DOI: 10.1597/11-151

It is clear that population-specific norms should be used when planning plastic and reconstructive surgery for selected patients. In this study, we aimed to generate nasal and labial reference values by applying a stereophotogrammetric technique. A further aim was to investigate the effect of sexual dimorphism, age-related changes, and the interrelation between nasal and labial morphology.

Matched MeSH terms: Lip/anatomy & histology*
Facial dimensions of Malay children with repaired unilateral cleft lip and palate: a three dimensional analysis

Zreaqat M, Hassan R, Halim AS

Int J Oral Maxillofac Surg, 2012 Jun;41(6):783-8.
PMID: 22424709 DOI: 10.1016/j.ijom.2012.02.003

This comparative cross-sectional study assessed the facial surface dimensions of a group of Malay children with unilateral cleft lip and palate (UCLP) and compared them with a control group. 30 Malay children with UCLP aged 8-10 years and 30 unaffected age-matched children were voluntarily recruited from the Orthodontic Specialist Clinic in Hospital Universiti Sains Malaysia (HUSM). For the cleft group, lip and palate were repaired and assessment was performed prior to alveolar bone grafting and orthodontic treatment. The investigation was carried out using 3D digital stereophotogrammetry. 23 variables and two ratios were compared three-dimensionally between both groups. Statistically significant dimensional differences (P<0.05) were found between the UCLP Malay group and the control group mainly in the nasolabial region. These include increased alar base and alar base root width, shorter upper lip length, and increased nose base/mouth width ratio in the UCLP group. There were significant differences between the facial surface morphology of UCLP Malay children and control subjects. Particular surgical procedures performed during primary surgeries may contribute to these differences and negatively affect the surgical outcome.

Matched MeSH terms: Cleft Lip/pathology*; Cleft Lip/surgery; Lip/pathology
Mutation screening of IRF6 among families with non-syndromic oral clefts and identification of two novel variants: review of the literature

Salahshourifar I, Wan Sulaiman WA, Halim AS, Zilfalil BA

Eur J Med Genet, 2012 Jun;55(6-7):389-93.
PMID: 22440537 DOI: 10.1016/j.ejmg.2012.02.006

Non-syndromic oral clefts share the main clinical features of Van der Woude Syndrome (VWS), with the exception of the lower lip pit. Thus, about 15% of VWS cases are indistinguishable from cases with non-syndromic oral clefts. IRF6 mutations are the major cause of VWS; however, variants in this gene show strong association with non-syndromic oral clefts, with a higher increased risk among cases with cleft lip only (CLO). A total of 39 individuals, including 16 patients with CLO and 23 patients with a family history of cleft, were examined for IRF6 mutations in the present study. Seven variants, including five known (c.-75-4 A>; G, c.-73T>; C, c.459G>; T 5, c.820G>; A, and c.1060 + 37C>; T) and two novel (c.-75-23G>; C and c.1380G>; T), were found. Both novel variants were inherited from non-affected parents and we did not find also in the 120 control chromosomes. In silico analysis revealed that both c.1380G>; T and c.-75-23G>; C variants may disrupts a putative exonic splicing enhancer and intronic splicing binding site for SC35, respectively. Taken together, the presence of deleterious IRF6 variants in patients with non-syndromic oral clefts could be most likely an evidence for VWS. While, IRF6 variants could, at best, contribute to clefting as part of a complex inheritance pattern, with both additional genes and environmental factors having a role.

Matched MeSH terms: Cleft Lip/genetics*
The nasopharynx in infants with cleft lip and palate

Rajion ZA, Al-Khatib AR, Netherway DJ, Townsend GC, Anderson PJ, McLean NR, et al.

Int J Pediatr Otorhinolaryngol, 2012 Feb;76(2):227-34.
PMID: 22136741 DOI: 10.1016/j.ijporl.2011.11.008

The purpose of this study was to use three-dimensional computed tomography data and computer imaging technology to assess the skeletal components of the naso-pharyngeal area in patients with cleft lip and palate and to quantify anatomical variations.

Matched MeSH terms: Cleft Lip/physiopathology; Cleft Lip/radiography*

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