Displaying publications 1 - 20 of 26 in total

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  1. Trott JA, Mohan N
    Br J Plast Surg, 1993 Apr;46(3):215-22.
    PMID: 8490700
    This paper is a preliminary report on a strategy to perform open tip rhinoplasty at the time of lip repair in bilateral cleft lip and palate deformity. This method was devised to suit unique socio-economic circumstances in the Malaysian centre of Alor Setar. Of 8 cases having surgery in 1991, 7 returned for follow-up with results being documented photographically. It is concluded that this aggressive approach is justified in severe bilateral cleft lip and palate deformity because of the cost effectiveness of limiting the number of interventions. Furthermore, it provides optimally orientated nasal tip anatomy and reduces the social stigma of cleft lip nose appearance from the earliest possible time in the child's development.
    Matched MeSH terms: Cleft Lip/surgery*; Lip/surgery
  2. Arshad AR
    Cleft Palate Craniofac J, 1995 Mar;32(2):167-9.
    PMID: 7748879
    Midline cleft of the lower lip is defined as a midline vertical cleft of the soft tissue of the lower lip. It may present with a midline cleft of the mandible. It may also be accompanied by other congenital anomalies such as a cleft tongue, ankyloglossia, a heart lesion, and absence of the hyoid bone. The etiologic cause is thought to be a failure of mesodermal penetration into the midline structures of the first branchial arch. This case report is on a female child who presented with an incomplete midline cleft of the soft tissue of the lower lip. It was surgically corrected with a vertical wedge excision and primary closure.
    Matched MeSH terms: Lip/surgery
  3. Mourougayan V
    Cleft Palate Craniofac J, 2006 Nov;43(6):656-8.
    PMID: 17105330
    To study the quality of scars following the use of butyl cyanoacrylate to close the skin during cleft lip repair.
    Matched MeSH terms: Cleft Lip/surgery*; Lip/surgery
  4. 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/surgery*; Lip/surgery
  5. Normastura AR, Mohd Khairi MD, Azizah Y, Nizam A, Samsuddin AR, Naing L
    Med J Malaysia, 2008 Mar;63(1):21-5.
    PMID: 18935726
    The aim of this study was to determine the prevalence and association of speech disorders among operated cleft lip and palate children (CLP) in Northeast Malaysia. A comparative cross sectional study was performed on 98 operated CLP and 109 non-cleft subjects that aged between 3- 12-years-old. Data collection was done clinically and also by recording speech samples of each subject from both groups using a portable cassette recorder. Results showed that the prevalence of speech abnormality was 61.2% (95% CI: 51.41-71.04) and the risk of having speech abnormality was 174.5 times (95% CI: 23.04, 1320.67; P value < 0.001) in CLP children compared to non-cleft children. Therefore it was found that children with appropriately repaired CLP in Northeast Malaysia failed to have normal speech.
    Matched MeSH terms: Cleft Lip/surgery*
  6. Burezq H, Bang RL, George A, Mukhtar A
    J Craniofac Surg, 2007 Jul;18(4):971-4.
    PMID: 17667698
    Prominent premaxilla is one of the problems encountered when dealing with bilateral complete cleft lip and palate patients. Secondary alveolar bone grafting with these patients would achieve filling of the osseous defect, supports the alar base, eliminate the oro-nasal fistula and enhance the maxillary instability. This article describes the management of a bilateral cleft lip and palate patient with an extremely protruding premaxilla done in one stage surgery. To our knowledge, this is the first report of such degree of severity in the English literature.
    Matched MeSH terms: Cleft Lip/surgery*
  7. Patil PG, Nimbalkar-Patil SP
    J Prosthodont, 2018 Jan;27(1):94-97.
    PMID: 27002917 DOI: 10.1111/jopr.12464
    Bilateral cleft lip/cleft palate is associated with nasal deformities typified by a short columella. The presurgical nasoalveolar molding (NAM) therapy approach includes reduction of the size of the intraoral alveolar cleft as well as positioning of the surrounding deformed soft tissues and cartilages. In a bilateral cleft patient, NAM, along with columellar elongation, eliminates the need for columellar lengthening surgery. Thus the frequent surgical intervention to achieve the desired esthetic results can be avoided. This article proposes a modified activation technique of the nasal stent for a NAM appliance for columellar lengthening in bilateral cleft lip/palate patients. The design highlights relining of the columellar portion of the nasal stent and the wire-bending of the nasal stent to achieve desirable results within the limited span of plasticity of the nasal cartilages. With this technique the vertical taping of the premaxilla to the oral plate can be avoided.
    Matched MeSH terms: Cleft Lip/surgery*
  8. Goldstein MH
    Plast Reconstr Surg, 1990 Mar;85(3):446-52.
    PMID: 2304997
    These cases illustrate a new concept in lip repair. This approach recognizes the great inherent elasticity of the oral cavity and takes advantage of the florid blood supply of the region. Recent laboratory studies of Taylor et al., as well as the works of Manchot and Salmon, are combined with anthropologic observations of tribal customs to formulate another way of looking at lip reconstruction. Triangularization of surgical defects, lip switching, and mobilization of distant flaps are avoided by taking advantage of stretched local tissues. Preoperative expansion is discussed as a future option.
    Matched MeSH terms: Lip/surgery*
  9. 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 Lip/surgery*
  10. 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 Lip/surgery*
  11. 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 Lip/surgery*
  12. 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 Lip/surgery*
  13. 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 Lip/surgery*
  14. Haque S, Alam MK, Khamis MF
    BMC Pediatr, 2017 May 06;17(1):119.
    PMID: 28477625 DOI: 10.1186/s12887-017-0870-4
    BACKGROUND: Cleft lip and palate (CLP) is one of the most common birth defects. Multiple factors are believed to be responsible for an unfavorable dental arch relationship in CLP. Facial growth (maxillary) retardation, which results in class III malocclusion, is the primary challenge that CLP patients face. Phenotype factors and postnatal treatment factors influence treatment outcomes in unilateral cleft lip and palate (UCLP) children, which has led to a great diversity in protocols and surgical techniques by various cleft groups worldwide. The aim of this study was to illustrate the dental arch relationship (DAR) and palatal morphology (PM) of UCLP in Bangladeshi children and to explore the various factors that are responsible for poor DAR and PM.

    METHODS: Dental models of 84 subjects were taken before orthodontic treatment and alveolar bone grafting. The mean age was 7.69 (SD 2.46) years. The DAR and PM were assessed blindly by five raters using the EUROCRAN index (EI). Kappa statistics was used to evaluate the intra- and inter-examiner agreement, chi square was used to assess the associations, and logistic regression analysis was used to explore the responsible factors that affect DAR and PM.

    RESULTS: The mean EUROCRAN scores were 2.44 and 1.93 for DAR and PM, respectively. Intra- and inter-examiner agreement was moderate to very good. Using crude and stepwise backward regression analyses, significant associations were found between the modified Millard technique (P = 0.047, P = 0.034 respectively) of cheiloplasty and unfavorable DAR. Complete UCLP (P = 0.017) was also significantly correlated with unfavorable DAR. The PM showed a significant association with the type of cleft, type of cheiloplasty and type of palatoplasty.

    CONCLUSION: This multivariate study determined that the complete type of UCLP and the modified Millard technique of cheiloplasty had significantly unfavorable effects on both the DAR and PM.

    Matched MeSH terms: Cleft Lip/surgery
  15. 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 Lip/surgery*
  16. Suhaili DN, Somasundaram S, Lau SH, Ajura AJ, Roslan AR, Ramli R
    Int J Pediatr Otorhinolaryngol, 2011 Jan;75(1):131-3.
    PMID: 21067822 DOI: 10.1016/j.ijporl.2010.10.004
    Diprosopus or duplication of the lower lip and mandible is a very rare congenital anomaly. We report this unusual case occurring in a girl who presented to our hospital at the age of 4 months. Surgery and problems related to this anomaly are discussed.
    Matched MeSH terms: Lip/surgery
  17. Abu-Rub N, Samsudin AR, Abdullah AB, Abdullah N
    Aust Orthod J, 2005 May;21(1):39-43.
    PMID: 16433080
    Presurgical orthopaedics has been employed since the 1950s as an adjunctive neonatal therapy for the correction of cleft lip and palate. It is accepted that presurgical orthopaedic plates facilitate lip repair and balanced orofacial growth.
    Matched MeSH terms: Cleft Lip/surgery
  18. Goh BS, Tang CL, Hashim ND, Annamalay T, Abd Rahman FN
    PMID: 30578988 DOI: 10.1016/j.ijporl.2018.12.010
    OBJECTIVE: There is a dearth of studies on long term hearing status and behavioural patterns among cleft lip and/or palate children after their primary lip and palate closure in Malaysia. This study describes the audiology status and behavioural patterns in a group of school aged children with cleft lip and/or palate.

    METHOD: A cross sectional study was carried out where caretakers of cleft lip and/or palate were asked to complete the translated Malay language version of Strength Difficulties Questionnaire. The hearing status of the children was analyzed based on recent pure tone audiometric and tympanogram results. The patients' age, gender, type of cleft pathology, age of palatal surgery and behavioural patterns were examined for their potential relationship with hearing status.

    RESULTS: A total of 74 children (148 ears) aged between 7 and 17 years with cleft lip and/or palate were recruited. The result showed 37 ears (25.0%) had hearing loss with majority suffered from mild conductive hearing loss. There were 16 ears (10.8%) that had persistent middle ear effusion. Hearing improvement occurred when palatal repair was performed at the age of less than 1 year old. (p = 0.015) There was no significant relationship between patients' gender, age, type of cleft and history of myringotomy with their hearing status. In terms of behavioural patterns, 16.3% were abnormal for total behavioural score, 39.2% for peer problem and 17.6% for conduct problem. For prosocial behaviour, 16.3% were rated low and very low. There was fair correlation between age and hyperactivity problems (r = 0.44). Patients' gender, type of cleft pathology, had been teased apart and hearing status was found not related to behavioural problems.

    CONCLUSION: Cleft lip and/or palate patients have a good longterm hearing outcome. Majority had normal hearing and if there is hearing impairment, it is only a mild loss. Early palatal repair surgery before the age of 1 year can significantly reduce the risk of hearing loss. Cleft lip and/or palate patients experienced peer problems. There was no significant correlation between behavioural difficulty and hearing status among school-aged children with cleft lip and palate.

    Matched MeSH terms: Cleft Lip/surgery*
  19. Zreaqat M, Hassan R, Halim AS
    Cleft Palate Craniofac J, 2009 May;46(3):326-30.
    PMID: 19642750 DOI: 10.1597/07-210.1
    To determine the treatment outcome based on dentoalveolar relationships among Malay children born with nonsyndromic complete unilateral cleft lip and palate (UCLP).
    Matched MeSH terms: Cleft Lip/surgery*
  20. Noor SN, Musa S
    Cleft Palate Craniofac J, 2007 May;44(3):292-303.
    PMID: 17477746
    OBJECTIVES: Determination of the psychosocial status and assessment of the level of satisfaction in Malaysian cleft palate patients and their parents.
    DESIGN: Cross-sectional study.
    PARTICIPANTS AND METHODS: Sixty cleft lip and palate patients (12 to 17 years of age) from Hospital Universiti Sains Malaysia and their parents were selected. The questionnaires used were the Child Interview Schedule, the Parents Interview Schedule, and the Cleft Evaluation Profile (CEP), administered via individual interviews.
    RESULTS: Patients were teased because of their clefts and felt their self-confidence was affected by the cleft condition. They were frequently teased about cleft-related features such as speech, teeth, and lip appearance. Parents also reported that their children were being teased because of their clefts and that their children's self-confidence was affected by the clefts. Both showed a significant level of satisfaction with the treatment provided by the cleft team. There was no significant difference between the responses of the patients and their parents. The features that were found to be most important for the patients and their parents, in decreasing order of priority, were teeth, nose, lips, and speech.
    CONCLUSIONS: Cleft lip and/or palate patients were teased because of their clefts, and it affected their self-confidence. The Cleft Evaluation Profile is a reliable and useful tool to assess patients' level of satisfaction with treatment received for cleft lip and/or palate and can identify the types of cleft-related features that are most important for the patients.
    Matched MeSH terms: Cleft Lip/surgery
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