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Embryological Development Disorders
Published in R James A England, Eamon Shamil, Rajeev Mathew, Manohar Bance, Pavol Surda, Jemy Jose, Omar Hilmi, Adam J Donne, Scott-Brown's Essential Otorhinolaryngology, 2022
Cleft palate: Defect of secondary palateMay be incomplete, complete, bilateral, unilateral, or submucous
A Study of Facial Growth in Patients with Unilateral Cleft Lip and Palate Treated by the Oslo CLP Team
Published in Niall MH McLeod, Peter A Brennan, 50 Landmark Papers every Oral & Maxillofacial Surgeon Should Know, 2020
The subsequent repair of the remaining posterior cleft palate was carried out using a von Langenbeck repair in all patients. Lateral palatal release incisions were therefore performed in all patients, a muscle dissection was included, and the pterygoid hamuli were routinely in-fractured. The posterior cleft palate repair was initially undertaken at 3–4 years, but this gradually reduced during the study period and by 1974 all palate repairs were completed by 18 months of age. Bone grafting of the alveolar cleft was introduced in 1977 and carried out on patients between 8 and 11 years of age. Secondary cleft lip and nose revision was carried out in almost all patients, usually after completion of orthodontics (around 15 years of age). When required, surgery for velopharyngeal insufficiency was carried out preferably before the child started school (7 years of age) using a superiorly based pharyngeal flap.
Phenobarbital
Published in Stanley R. Resor, Henn Kutt, The Medical Treatment of Epilepsy, 2020
Teratogenicity probably occurs during barbiturate treatment in pregnancy. As with other AEDs, the overall risk of a malformation is about twice that of the normal population. Cleft palate and cardiac anomalies are the most frequent complications. Pregnancy should always be discussed with women of child-bearing age being treated with AEDs.
Epidermal growth factor signalling pathway in endochondral ossification: an evidence-based narrative review
Published in Annals of Medicine, 2022
L. Mangiavini, G. M. Peretti, B. Canciani, N. Maffulli
More recently, in vivo models have been analysed to confirm the essential role of the EGF pathway in bone growth. EGFR knockout mice were stillbirth or lived only up to 6–8 days, displaying epithelial alterations and dysfunctions in several tissues, such as lungs and intestine. Interestingly, up to one-third of those mice had cleft palates, from retardation in skeletal development [98,99]. In humans, the cleft palate has been associated with polymorphism in TGFA gene, encoding for TGF-α, thus linking this condition to the EGF pathway [100]. Palate growth requires a correct development of the mandibular Meckel’s cartilage, and palate explants of Egfr-\- mice showed a decrease in the dimensions of Meckel’s cartilage, with the presence of undifferentiated cells with lower content of proteoglycans, consistent with an EGF-dependent modulation of chondrogenesis [101]. MMPs, downstream targets of EGF, mediate this phenotype [101]. Moreover, in vitro culture of palate organoids with human MSCs from the umbilical cord demonstrated that EGF significantly promoted proliferation, further proving its involvement in osteogenesis [102]. EGF-like protein signalling has also been associated with other human conditions characterised by growth retardation and skeletal abnormalities from impaired endochondral ossification [103,104].
Long-term outcomes in children with and without cleft palate treated with tympanostomy for otitis media with effusion before the age of 2 years
Published in Acta Oto-Laryngologica, 2020
Maki Inoue, Mariko Hirama, Shinji Kobayashi, Noboru Ogahara, Masahiro Takahashi, Nobuhiko Oridate
Otitis media with effusion (OME) is common in infants with cleft palate due to Eustachian tube (ET) dysfunction [1]. Various studies have reported that up to 90% and more of children with cleft palate may suffer from OME [2,3]. In children with cleft palate, ET dysfunction is probably caused by abnormal insertion of the tensor veli and levator veli palatini muscles. The tensor veli palatini muscle is involved in middle ear ventilation through the ET opening mechanism. Velopharyngeal disclosure, owing to the levator veli palatini muscle impairment, may also lead to ET dysfunction, specifically related to peritubal lymphoid hyperplasia, resulting from soiling of the nasal cavity with food [1]. Additionally, poor ventilation of the middle ear cavity owing to ET dysfunction causes negative pressure and retraction of the tympanic membrane (TM), thus leading to OME.
Cone beam computed tomography imaging of superior semicircular canal morphology: a retrospective comparison of cleft lip/palate patients and normal controls
Published in Acta Odontologica Scandinavica, 2018
Oğuzhan Altun, Suayip Burak Duman, Ibrahim Sevki Bayrakdar, Yasin Yasa, Sacide Duman, Sevcihan Günen Yılmaz
Cleft lip and palate (CL/P) is a common birth defect (∼9.1 cases per 10,000 births) and varies by ethnic group, geographical location and socioeconomic conditions [1]. A cleft palate is attributable to complete or incomplete assembly of the medial nasal prominence(s) on one or both sides [2]. A CL/P compromises hearing, speech and facial configuration. For several reasons, it is essential to explore the relationship between CL/P and other malformations. In addition, the association of CL/P with other congenital anomalies would increase our understanding of the embryogenic situation underlying the malformation [3]. Children with CL/P experience feeding difficulties, dental anomalies (e.g. tooth agenesis or supernumary teeth) and an increased risk of infection; they may also eventually develop speech and socio-psychological problems because they are stigmatized. A CL/P occurs more often in newborn males than females. Although facial regions near the cleft may experience delayed growth, surgical intervention allows individuals born with a CL/P to exhibit craniofacial, catch-up skeletal growth [4,5]. As a CL/P can affect maxillofacial bone structure, we explored whether semicircular canal dehiscence (SSCD) is more common in CL/P patients than normal controls.