Therapy For The Correction Of Cleft Lip And Palate

There may be a link between a popular seizure medication and birth defects such as cleft lip and cleft palate. According to the National Institute of Dental and Craniofacial Research, there were an annual number of clip lip with or without cleft palate case of 4,209 for the years 1999 to 2001. There has been an abundance of research done on clp. One interesting study is called, The syndrome of ankyloblepharon, ectodermal defects and cleft lip and palate: an autosomal dominant condition by R.J. HAY, R.S. WELLS
British Journal of Dermatology - Volume 94, Issue 3, pages 277289, March 1976. Here is an excerpt: Seven patients from four families are reported who had an inherited condition of which the main features were ankyloblepharon, ectodermal defects and cleft lip and palate. The ectodermal defects were partial or complete hair loss, absent or dystrophic nails, pointed widely spaced teeth and partial anhidrosis. Associated anomalies included lacrimal duct atresia, supernumerary nipples, syndactyly and auricular deformities. The inheritance of this abnormality was consistent with that of an autosomal dominant trait. The relationship between this and similar syndromes is discussed.

nother interesting study is called, Brief Communication Nature Genetics 29, 141142 (1 October 2001). Mutation of PVRL1 is associated with sporadic, non-syndromic cleft lip/palate in northern Venezuela Mehmet A. , Koji Suzuki , Marie M. Tolarova , Tania Bustos , Iglesias & Richard A. Spritz Here is an excerpt: Abstract - Non-syndromic cleft lip with or without cleft palate (CL/P, MIM 119530) is among the most common of major birth defects. Homozygosity for a nonsense mutation of PVRL1, W185X, results in an autosomal recessive CL/P syndrome on Margarita Island.

Another interesting study is called, Fetal cleft lip and palate detection by three-dimensional ultrasonography by W. Lee MD, J. S. Kirk, K. W. Shaheen, R. Romero, A. N. Hodges, C. H. Comstock - Ultrasound in Obstetrics & Gynecology Volume 16, Issue 4, pages 314320, 1 September 2000. Here is an excerpt: Abstract - Objectives - To demonstrate a standardized approach for the evaluation of cleft lip and palate by three-dimensional (3D) ultrasonography. Design - This was a retrospective study of seven fetuses with confirmed facial cleft anomalies. Post-natal findings were compared to a blinded review of 3D volume data from abnormal fetuses with seven other normal fetuses that were matched for gestational age. Upper lip integrity was examined by 3D multiplanar imaging. Sequential axial views were used to evaluate the maxillary tooth-bearing alveolar ridge contour and anterior tooth socket alignment. Alveolar ridge disruption suggested cleft palate. Premaxillary protrusion, either by multiplanar imaging or surface rendering, indicated bilateral cleft lip and palate. Results - Post-natal findings confirmed bilateral cleft lip and palate (four cases), unilateral cleft lip and palate (one case), and unilateral cleft lip (two cases). Multiplanar review identified all three fetuses with unilateral cleft lip, three of four fetuses with bilateral cleft lip, one fetus with unilateral cleft palate, and three of four fetuses with bilateral cleft palate. Surface rendering correctly identified all cleft lips, with the exception of one fetus, who was thought to have a unilateral cleft lip and palate, despite the actual presence of a bilateral lesion. One cleft palate defect was directly visualized by 3D surface rendering. No false-positives occurred.

Another study is called, Primary Correction of the Unilateral Cleft Lip Nose: A 15-Year Experience Plastic & Reconstructive Surgery - April 1986 - Volume 77 - Issue 4. Here is an excerpt: Abstract - This paper reviews a 15-year personal experience based on 400 unilateral cleft nasal deformities that were reconstructed using a method that repositions the alar cartilage by freeing it from the skin and lining and shifts it to a new position. The rotation-advancement lip procedure facilitates the exposure and approach to the nasal reconstruction. The nasal soft tissues are transected from the skeletal base, reshaped, repositioned, and secured by using temporary stent sutures that readapt the alar cartilage, skin, and lining. The nasal floor is closed and the ala base is positioned to match the normal side. Good subsequent growth with maintenance of the reconstruction has been noted in this series. The repair does not directly expose or suture the alar cartilage. Improvement in the cleft nasal deformity is noted in 80 percent of the cases. Twenty percent require additional techniques to achieve the desired symmetry. This method has been used by the author as his primary unilateral cleft nasal repair and has been taught to residents and fellows under his direction with good results. This technique eliminates the severe cleft nasal deformity seen in many secondary cases.

We all owe a debt of gratitude to these researchers for their fine work and dedication. For more information, please read the studies in their entirety.