Burden of cleft surgery —a 21-year follow-up of patients with cleft lip and palate
ConclusionsUnsurprisingly, both the inpatient and outpatient burdens of care are influenced by the complexity of the cleft and increase with worsening severity. Our results will help inform parents of the likely trajectory their child will face when diagnosed with each subtype of cleft. The 2014 data shows that modern cleft care is changing; a combination of reduced hospital stay and the addition of streamlined outpatient appointments will both be of great benefit. The influence of modern day life will hopefully reduce the associated burden that has been highlighted in this paper and it is vital the benefits of modernisation are communicated to parents as well.Level of evidence: Level III, risk/prognostic study.
Summary: Robin sequence is a congenital anomaly, first described by Pierre Robin as a triad of micrognathia, upper airway obstruction and glossoptosis. The most significant airway management technique is the use of distraction osteogenesis to advance the mandible. On the other hand, late complications such as permanent dentition loss and malformation of the damaged teeth have been reported. Therefore, long-term follow-up after mandibular distraction is important. In our case report, we describe 17 years of follow-up after mandibular distraction performed in a 4-month-old male infant with Robin sequence. The patient was a...
Peer support. Engaging exchanges on velopharyngeal surgery. Access to timely resources. SIG 5 offers all that and more. What would you say to encourage other colleagues to join SIG 5? Angela Dixon: For much of my career I was the only SLP in my state who specialized in cleft/craniofacial disorders. That was a lot of pressure and can be very isolating. It was difficult to not have an easy team of SLPs to learn from, bounce ideas off, etc. Joining SIG 5 provided that for me. I met a group of SLPs who had passions similar to mine, and SIG 5 allowed me an opportunity to network, learn, grow, and eventually even make friends. M...
CONCLUSIONS: Most patients with isolated cleft lip may not require long-term, longitudinal evaluation by cleft team specialists. Cleft teams should develop limited follow-up protocols for these children to improve resource allocation and promote value-based care in this patient population. PMID: 31961207 [PubMed - as supplied by publisher]
Infants with cleft palate or cleft lip and palate (CP/CLP) have specific feeding needs based upon unique anatomy and swallow physiology. Poor or absent inner oral pressure and compensatory muscle movements affect all phases—oral, pharyngeal, and esophageal—of swallowing, and in some cases, increase risk of aspiration. These babies expend a significant amount of energy in the act of feeding. They demonstrate an average rate of 109.26 sucks per minute compared to infants without clefts who averaged 75.07 sucks per minute. Increased energy expenditure might lead to fatigue. Under these conditions, infants experien...
Conclusions These findings suggest that young children with NSCL/P experience delays relative to their peers across multiple speech and language constructs. Differences between children with NSCL/P and their typically developing peers appear to decrease with age. Supplemental Material https://doi.org/10.23641/asha.11356904. PMID: 31841365 [PubMed - as supplied by publisher]
CONCLUSIONS: Seven-year-olds are direct and straightforward in their reactions to cleft palate speech characteristics. More pronounced signs of VPI and articulatory difficulties, also minor ones, are noted. Clinically, articulatory impairments may be more important to treat than minor signs of VPI. PMID: 31818136 [PubMed - as supplied by publisher]
ConclusionsThe amount of maxillary advancement does not affect the velopharyngeal function in cleft patients.
CONCLUSION: At age 5, poor speech outcomes with some differences between participating centers were seen but could not be attributed to surgical protocol. As one center had very few participants, the results from that center should be interpreted with caution. PMID: 31746642 [PubMed - as supplied by publisher]
We describe the management of the proband, which involved attempting to lengthen the palate and to retroposition the abnormally anteriorly directed velar musculature, along with speech therapy. PMID: 31607140 [PubMed - as supplied by publisher]