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Copyright of Nouveau Praticien Vétérinaire Canine & Féline is the property of EDP Sciences and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Nouveau Praticien Vétérinaire - Équine is the property of EDP Sciences and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revue d'Orthopédie Dento-Faciale is the property of Parresia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Pierre Robin’s sequence PRS is a congenital malformative sequence with a retrognathism, a glossoptosis and an upper respiratory obstruction with an associated cleft palate. This malformative association can be disabling for both the child and his parents, because of its aesthetic, functional, psychological and social impacts. Patients and methods: We have investigated 14 patients with PRS presenting cleft palates, collected over a period of 5 years, from March 2014 to November 2019 in the pediatric surgical emergencies department (PSE) in Rabat Children’s Hospital (HER). Results: Nine of the 14 patients had a complete cleft palate. The average age of intervention was 23 months ranging from 13 months to 4 years. The study showed a slight female predominance (n = 8, 57%). Regarding the treatment, 3 patients were treated with the Bardach’s technique, 3 had the Von Langenbeck’s technique, 3 had the Push-back technique and one patient who suffered from a post-operative persisting velar division was treated by veloplasty 3rd generation. The hospital stay was around 24 hours and the post-operative follow-up was uncomplicated for all our patients. Conclusion: Although we had a relatively high success with our approach, the complexity and lack of consensus regarding the management of Pierre Robin’s sequence still requires the involvement of a multidisciplinary team. The main aim is to give the best aesthetical and functional results in order to reduce the suffering of the PRS children and families.

Résumé Introduction Les fentes vélopalatines imposent une fermeture chirurgicale au cours des premières années de vie. La réparation du voile et du palais de manière anatomique est complexe sur le plan chirurgical, du fait de la finesse des tissus et de la configuration locale endobuccale. L’apprentissage par la répétition sur simulateur est utile avant de réaliser le geste au bloc opératoire. Or, il n’existe aucun matériel dédié à l’apprentissage des sutures endobuccales dans la chirurgie vélopalatine. Nous en avons donc confectionné un de manière artisanale afin de s’entraîner avant le geste chirurgical. Construction du simulateur Le simulateur a été construit à partir de données anatomiques précises. Un tuyau en acier, fixé sur un socle rigide, formait la cavité buccale. Une cuillère fendue retravaillée permettait de reproduire le palais. L’ensemble était amovible, ce qui permettait d’appliquer un pansement hydrocellulaire avant l’entraînement aux sutures. Utilisation du simulateur Notre simulateur a été testé par 3 chirurgiens seniors de notre service dans des conditions proches de la réalité afin d’évaluer sa fidélité. Conclusion Disposer d’un simulateur de suture de fentes vélopalatines au sein des centres prenant en charge cette pathologie est bénéfique pour l’apprentissage. Notre simulateur a un coût de revient faible, il est facile à réaliser de manière artisanale et fidèle à la réalité anatomique des patients. Summary Introduction Cleft palate requires surgery in the first years of life, furthermore repairing anatomically the soft and hard palate is complex on a surgical level because of the fine tissues and the local intraoral configuration. It is valuable to train first on simulators before going to the operating room. However, there is no material dedicated to learning how to perform intraoral sutures in cleft palate surgery. We made one, in an artisanal manner, in order to practice before the real surgical gesture. Building the simulator The simulator was designed based on precise anatomical data. A steel pipe, fixed on a rigid base represented the oral cavity. An adapted split spoon represented the palate. All pieces could be removed in order to apply a hydrocellular dressing before training for sutures. Use of the simulator Our simulator was tested by 3 senior surgeons in our department in close to real-life conditions in order to evaluate its anatomical accuracy. Conclusion It is valuable to have a simulator to train on cleft palate sutures within teaching university hospitals that manage this pathology. Our simulator has a very low cost, it is easy to make and is anatomically accurate. [ABSTRACT FROM AUTHOR]

Résumé Depuis 18 ans, notre protocole corrige la déformation narinaire et transpose les muscles élévateurs du voile dès la première opération, tout en maîtrisant la rançon cicatricielle. Pas de doute, le meilleur traitement des séquelles est leur prévention : la narine est presque normale ; les fistules bucco-nasales ont disparu ; une large arcade maxillaire monobloc est restaurée en dentition primaire. Tout concourt à une ventilation nasale. Les traitements secondaires en sont transformés. Dans ce contexte nouveau ne sont décrites ici que les techniques utiles. La correction des déformations labio-narinaires s’inspire des procédés primaires. La qualité de la réparation musculaire ne peut, à elle seule, éviter l’insuffisance vélopharyngée. Il faut compenser la brièveté vélaire et l’hypotonie par reprise de la technique de Sommerlad, lipofilling du pharynx et dans les rares échecs, sphinctéroplastie d’Orticochea. Summary For 18 years our protocol has corrected the cleft lip nose and achieved an intravelar veloplasty at the time of the first operation, leaving the least scaring as possible. No doubt that the best treatment of the sequellae is their prevention: – the oro-nasal fistulas have disappeared; the nostril is almost normal; the continuity of a wide maxillary arch is restored in primary dentition – all that favor a nasal ventilation. This context has changed the nature of the secondary treatment described here. When lip and nose are not good enough we must address the residual deformities with the primary surgery principles. The velopharyngeal insufficiency calls for a velar re-repair and the pharyngeal depth is to be reduced by lipofilling. The rare cases of failure are improved by an Orticochea sphincteroplasty. [ABSTRACT FROM AUTHOR]

Résumé Le traitement des fentes labio-palatines, s’il est source de perplexité avec son foisonnement de protocoles fonctionnels, est riche d’enseignements qui ont guidé nos choix pour l’âge de la première opération et la chronologie opératoire prévenant le mieux la rançon cicatricielle palatine. En définitive, la réponse fonctionnelle la plus aboutie depuis 18 ans surprend car elle a toujours été combattue : c’est celle d’une vraie rhinoplastie primaire. Au-delà de l’ambition esthétique, promesse d’une bonne intégration sociale, elle installe dès la première opération une ventilation nasale, clé d’une croissance faciale harmonieuse, sans sacrifier, bien au contraire, les autres fonctions car elles sont interactives et préservent la ventilation nasale. Summary If the multiplicity of functional protocols of cleft lip and palate treatment has been bewildering, it is now a source of learning. The lessons we can draw from them assist us to choose the best age for the primary surgery and a chronology that prevents the palate from the worst scaring. Eventually, with 18 years of follow-up, the best functional achievement comes unexpectedly from an ambitious primary rhinoplasty that had till now been condemned. Not only do the patients have good appearance and social integration, but the nasal mode of breathing established at the time of the primary surgery favors a good facial growth without any compromise. Reciprocally, all the interacting functions benefit from a nasal ventilation. [ABSTRACT FROM AUTHOR]

Résumé L’objectif de ce travail était d’évaluer nos pratiques en étudiant la durée d’hospitalisation et le vécu parental après chirurgie primaire d’une fente vélaire ou vélo-palatine. Matériel et méthode Étude monocentrique rétrospective par analyse des dossiers et questionnaire téléphonique (vécu parental) des patients opérés d’une chirurgie primaire pour fente vélaire ou vélopalatine isolée, ou associée à une fente labiale, ou rentrant dans le cadre d’une forme syndromique. Résultats Quarante-neuf patients (25 G-24 F) ont bénéficié de 44 Wardill et 5 Furlow (âge moyen 11 mois 1/2) entre 2010 et 2012. La durée moyenne du séjour post-opératoire était de 1,5 jours. Trente-trois parents ont été joints (67 %). Le retour s’était très bien ou bien passé dans 82 % des cas. La douleur à domicile était évaluée par les parents comme nulle ou peu intense dans 73 % des cas. Pour 16 % des parents, l’enfant paraissait « inconfortable ». La prescription d’antalgique n’était suivie que dans 70 % des cas. La durée d’hospitalisation était jugée par les familles comme « bonne » dans 70 % des cas, « trop longue » pour 12 % et « trop courte » pour 18 % notamment par gêne à l’alimentation ou angoisse parentale. Conclusion Même si la chirurgie palatine est réputée douloureuse, les techniques anesthésiques et les protocoles antalgiques actuels permettent d’envisager des suites extrêmement simples et rapides autorisant un retour précoce des enfants à domicile. Summary The aim of this study was to evaluate our practices by studying the duration of hospitalization and the parental real-life experience after a primary surgery of a cleft palate. Materials and methods Monocentric retrospective study by analysis of the patients files and phone interview of the parents whose children were operated for a primary surgery of a cleft palate isolated, or associated with a labial cleft, or included in a syndromic form. Results Forty-nine patients (25 B-24 G) were performed by 44 Wardill and five Furlow procedures (average age: 11 months ½) between 2010 and 2012. The average duration of the post-operative stay was 1.5 days. Thirty-three parents were contacted (67%). The return was “very well” or “well done” in 82% of the cases. The pain at home was estimated by the parents as “worthless” or “little intense” in 73% of the cases. For 16% of the parents, the child seemed “uncomfortable”. The prescription of analgesic was followed only in 70% of the cases. The duration of hospitalization was considered by the families as “good one” in 70% of the cases, “too long” for 12% and “too short” for 18% in particular because of difficulty in eating or parental anxiety. Conclusion Even if palatine surgery is considered to be painful, anaesthetic techniques and current analgesic protocols allow to envisage very simple and fast consequences, authorizing an early return of the children at home. [ABSTRACT FROM AUTHOR]

Cleft palate is the absence of the vault of the mouth resulting in communication between the nose and the mouth. The current frequency of cleft is 0.3% among black people. The incriminated etiological factors of this congenital malformation are exogenous and genetic. The diagnostic is clinical and above all marked by the consequences linked to the cleft, which are multiple morphological problems entailing difficulties from the first days of life (sackling impossible in the event of total cleft lip and palate), functional disorders linked to cleft velopalatine by bucco-nasal reflux, major phonation disorder, dysfunction of the Eustachian tubes causing hearing and otorhinolaryngology (ORL) disorders, breathing disorders. Thanks to the progress of ultrasound, the diagnosis can sometimes be made during pregnancy. Obstetric ultrasound can diagnose cleft lip and palate from the 16th week of amenorrhea. The Veau-Wardill classification based on embryology makes it possible to understand the different types.The care is now organized in a multidisciplinary frameware where the coordination of each specialty will make it possible to harmonize the different treatments. The current attitude is based on the principe of early management to restore the functionality of the velopalatine muscle straps as quickly as possible, reducing the risk of phonatory and auditory sequelae.Concerning cleft palates, the data are fragmented and almost non-existent in the Central African Republic, hence the interest in publishing this clinical case highlighted by chance. We report a clinical case of neglected cleft palate in a 13-year-old girl discovered during a cleft lip and palate screening campaign at the Pediatric University Hospital of Bangui., (Copyright © 2023 SFMTSI.)

Résumé Objectif Les anomalies du développement maxillofacial concernent 1 pour 700 naissances. Environ 30 % des diagnostics anténatals (fentes du palais primaire isolée associée ou non à une atteinte du palais secondaire) sont corrigés en postnatal. Cette étude observationnelle rétrospective a pour but d’analyser la corrélation entre le dépistage échographique et l’aspect postnatal dans le cadre des fentes toutes confondues, en comparant les données anté- et postnatales. Méthodes Tous les enfants nés entre le 1er décembre 2009 et le 31 janvier 2014 dans un centre de référence de diagnostic anténatal et présentant une fente du palais primaire et/ou secondaire ont été inclus. Les malformations associées à une fente ont été exclus. Une comparaison a été réalisée entre les données anténatales selon les comptes rendus d’échographie et celles postnatales décrites par le chirurgien maxillofacial lors de la chirurgie. Résultats Quarante-quatre enfants ont été inclus et 3 exclus en raison d’une anomalie associée. Parmi ces 41 enfants, 27 enfants ont bénéficié d’un dépistage. Le diagnostic échographique et clinique était identique pour 23 cas (85,2 %) et inexact pour 4 patientes (14,8 %). En cas d’atteinte du palais primaire un diagnostic anténatal a été réalisé pour 19 cas sur 21 (90,5 %), mais seulement 8 sur 20 si l’atteinte concernait uniquement le palais secondaire (42,1 %) dont 7 avec une séquence de Pierre-Robin. Discussion La sensibilité du dépistage anténatal des fentes du palais primaire et secondaire augmente ces dernières années avec un taux de 85,2 % dans notre série. Par contre, pour les fentes du palais secondaire seules, la caractérisation semble être plus difficile et l’échographie 3D n’améliore pas toujours la performance du dépistage. Conclusion L’échographie 2D semblerait suffisante pour le dépistage de la fente du palais primaire et secondaire. L’échographie 3D pourrait être utile pour une meilleure représentation de la fente pour les futurs parents. Un même langage concernant la classification des fentes, faciliteraient l’harmonisation des comptes rendus et une meilleure compréhension entre les professionnels. La présence du chirurgien maxillofacial en salle d’échographie, permettrait à l’échographiste d’orienter son échographie de façon précise, voire d’améliorer sa courbe d’apprentissage. Objectives Anomalies of the maxillofacial development concern 1 for 700 births. About 30 % of prenatal diagnoses of isolated primary cleft palate or associated with a cleft of secondary palate will be corrected in postnatal. This retrospective observational study was designed to compare the antenatal data and postnatal diagnosis regarding a series of clefts. Materials and methods All children born between 1 December 2009 and 31 January 2014 in a prenatal diagnostic reference center and having a cleft palate were included. Newborns with an abnormality associated with the cleft were excluded. A comparison was made between the data in the antenatal ultrasound reports and postnatal those described by the surgeon during surgery. Results Forty-four children were included and three infants were excluded due to associated anomalies. Of those 41 children, 27 children have been screened. Ultrasound and clinical diagnosis was the same for 23 cases (85.2 %) and inaccurate for 4 patients (14.8 %). In case of primary cleft palate prenatal diagnosis was performed to 19 cases of 21 (90.5 %), but only 8 of 20 if only secondary cleft palate (42.1 %) including 7 with a Pierre-Robin sequence. Discussion Antenatal screening sensitivity of primary and secondary cleft palate increase in recent years with a rate of 85.2 % in our series. By contrast, diagnosis of isolated secondary cleft palate seems to be more difficult and 3D ultrasound does not always improve screening performance. Conclusion Ultrasound 2D seem sufficient for screening of primary and secondary cleft palate. The 3D ultrasound may be useful for a better representation of the cleft for future parents. The same language concerning the classification of the clefts facilitates harmonization of reporting and understanding between professionals. The presence of the maxillofacial surgeon ultrasound room would allow the sonographer to direct its ultrasound accurately or improve its learning curve. [ABSTRACT FROM AUTHOR]

In particular clinical situations of partial edentulism, partial removable prosthesis represents the treatment of choice despite the progress of implantology. In this paper, we present a case of a patient with cleft palate. This congenital anomaly and its surgical treatment affect the oral cavity, causing limitation of mouth opening, loss of several teeth, unfavorable intermaxillary relations and anterior maxilla bone defect. Our treatment planning aimed to restore the function and the esthetics. [ABSTRACT FROM AUTHOR]

Introduction: Current published long-term provincial or territorial congenital anomaly data are lacking for Canada. We report on prevalence (per 1000 total births) and trends in 1997-2019, in Alberta, Canada, for selected congenital anomalies. Associated risk factors are also discussed., Methods: We used data from the Alberta Congenital Anomalies Surveillance System (ACASS) to calculate the prevalence and perform chi-square linear trend analyses., Results: From 1997 to 2019, the overall prevalence of neural tube defects was stable, at 0.74 per 1000 total births. The same was true for spina bifida (0.38), orofacial clefts (1.99), more severe CHDs (transposition of the great arteries, 0.38; tetralogy of Fallot, 0.33; and hypoplastic left heart syndrome, 0.32); and gastroschisis (0.38). Anencephaly, cleft palate and anorectal malformation significantly decreased with a prevalence of 0.23, 0.75 and 0.54 per 1000 total births, respectively. Significantly increasing trends were reported for anotia/microtia (0.24), limb reduction anomalies (0.73), omphalocele (0.36) and Down syndrome (2.21) and for hypospadias and undescended testes (4.68 and 5.29, respectively, per 1000 male births)., Conclusion: Congenital anomalies are an important public health concern with significant social and societal costs. Surveillance data gathered by ACASS for over 40 years can be used for planning and policy decisions and the evaluation of prevention strategies. Contributing genetic and environmental factors are discussed as is the need for continued surveillance and research., Competing Interests: The authors declare no conflicts of interest.

Copyright of Revue d'Orthopédie Dento-Faciale is the property of Parresia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revue d'Orthopédie Dento-Faciale is the property of Parresia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

INTRODUCTION: The goals of this study were to delineate the protocols employed for managing patients with cleft lip and palate deformities, delineate the challenges facing practitioners and patients, and to determine the patient and physician barriers to cleft care delivery in the region. METHODS: Survey questionnaires were administered to practitioners attending the second Pan-African Congress on Cleft Lip and Palate (PACCLIP), which took place in Ibadan, Nigeria, West Africa from February 4-7, 2007. The conference included 225 participants, representing 17 African countries. RESULTS: Protocols for repair of cleft lip and palate deformities were varied, with Millard's and von Langenbeck's techniques being the preferred approach for the management of cleft lip and palate deformities, respectively. A large proportion of providers have limited access to core cleft care supporting teams, especially speech language pathologists, orthodontists, and audiologists. Several challenging barriers to cleft care were also identified at both the institutional and individual levels and are reported. CONCLUSION: Geographic separation in Africa presents a similar challenge due to isolationism as it does to surgeons in Europe. Specific to Africa are the increased barriers to care, and economic and financial hardship at various levels. A focus on funding, team building, infrastructural support, and patient education appear to be crucial in improving the care and lives of children with facial clefts in Africa.

Résumé: Ont été considérées comme éligibles pour cette méta-analyse* 26 études épidémiologiques. Des associations significatives ont été trouvées entre des malformations et des polluants de l'air : risque accru de cardiopathies et fentes faciales en cas d'exposition au NO2, au SO2 ou aux PM2,5. Ces résultats sont à vérifier avec des études où la description des cas permettrait une meilleure classification des malformations, où les méthodes d'évaluation des expositions seraient plus précises, et où les facteurs de confusion seraient mieux contrôlés. This meta-analysis* of 26 epidemiological studies found significant associations between congenital malformations and air pollutants; specifically, risks of heart disease and cleft lip or cleft palate increased with exposure to NO2, SO2 or PM2.5. These results need to be verified by studies with case descriptions that enable better classification of malformations, with more accurate exposure assessment methods, and better control for confounding factors. [ABSTRACT FROM AUTHOR]

Copyright of Revue d'Orthopédie Dento-Faciale is the property of Parresia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The cleft lip and palate patients present alterations accompanied by a low growth and development potential of the maxillofacial structures. Depending on the phenotypic manifestations, they can be mild or severe. That is why these patients need an integrated and individualized program of control and stimulation during the growing stage. On the other hand, it is well known that the secondary problems resulted by surgical procedures may increase these alterations, making the orthodontics therapy being a great importance to obtain the correct balance, harmony and satisfactory results. This article presents the general orthopedics and orthodontics indicated to achieve optimal results in different stages during development and evolution of the multidisciplinary treatment. [ABSTRACT FROM AUTHOR]

Copyright of Mondo Ortodontico is the property of Masson SPA and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Summary: Objective: The aim was to determine the overall sensibility changes in the area of the infraorbital nerve on patients with unilateral clefts lips and unilateral clefts lips and palate who had undergone primary surgical correction according to the principles of Delaire. Patients and method: Twenty patients (7–20years) with unilateral cleft lips (and palate) who had undergone surgery in infancy according to Delaire were included. Cutaneous sensibilities of the nasolabial fold and of the upper lip were tested using four cutaneous modalities. A tactil superficial sensibility light touch test, a two-point discrimination test (McKinnon-Dellon Disk-Criminator), and the determination of cold and warm detection thresholds (Quantitative Sensory Testing, Medoc Thermal Sensory Analyser). The possible difference of the sensibility between operated and controlateral sides of the face were compared. Results were finally compared to a control group of twenty healthy volunteers. Results: No significant difference could be found between the operated and non-operated side of the cleft group. There was also no difference between the cleft and the control group. Specific difference of perception between nasolabial fold and lip encountered in the literature were confirmed by the experiments. Conclusion: The large subperiostal approach according to Delaire during the primary surgical procedure have not affected long term infraorbital sensibility of patients with unilateral complete cleft lip. [ABSTRACT FROM AUTHOR]

Summary: Objective: This study aims to present the epidemiological profile of clefts lip/palate observed in the eastern of Democratic Republic of Congo (DRC) from January 2002 to May 2004, period of civil wars. Method: It is a retrospective study realized at Doctors on Call for service Learning Center (DOCS LC) in Goma/DRC concerning 89 cases of cleft lip/palate operated during the same period. The data processing was facilitated by the software package SPSS 17.0 installed in the IT center of DOCS. Results: The average age of the consultation is 9.9years with extreme of zero and 42years. Both sexes are concerned: 50.6% of male and 49.4% of female. The more cleft extends from the superior lip to the palate through the alveolus, the more the frequency of the various types of clefts lips/palate decreases: 59.6% (simple clefts lip), 37.1% (labio-alveolar clefts), and 2.2% (cleft palate). The left incomplete cleft lip variety represents 33.7% of all varieties. Most of clefts lips/palate come from the first to the fifth pregnancy with a peak of frequency (19.1%) in the second pregnancy. No family history about congenital deformation was found from 97% of our patients. Conclusion: The epidemiology of cleft lip/palate in our area would be more connected to environmental factors than genetics: no family history of congenital deformation was seen for most of our patients during this period of civil war. [ABSTRACT FROM AUTHOR]

Copyright of Revue de Stomatologie & de Chirurgie Maxillo-Faciale is the property of Masson SPA and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Summary: Median cleft lip and palate are one of the facial manifestations of holoprosencephaly, a brain malformation resulting from a defect in the development of the prosencephalon, the embryonic precursor of the forebrain. It can occur in isolation or as part of a broader pattern of malformation in many different syndromes. The diagnosis of holoprosencephaly requires a complete malformative assessment. Case report: First case: a newborn baby seen at birth for a median cleft lip associated with a complex craniofacial malformation. The search for malformations revealed the absence of the median cerebral structure and trisomy 13. The baby died at 48h. Second case: A 28-day-old newborn baby consulting for a median cleft lip and palate. The brain ultrasounds showed no anomalies of the median cerebral structure. The malformative assessment revealed no other malformation. Discussion: Holoprosencephaly is a complex developmental brain malformation. From the advances in neuroimaging and genetics, our understanding of the etiology and pathogenesis of this condition has advanced dramatically. This advance should lead to improved management of common medical complications and more optimal family counseling. Surgical treatment is the preferred therapy for viable malformations. [ABSTRACT FROM AUTHOR]

Résumé: Le syndrome de Stickler est une maladie génétique rare (incidence 1/7500 naissances) hétérogène d’un point de vue génétique et clinique, liée à une mutation de gènes du collagène. Ce syndrome associe des malformations crâniofaciales, des manifestations ostéoarticulaires et sensorielles oculaires et auditives. Le syndrome de Pierre Robin, comportant une fente palatine, un rétrognatisme et un micrognatisme peut révéler un syndrome de Stickler à la naissance (25 % des patients) et entraîner des difficultés respiratoires néonatales. L’atteinte ophtalmologique se manifeste par une forte myopie, des anomalies du vitré et un risque élevé de décollement de rétine (60 % des patients) conduisant à une cécité (4 % des patients). Une surdité sévère apparaît tôt dans l’enfance, conduisant à des retards d’acquisition scolaire. L’arthrose précoce (75 % des patients) survenant avant 30 ans est une complication majeure, responsable de douleurs chroniques de hanches, de lombalgies chroniques, d’un handicap fonctionnel et justifie fréquemment des remplacements prothétiques. Les anesthésies itératives sont d’autant plus à risque que les patients ont des malformations crâniofaciales. Le statut osseux des patients mériterait d’être évalué, car l’influence génétique couplée au handicap physique favoriserait la fragilité osseuse. Le clinicien doit connaître l’existence du syndrome de Stickler afin de dépister les malades et leurs apparentés, de prévenir les complications fonctionnelles, d’organiser une prise en charge multidisciplinaire et le conseil génétique. [ABSTRACT FROM AUTHOR]

Abstract: Cleft lips and palates (CLPs) are the most common human facial malformations. Depending on the ethnic and/or geographical origin of the studied populations, they can affect up to 1/500 newborns. The treatment of these patients is multidisciplinary because these malformations have not only aesthetic consequences but also functional consequences as the phonation, hearing, deglutition, mastication and ventilation are altered. These consequences can also be psychological since the building of the body image, the way others perceive it, is likely to be seriously altered. In Europe there are over 210 reference hospitals for children affected by CLP. Besides, about 190 different protocols were identified. So far no generic protocol was recognized by the medical community as a whole. This discrepancy can be explained by the fact that the aesthetic and functional result of a protocol cannot be accurately assessed before adulthood when the child''s growth is complete. Patients presenting with CLP don’t usually seem to present with any serious psychological or psychiatric pathology. Yet a close review of the related literature shows that disorders are actually described: behavioural troubles, anxiety, depression and esthetical dissatisfaction with one''s face in children as well as in adults. The difficulty in interpreting these disorders lies in the various factors that are likely to impact this condition (family setting, importance and type of the cleft, surgery protocol, growth, social environment…). A multidisciplinary examination of the face and a careful consideration of concerned families show the importance of the psychological context and the risks of a disharmonious structuring of the parents-child relationships on the child''s development. The identification of the difficulties faced by these families, depending on the child''s age, can be easily identified. Of course they can be identified at birth when the family first sees the child and later on at each stage of the child''s life cycle (when starting at kindergarten where the child socialises for the very first time, at the start of the first year in primary school where pupils learn how to read and then at the start of secondary school which is yet another crucial step for the child due to the adolescence period). It is also obvious that an adult affected by CLP has a particularly heavy medical history as the patient had to go through various treatments and surgical interventions during his childhood and adolescence, which is even sometimes maintained at adulthood. Repeated appointments with the different specialists involved in their treatment punctuate their life as well as their parents’. This medico-surgical setting for facial malformations i.e. the features of the patient''s face which are largely involved in their interpersonal relationships and the expression of emotions can have serious consequences. Most children presenting with CLPs and living in France benefit from regular follow-up schemes carried out in competent reference centres by a multidisciplinary team whose members represent each of the fields of expertise involved in the correction of this malformation: infantile and maxillofacial surgery, otorhinolaryngology (or ENT), orthophony and dentofacial orthopedics. Only the two French reference centres benefit from the permanent presence of a psychologist. This raises the question whether every care centre should take into care these children and their parents’ mental health by offering psychological support during the course of the therapeutic follow-up scheme for these children, and this from an early age on as is recommended by the American Cleft Palate Craniofacial Association. [Copyright &y& Elsevier]

Abstract: Objective: Prenatal diagnosis of cleft lip and palate has been available for over 25 years. 3D ultrasound has significantly improved prenatal screening and perinatal care. Surface rendering of the fetal face is frequently asked by parents during exam and it has been shown to substantially improve parental-fetal bonding. However, little is known about the parental impact of surface ultrasound of the abnormal fetal face. We thus decided to assess parental feelings after 3D surface rendering of the fetal face in cleft lip and palate. Patient(s) and method: Between January 2003 and December 2006, a questionnaire was systematically proposed after birth to the parents who had 3D examination during pregnancy for lip and cleft palate. Analysis of results was performed retrospectively. Results: Twenty-three couples answered to inclusion criteria, 12 have been contacted, 9 responded. 3D ultrasound was not perceived as disturbing in 78% of parents. On the contrary 3D pictures had a positive effect and better prepare parents to birth. All of them even more considered that it should be systematically performed. Discussion and conclusion: Prenatal diagnosis of cleft lip and palate is known to improve parental well-being during the perinatal period. Furthermore, in addition to improved diagnosis, 3D ultrasound also provides a better understanding and acceptance of the malformation than 2D examination. The parental impact of 3D ultrasound is positive supporting and strengthening a systematic use in isolated fetal lip and cleft palate. [Copyright &y& Elsevier]

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Summary: Study objective: The aim of this retrospective study is to describe and evaluate the long term morphologic results of patients who present unilateral complete cleft lip and palate. Patients and methods: Thirty-two patients with non syndromic unilateral complete cleft lip and palate were operated early by the same surgeon, at the mean age of 70,4 days old, with two operating procedures. The first group was operated of cheiloplasty with the Millard method during the neonatal period, associated to the closure of the palate in the same time. The second group was operated with a modified Millard method during the neonatal period associated to a closing of the palate by the Wardill method at the age of ten months old. The criteria of evaluation were the anatomic remaining abnormalities after surgery of nose, lips, primary and secondary palate (back of 17 years). Results: Our results show that Millard method and derived are taken as a whole effective, even if the number of secundary surgery and supplementary adjustments was sizeable (87%). The postoperative abnormalities concerning red lip (discontinuity, mucous excess) were frequent (53%), but easily correctable. The secondary surgeries were for mainly minor touch up of lip (46%), second time palate surgeries (53%), and rhinoplasties (40%). Conclusion: Progress in anesthesia and reanimation allowed us to assure an early management of clefts. The absence of incorrigible after-effects by a secondary surgery of the first-operated patients encouraged the team to continue in this way. [Copyright &y& Elsevier]

Summary: The aim was to examine the bony maxillary structures by computed tomographic measurements in newborns with unilateral cleft lip and palate before cheiloplasty. Analysis of maxillary bone was performed and size parameters were measured by computed-tomographic analysis in 12 infants with unilateral cleft lip and palate. We compared the bony maxillary length and the bony maxillary width between the cleft side and the healthy side. For eight patients, the bony maxillary length was different between the cleft side and the healthy side. For three patients, the bony maxillary width was different between the incisor alveolar structure in the cleft side and the healthy side. For six patients, the bony maxillary width was different between the canine alveolar structure in the cleft side and the healthy side. We noted an asymmetry without hypoplasy in bony maxillary structure in newborns before cheiloplasty. The data can serve as the starting point for a control and later evaluation on the efficiency of different therapeutic approaches of alveolar and maxillary development in children with cleft lip and palate. [Copyright &y& Elsevier]

Copyright of Revue de Stomatologie & de Chirurgie Maxillo-Faciale is the property of Masson SPA and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revue de Stomatologie & de Chirurgie Maxillo-Faciale is the property of Masson SPA and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revue de Stomatologie & de Chirurgie Maxillo-Faciale is the property of Masson SPA and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revue de Stomatologie & de Chirurgie Maxillo-Faciale is the property of Masson SPA and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revue de Stomatologie & de Chirurgie Maxillo-Faciale is the property of Masson SPA and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revue de Stomatologie & de Chirurgie Maxillo-Faciale is the property of Masson SPA and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revue de Stomatologie & de Chirurgie Maxillo-Faciale is the property of Masson SPA and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revue de Stomatologie & de Chirurgie Maxillo-Faciale is the property of Masson SPA and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revue de Stomatologie & de Chirurgie Maxillo-Faciale is the property of Masson SPA and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revue de Stomatologie & de Chirurgie Maxillo-Faciale is the property of Masson SPA and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revue de Stomatologie & de Chirurgie Maxillo-Faciale is the property of Masson SPA and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revue de Stomatologie & de Chirurgie Maxillo-Faciale is the property of Masson SPA and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revue de Stomatologie & de Chirurgie Maxillo-Faciale is the property of Masson SPA and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revue de Stomatologie & de Chirurgie Maxillo-Faciale is the property of Masson SPA and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revue de Stomatologie & de Chirurgie Maxillo-Faciale is the property of Masson SPA and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)