Unoperated complete unilateral cleft lip and palate: A case report on occlusion, craniofacial morphology and oral function
A 26-year old female with unoperated complete unilateral cleft lip and palate was reported. 1. Occlusion: No cross-bite was observed in both the anterior and buccal segments. 2. Craniofacial morphology: Analysis of the lateral roentogenographic cephalograms revealed that the length of the anterior c...
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| Published in | Journal of Japanese Cleft Palate Association Vol. 8; no. 1; pp. 105 - 115 |
|---|---|
| Main Authors | , , , , , , , , , , , , |
| Format | Journal Article |
| Language | Japanese |
| Published |
Japanese Cleft Palate Association
15.07.1983
|
| Online Access | Get full text |
| ISSN | 0386-5185 2186-5701 |
| DOI | 10.11224/cleftpalate1976.8.1_105 |
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| Abstract | A 26-year old female with unoperated complete unilateral cleft lip and palate was reported. 1. Occlusion: No cross-bite was observed in both the anterior and buccal segments. 2. Craniofacial morphology: Analysis of the lateral roentogenographic cephalograms revealed that the length of the anterior cranial base was in the normal range, the maxilla was loca t e d anteriorly relative to the anterior cranial base and the maxillary depth was larger than th e noncleft subjects, although its vertical growth was less. Form and position of the mandible were in the category of the non-cleft subjects. These findings suggest that restricted growth, especially in the anteroposterior direction, of both jaws observed in the operated UCLP patients w a s caused by the plastic surgery during the infantile and early preschool period. 3. Speech: Severe hypernasality was evident. 4. Facial appearance: Analysis of Moir e topography indicated the deviation of tip of the nose to the non-cleft side. 5. Function of the tongue during swallowing: Since the lip, alveolus and palate were kept wide open, the usual stripping action of the tongue was not observed but peculiar movement of the tongue was evident. That is, according to the cine-radiography, dorsum of the tongue w as elevated to seal the cleft and food was kept on the floor of the mouth at the first phase of swallowing. Food was, then, swallowed along the lateral margin of the tongue. According t o the EMG activity of the tongue during swallowing, extremely long period of time was necessary for an act of swallowing in comparison to the non-cleft subjects. The pattern of the EMG activity was found to be polyphasic which was not common in the non-cleft subjects. |
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| AbstractList | A 26-year old female with unoperated complete unilateral cleft lip and palate was reported.1. Occlusion: No cross-bite was observed in both the anterior and buccal segments.2. Craniofacial morphology: Analysis of the lateral roentogenographic cephalograms revealed that the length of the anterior cranial base was in the normal range, the maxilla was loca t e d anteriorly relative to the anterior cranial base and the maxillary depth was larger than th e noncleft subjects, although its vertical growth was less. Form and position of the mandible were in the category of the non-cleft subjects. These findings suggest that restricted growth, especially in the anteroposterior direction, of both jaws observed in the operated UCLP patients w a s caused by the plastic surgery during the infantile and early preschool period.3. Speech: Severe hypernasality was evident.4. Facial appearance: Analysis of Moir e topography indicated the deviation of tip of the nose to the non-cleft side.5. Function of the tongue during swallowing: Since the lip, alveolus and palate were kept wide open, the usual stripping action of the tongue was not observed but peculiar movement of the tongue was evident. That is, according to the cine-radiography, dorsum of the tongue w as elevated to seal the cleft and food was kept on the floor of the mouth at the first phase of swallowing. Food was, then, swallowed along the lateral margin of the tongue. According t o the EMG activity of the tongue during swallowing, extremely long period of time was necessary for an act of swallowing in comparison to the non-cleft subjects. The pattern of the EMG activity was found to be polyphasic which was not common in the non-cleft subjects.
26歳11カ月まで,口唇裂および口蓋裂が共に未手術のままであった片側性完全唇・顎・口蓋裂患者(女子)の初診時の咬合状態,頭蓋・顔面の形態的所見ならびに嚥下時における舌の機能的所見について報告した.咬合所見:前歯部,臼歯部共に正常な被蓋関係を呈し,形成手術の患者に一般的な著しい咬合の異常は認められなかった.頭蓋・顔面の形態的所見:1)頭部X線規格写真により,非破裂者群の平均と比較した結果、前頭蓋底の前後径は変らず,上顎部は前後的に過成長を示し,前頭蓋底に対して前方位をとったが,下方へは劣成長を認めた.また,下顎については,形成手術後の患者の平均像である下顎枝高の短小,下顎角の開大,下顎下縁平面の急傾斜,オトガイ部の前頭蓋底に対する後方位は認められず,非破裂者群の平均と比べて下顎枝高,下顎角は標準偏差内にあり,前頭蓋底に対するオトガイ部の位置はむしろ前方位をとり,下顎下縁平面は平坦化を示した.2)モアレ写真により顔面形態を検討した結果,鼻尖部は健側に偏位していた.これらの事実より,乳幼児期の形成手術は咬合状態ならびに口腔・顔面の成長に大きな影響を与えるということ,また,裂を有する個体の顔面の成長能力は,垂直方向の成長に関しては疑問が残るものの,前後方向には非破裂者より劣るものではないことが示唆された,発音:著しい開鼻声であった.舌の機能的所見:1)X線映画で嚥下時の舌の動きを検討した結果、舌背を高くして食塊の鼻腔への流入を防ぎ,食物を口腔底に蓄え,舌の側縁を経て嚥下する特異な嚥下パターンが認められた.2)嚥下時の舌の筋電図所見によれば,舌筋の放電持続時間は非破裂者よりきわめて長くかつ多相性の放電パターンが認められ、複雑な舌運動をすることが示唆された. A 26-year old female with unoperated complete unilateral cleft lip and palate was reported. 1. Occlusion: No cross-bite was observed in both the anterior and buccal segments. 2. Craniofacial morphology: Analysis of the lateral roentogenographic cephalograms revealed that the length of the anterior cranial base was in the normal range, the maxilla was loca t e d anteriorly relative to the anterior cranial base and the maxillary depth was larger than th e noncleft subjects, although its vertical growth was less. Form and position of the mandible were in the category of the non-cleft subjects. These findings suggest that restricted growth, especially in the anteroposterior direction, of both jaws observed in the operated UCLP patients w a s caused by the plastic surgery during the infantile and early preschool period. 3. Speech: Severe hypernasality was evident. 4. Facial appearance: Analysis of Moir e topography indicated the deviation of tip of the nose to the non-cleft side. 5. Function of the tongue during swallowing: Since the lip, alveolus and palate were kept wide open, the usual stripping action of the tongue was not observed but peculiar movement of the tongue was evident. That is, according to the cine-radiography, dorsum of the tongue w as elevated to seal the cleft and food was kept on the floor of the mouth at the first phase of swallowing. Food was, then, swallowed along the lateral margin of the tongue. According t o the EMG activity of the tongue during swallowing, extremely long period of time was necessary for an act of swallowing in comparison to the non-cleft subjects. The pattern of the EMG activity was found to be polyphasic which was not common in the non-cleft subjects. |
| Author | Yasuda, Yoshihide Kitamura, Takashi Nakagawa, Koichi Tsuchiya, Masafumi Yoshida, Kenmi Maeda, Sachiko Horisaka, Takashi Shimada, Junji Adachi, Satoshi Sugimura, Masahito Kakiuchi, Yasuhiro Wada, Takeshi Sakuda, Mamoru |
| Author_FL | 前田 早智子 杉村 正仁 北村 隆 吉田 建美 保田 好秀 和田 健 垣内 康弘 土屋 雅文 足立 敏 作田 守 堀坂 孝 中川 浩一 島田 純治 |
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| References | 8)高橋新次郎: 新編歯科矯正学, 増補版. 62, 永末書店, 京都, 1975. 9)香月武, 後藤昌昭, 蔵田副雄他: 顔面モアレ写真の分析による外鼻の対称性の数値化. 日口蓋誌, 5; 145-153, 1980. 2)石川富士郎, 遠藤孝, 亀谷哲也他: 唇- 顎- 口蓋裂患者の矯正学的観察特に顎, 顔面部の形態について. 日矯歯誌, 29; 50-60, 1970. 4) Bishara, S. E., Krause, C. J., Felling, C. et al.: Facial and dental relationships of individuals with unoperated clefts of the lip and/or palate. Cleft Palate J., 13; 238-252, 1976. 19) Clean, J. F.: Deglutition: A study of form and function. Amer. J. Orthodont., 51; 566-594, 1965. 5) Fukuhara, T., Hanada, K., Wakui, Y. et al.: Cephalometric and dental arch analysis on an ad u lt patient of nonoperated cleft palate and review of the references. J. Jap. Orthodont. Soc., 33; 56-62, 1974. 10) Yoshida, K., Takada, K., Sakuda, M. et al.: EMG Approach to Assessing Tongue Activity Using Miniature Surface Electrodes, J. Dent. Res., 61; 1148-1152, 1982. 16) Enlow, D. H.: Handbook of facial growth, 48-75, W. B. Sanders Co., Philadelphia, London, Toronto, 1975. 14) Pruzansky, S.: Factors determining arch form in clefts of the lip and palate, Amer. J. Orthodont., 41; 827-851, 1955. 1 ) Mestre, J. C., De Jesus, J. and Subtelny, J. D.: Unoperated oral clefts at maturation. Angle Orthodont, 30; 78-85, 1960. 3 ) Ross, R. B. and Johnston, M. C.: Cleft lip and palate. 114-120, Williams and Wilkins, Baltimore, 1 972. 7) Tulley, W. J. and C ampbell, A. C.: A manual of practical orthodontics. 3rd ed. 33-37, John Wright & Sons, Bristol, 1970. 6) A therton, J. D.: Morphology of facial bones in skulls with unoperated unilateral cleft palate. Cle f t palate J., 4; 18-30, 1967. 11)作田守: 口蓋裂の基礎と臨床- 顔面の成長を中心に. 日矯歯誌, 37; 139-160, 1978. 18)根本辰郎: モアレ縞自動解析による口唇裂患者の顔面変形度の三次元的観察. 日口外誌, 25; 798-814, 1979. 21)和田卓郎; 口腔領域におけるX線映画法の応用, 嚥下機構について. 広大歯誌, 1-7, 1979. 13)北村隆: 歯科矯正治療を受けた片側性完全唇・顎・口蓋裂患者の頭蓋・顔面の成長- 側方頭部X線規格写真による経年的研究. 日口蓋誌, 7; 107-141, 1982. 15)中川皓文, 丹根0夫, 大山芳明他: 唇顎口蓋裂患児の歯と咬合の異常に関する研究. 日口蓋誌, 7; 155-171, 1982. 12)林勲: 片側性完全唇・顎・口蓋裂者の顎・顔面頭蓋の成長- 頭部X線規格写真法による研究. 日矯歯誌, 34; 33-65, 1975. 20) Subtelny, J. D.: Malocclusions, orthodontic corrections and orofacial muscle adaptation. Ang le Orthodont., 40; 170-201, 1970. 17)永冨照子: 口唇が前歯およびその歯周組織に及ぼしている影響についての組織学的研究. 日矯歯誌, 32; 99-120, 1973. |
| References_xml | – reference: 10) Yoshida, K., Takada, K., Sakuda, M. et al.: EMG Approach to Assessing Tongue Activity Using Miniature Surface Electrodes, J. Dent. Res., 61; 1148-1152, 1982. – reference: 1 ) Mestre, J. C., De Jesus, J. and Subtelny, J. D.: Unoperated oral clefts at maturation. Angle Orthodont, 30; 78-85, 1960. – reference: 20) Subtelny, J. D.: Malocclusions, orthodontic corrections and orofacial muscle adaptation. Ang le Orthodont., 40; 170-201, 1970. – reference: 18)根本辰郎: モアレ縞自動解析による口唇裂患者の顔面変形度の三次元的観察. 日口外誌, 25; 798-814, 1979. – reference: 9)香月武, 後藤昌昭, 蔵田副雄他: 顔面モアレ写真の分析による外鼻の対称性の数値化. 日口蓋誌, 5; 145-153, 1980. – reference: 21)和田卓郎; 口腔領域におけるX線映画法の応用, 嚥下機構について. 広大歯誌, 1-7, 1979. – reference: 2)石川富士郎, 遠藤孝, 亀谷哲也他: 唇- 顎- 口蓋裂患者の矯正学的観察特に顎, 顔面部の形態について. 日矯歯誌, 29; 50-60, 1970. – reference: 19) Clean, J. F.: Deglutition: A study of form and function. Amer. J. Orthodont., 51; 566-594, 1965. – reference: 5) Fukuhara, T., Hanada, K., Wakui, Y. et al.: Cephalometric and dental arch analysis on an ad u lt patient of nonoperated cleft palate and review of the references. J. Jap. Orthodont. Soc., 33; 56-62, 1974. – reference: 11)作田守: 口蓋裂の基礎と臨床- 顔面の成長を中心に. 日矯歯誌, 37; 139-160, 1978. – reference: 8)高橋新次郎: 新編歯科矯正学, 増補版. 62, 永末書店, 京都, 1975. – reference: 4) Bishara, S. E., Krause, C. J., Felling, C. et al.: Facial and dental relationships of individuals with unoperated clefts of the lip and/or palate. Cleft Palate J., 13; 238-252, 1976. – reference: 14) Pruzansky, S.: Factors determining arch form in clefts of the lip and palate, Amer. J. Orthodont., 41; 827-851, 1955. – reference: 3 ) Ross, R. B. and Johnston, M. C.: Cleft lip and palate. 114-120, Williams and Wilkins, Baltimore, 1 972. – reference: 6) A therton, J. D.: Morphology of facial bones in skulls with unoperated unilateral cleft palate. Cle f t palate J., 4; 18-30, 1967. – reference: 7) Tulley, W. J. and C ampbell, A. C.: A manual of practical orthodontics. 3rd ed. 33-37, John Wright & Sons, Bristol, 1970. – reference: 13)北村隆: 歯科矯正治療を受けた片側性完全唇・顎・口蓋裂患者の頭蓋・顔面の成長- 側方頭部X線規格写真による経年的研究. 日口蓋誌, 7; 107-141, 1982. – reference: 15)中川皓文, 丹根0夫, 大山芳明他: 唇顎口蓋裂患児の歯と咬合の異常に関する研究. 日口蓋誌, 7; 155-171, 1982. – reference: 12)林勲: 片側性完全唇・顎・口蓋裂者の顎・顔面頭蓋の成長- 頭部X線規格写真法による研究. 日矯歯誌, 34; 33-65, 1975. – reference: 16) Enlow, D. H.: Handbook of facial growth, 48-75, W. B. Sanders Co., Philadelphia, London, Toronto, 1975. – reference: 17)永冨照子: 口唇が前歯およびその歯周組織に及ぼしている影響についての組織学的研究. 日矯歯誌, 32; 99-120, 1973. |
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| Snippet | A 26-year old female with unoperated complete unilateral cleft lip and palate was reported. 1. Occlusion: No cross-bite was observed in both the anterior and... A 26-year old female with unoperated complete unilateral cleft lip and palate was reported.1. Occlusion: No cross-bite was observed in both the anterior and... |
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| Title | Unoperated complete unilateral cleft lip and palate: A case report on occlusion, craniofacial morphology and oral function |
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