Cases reported "Cleft Palate"

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21/47. Klippel-Feil anomaly, cleft palate, and bifid tongue.

    The Klippel-Feil anomaly is a condition characterized by congenital vertebral fusion, which may be associated with a short neck and a low posterior hairline. In the patient presented here, there was congenital cervical fusion, cleft palate, and bifid tongue. The occurrence of cervical fusion and cleft palate has been reported previously, but this is the first report, to the author's knowledge, of these malformations being accompanied by a bifid tongue. The embryological association between Klippel-Feil anomaly and cleft palate has been alluded to on few occasions. Investigators have suggested that the short, fused neck limits movement of the head and thus of the tongue from between the palatal shelves. This report postulates that the mechanism is more complex and that it is based on a change in structural relations between certain key areas involved in the background of palatal shelf elevation.
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22/47. Severe postaxial acrofacial dysostosis: an anatomic and angiographic study.

    We describe a severe case of postaxial acrofacial dysostosis syndrome [POADS] or Genee-Wiedemann syndrome in a stillborn female. The report includes an arteriographic and anatomic study of the limbs. Previously unreported findings such as hypoplasia of the femora, ossification defect of the ischium and pubis, bilobed tongue, and lung hypoplasia were noted. This case documents further variability in the POADS or Genee-Wiedemann syndrome.
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23/47. tongue flap repair of oro-nasal fistulae in cleft palate patients. A review of 20 patients.

    At University College Hospital, between 1980 and 1985, sixty patients with cleft lip and palate deformity underwent transpalatal maxillary advancement for the correction of mid-face hypoplasia. One third of these patients subsequently required closure of oro-nasal fistulae and we present the results of these twenty cases where anteriorly based dorsal tongue flaps were used. Seventeen were successful and the causes of three failures are discussed.
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24/47. Changes in articulation and resonance after tongue flap closure of palatal fistulas: case reports.

    This paper describes speech changes in three patients after tongue flap closure of various sized palatal fistulas. In all three patients articulation and lingual mobility appeared to be unaffected by excision of tongue tissue for the procedure. However, a large protruding tongue flap was noted to interfere with the articulation of sibilants in one patient. All patients showed a reduction in overall hypernasal resonance and nasal emission, although one patient developed nasal turbulence postoperatively and another required a pharyngeal flap for total elimination of hypernasality. This paper points out the need for a systematic investigation into the effects of this surgery on speech.
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25/47. Polysomnographic indications for surgical intervention in Pierre Robin sequence: acute airway management and follow-up studies after repair and take-down of tongue-lip adhesion.

    The major concern for neonates with Pierre Robin sequence is the stability of the airways. The accepted management has been close clinical observation followed by surgical intervention if the airway was felt to be unstable. Six newborns with this diagnosis were admitted for evaluation in a 7-month period. Each underwent transcutaneous oxygen and carbon dioxide monitoring in a resting state. Each infant then was evaluated with infant polysomnography to ascertain the presence of obstructive apnea. pulse-oximetry was utilized to document the oxygen saturation of each child during the polysomnography. On the basis of these studies, four of the neonates required a tongue-lip adhesion to stabilize the airway. These four infants were reassessed with polysomnography postoperatively, prior to cleft palate repair, following palatoplasty, and after their tongue-lip adhesion was released. This method of evaluation allows early testing of the stability of the airway in a way that augments and confirms the clinical assessment of the infant, allowing appropriate surgical intervention when necessary. This method of evaluation also allows the safe prediction of airway stability following palatoplasty and release of the tongue-lip adhesion.
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26/47. Congenital median cleft of the lower lip, bifid tongue with ankyloglossia, cleft palate, and submental epidermoid cyst: report of a case.

    An unusual case of median cleft of the lower lip associated with bifid tongue and cleft palate is described. Four years later, the child developed a submental epidermoid cyst.
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27/47. Unoperated adult cleft lip and palate: changes in form and function after operation.

    This report describes the occlusion and craniofacial morphology--together with changes in tongue activity during swallowing before and after surgical correction--in a 26-year-old female patient with unilateral cleft lip and palate. Cross-bites were not observed before or after repair. Lateral cephalometric findings revealed a convex profile with a normal anterior cranial base length, a flat mandibular plane, and a short lower-anterior face height. Preoperative cineradiographic appraisal showed atypical tongue activity during swallowing. The dorsum of the tongue remained high to seal the cleft. The bolus was kept on the floor of the mouth and passed along the lateral margins of the tongue. The swallow duration, as determined by EMG of the tongue, was extremely long when compared with infant-operated cleft lip and palate patients and to noncleft subjects. Postoperatively, tongue function was similar to that in both cleft patients in whom closure was performed in infancy and to noncleft controls.
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28/47. Surgical closure of end-stage palatal fistulas using anteriorly-based dorsal tongue flaps.

    Effective closure of the recurrent palatal fistula demands proper diagnosis and anatomically-based classification, combined with an appreciation of surgical options. The anteriorly-based dorsal tongue flap is recommended to close large and/or compromised end-stage residual palatal fistula, provided that patient selection and surgical technique are meticulous. It has proved to be a safe and effective method of solving a difficult problem.
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29/47. Visual training and correction of articulation disorders by use of dynamic palatography: serial observation in a case of cleft palate.

    The dynamic palatograph is an electrical apparatus that generates a visual display of constantly changing palatolingual contact as a function of time, using an artificial palatal plate with affixed electrodes. This paper describes a technique of speech therapy incorporating dynamic palatography for a cleft palate patient. The patient, a 6-year-old Japanese girl with a repaired unilateral cleft lip and palate, had been judged to demonstrate articulation disorders involving contact of the tongue with the hard palate or alveolus following surgical improvement of velopharyngeal function. Prior to therapy the tongue tended to contact the hard palate more posteriorly than normal. After therapy with the dynamic palatograph, palatolingual contact was normal in comparison with average speakers. Our findings suggest that the facility of constant visual indication of tongue posture to the clinician and patient during corrective speech therapy using dynamic palatography may expedite results with cleft palate patients in the speech clinic when implemented in a carefully structured treatment plan.
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ranking = 0.42857142857143
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30/47. Subglossopalatal membrane.

    A newborn who experienced respiratory distress just after birth had an oral web that extended from the floor of the mouth anterior to the tongue up to the hard palate. The membrane was slit in the midline to facilitate air exchange. The patient did well without intubation, and the web was resected. To our knowledge, this is the second case of subglossopalatal membrane to be reported. Embryologic and anatomic considerations, along with a review of the literature, are presented.
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