Cleft Size and Maxillary Arch Dimensions in Unilateral Cleft Lip and Palate and Cleft Palate PDF
Preview Cleft Size and Maxillary Arch Dimensions in Unilateral Cleft Lip and Palate and Cleft Palate
To my parents Ingrid and Fred iii List of Papers This thesis is based on the following papers, which are referred to in the text by their Roman numerals. I Reiser E, Skoog V, Gerdin B, Andlin-Sobocki A. Association between cleft size and crossbite in children with cleft palate and unilateral cleft lip and palate. Cleft Palate Craniofac J. 2010;47:175-181. II Reiser E, Skoog V, Andlin-Sobocki A. Early dimensional changes in maxillary cleft size and arch dimensions of children with cleft lip and palate and cleft palate. Cleft Palate Craniofac J. 2011. Accepted. III Reiser E, Svee A, Andlin-Sobocki A. Facial growth in unilateral cleft lip and palate and cleft palate: associations with maxillary dimensions and cleft size in infancy. Submitted. IV Reiser E, Andlin-Sobocki A, Mani M, Holmström M. Initial size of cleft does not correlate with size and function of nasal airway in adults with unilateral cleft lip and palate. J Plast Surg Hand Surg. 2011;45:129-135. Reprints were made with permission from the respective publishers. Contents Introduction ................................................................................................... 11 Embryology .............................................................................................. 11 Etiology .................................................................................................... 12 Epidemiology ........................................................................................... 12 Classification ............................................................................................ 13 Anatomy of UCLP and CP ....................................................................... 13 Treatment of clefts in Uppsala, Sweden ................................................... 15 Surgery ................................................................................................. 16 Infant orthopaedics and orthodontics ................................................... 17 Maxillary arch dimensions and occlusion ................................................ 18 Facial growth ............................................................................................ 19 Nasal airway size and function ................................................................. 20 Cleft size ................................................................................................... 21 Aims of the thesis.......................................................................................... 23 Materials and Methods .................................................................................. 24 Subjects Papers I to III ............................................................................. 24 Subjects Paper IV ..................................................................................... 25 Surgery ..................................................................................................... 26 Methods .................................................................................................... 27 Dental cast measurements .................................................................... 27 Crossbite scoring ................................................................................. 28 Cephalometrics .................................................................................... 29 Nasal airway size and function ............................................................ 31 Reliability of the methods ........................................................................ 32 Dental cast measurements .................................................................... 32 Cephalometric measurements .............................................................. 32 Statistical analyses .................................................................................... 32 Paper I .................................................................................................. 32 Paper II ................................................................................................ 33 Paper III ............................................................................................... 33 Paper IV ............................................................................................... 34 Results ........................................................................................................... 35 Cleft size and crossbite (Paper I) .............................................................. 35 Changes in cleft size and maxillary arch dimensions (Paper II) .............. 37 Maxillary arch dimensions, cleft size, and facial growth (Paper III) ....... 41 Cleft size and nasal function (Paper IV) .................................................. 43 Discussion ..................................................................................................... 45 Materials and Methods ............................................................................. 45 Cleft size and crossbite (Paper I) .............................................................. 47 Changes in cleft size and maxillary arch dimensions (Paper II) .............. 48 Maxillary arch dimensions, cleft size, and facial growth (Paper III) ....... 50 Cleft size and nasal function (Paper IV) .................................................. 51 General discussion .................................................................................... 52 Clinical implications ................................................................................ 53 Conclusions ................................................................................................... 55 Populärvetenskaplig sammanfattning på svenska ......................................... 56 Acknowledgements ....................................................................................... 58 References ..................................................................................................... 60 Abbreviations AR Acoustic rhinometry BCLP Bilateral cleft lip and palate CB Crossbite CL Cleft lip CLP Cleft lip and palate CP Cleft palate CPo Cleft palate only ICC Intra-class correlation coefficient MCA 1 Minimal cross sectional area, ante- rior part of the nose (0 - 2.2 cm from nostril rim) MCA 2 Minimal cross sectional area, post- erior part of the nose (2.2 - 5.4 cm from nostril rim) mm millimetres INSP Nasal Airway Resistance during Inspiration PNIF Peak nasal inspiratory flow PRS Pierre Robin sequence RM Rhinomanometry SD Standard deviation SOIT Scandinavian Odor Identification Test UCLP Unilateral cleft lip and palate Vol 1 Nasal volume, anterior part of the nose (0 - 2.2 cm from nostril rim) Vol 2 Nasal volume, posterior part of the nose (2.2 - 5.4 cm from nostril rim) 3D Three-dimensional Additional abbreviations are explained in the associated text or figures.
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