Children born with cleft lip, cleft palate and other craniofacial disorders face numerous medical challenges beyond appearance.
Patients can face serious airway, feeding, speech and hearing problems, as well as social and psychological challenges, Laura Swibel Rosenthal, MD, of Loyola University Medical Center and colleagues write in the June 2012 issue of Otolaryngologic Clinics of North America."The management of patients with craniofacial syndromes is complex," Rosenthal and colleagues write. "Otolaryngologic [ear-nose-throat] evaluation is of paramount importance in providing adequate care for this patient population."
About 1 in 600 babies in the United States is born with a cleft lip and/or cleft palate, according to the Cleft Palate Foundation. The defect can range from a small notch in the lip to a grove that runs into the roof of the mouth. It can occur in isolation or in combination with other craniofacial birth defects. (A craniofacial disorder refers to an abnormality of the face and/or head.)
The first step in managing craniofacial patients is ensuring a safe airway. There's also a great potential for nasal obstruction and sleep apnea. And patients are at increased risk of developing upper airway problems such as sinusitis, laryngitis and rhinitis.
Hearing loss is common and often progressive. Thus, in addition to receiving standard newborn hearing screening, craniofacial patients should continue to receive periodic hearing tests, Rosenthal and colleagues write.
Craniofacial patients typically require several corrective surgeries, performed in staged fashion. Surgeons and anesthesiologists should be aware of the potential challenges these patients may have with general anesthesia.
The authors recommend a multidisciplinary approach, beginning with genetic counseling to determine the cause of the malformation, to inform parents about what to expect and to learn about the implications for other family members.
In addition to otolaryngologists, other specialists who typically care for craniofacial patients include pulmonologists, gastroenterologists, dentists and orthodontists. Depending on the congenital condition, a patient also may see pediatric specialists, such as cardiologists, ophthalmologists, neurosurgeons, endocrinologists, urologists, nephrologists and orthopaedic surgeons.
Most patients also need additional support services, including case management (social work), psychology or psychiatry, speech pathology, physical therapy, occupational therapy and other educational services.
The authors detail the management of major conditions associated with craniofacial disorders, including Apert syndrome, Crouzon syndrome, CHARGE syndrome, chromosome-22 and 22q11.2 deletion syndromes, DiGeorge syndrome, velocardiofacial syndrome (VCFS), Opitz G/BBB syndrome, congenital nasal pyriform aperture stenosis, Moebius syndrome, mandibulofacial dysostosis syndromes, oculoauricular-vertebral spectrum (OAVS), Goldenhar syndrome and Stickler syndrome.
Rosenthal is an assistant professor in the Departments of Otolaryngology and Pediatrics of Loyola University Chicago Stritch School of Medicine. Her special interests include cleft lip and palate, breathing difficulties, facial lesions, nasal/sinus problems, neck masses, pediatric ear, nose and throat, special-needs children and speech delay.
Co-authors are Nadieska Caballero, MD, of Loyola's Department of Otolaryngology and Amelia Drake, MD, of the University of North Carolina Hospital.
Jim Ritter | EurekAlert!
Inselspital: Fewer CT scans needed after cerebral bleeding
20.03.2019 | Universitätsspital Bern
Building blocks for new medications: the University of Graz is seeking a technology partner
19.03.2019 | Karl-Franzens-Universität Graz
Cancers that display a specific combination of sugars, called T-antigen, are more likely to spread through the body and kill a patient. However, what regulates...
DESY and MPSD scientists create high-order harmonics from solids with controlled polarization states, taking advantage of both crystal symmetry and attosecond electronic dynamics. The newly demonstrated technique might find intriguing applications in petahertz electronics and for spectroscopic studies of novel quantum materials.
The nonlinear process of high-order harmonic generation (HHG) in gases is one of the cornerstones of attosecond science (an attosecond is a billionth of a...
Nano- and microtechnology are promising candidates not only for medical applications such as drug delivery but also for the creation of little robots or flexible integrated sensors. Scientists from the Max Planck Institute for Polymer Research (MPI-P) have created magnetic microparticles, with a newly developed method, that could pave the way for building micro-motors or guiding drugs in the human body to a target, like a tumor. The preparation of such structures as well as their remote-control can be regulated using magnetic fields and therefore can find application in an array of domains.
The magnetic properties of a material control how this material responds to the presence of a magnetic field. Iron oxide is the main component of rust but also...
Due to the special arrangement of its molecules, a new coating made of corn starch is able to repair small scratches by itself through heat: The cross-linking via ring-shaped molecules makes the material mobile, so that it compensates for the scratches and these disappear again.
Superficial micro-scratches on the car body or on other high-gloss surfaces are harmless, but annoying. Especially in the luxury segment such surfaces are...
The Potsdam Echelle Polarimetric and Spectroscopic Instrument (PEPSI) at the Large Binocular Telescope (LBT) in Arizona released its first image of the surface magnetic field of another star. In a paper in the European journal Astronomy & Astrophysics, the PEPSI team presents a Zeeman- Doppler-Image of the surface of the magnetically active star II Pegasi.
A special technique allows astronomers to resolve the surfaces of faraway stars. Those are otherwise only seen as point sources, even in the largest telescopes...
11.03.2019 | Event News
01.03.2019 | Event News
28.02.2019 | Event News
26.03.2019 | Trade Fair News
26.03.2019 | Life Sciences
25.03.2019 | Trade Fair News