Antibiotic prophylaxis for preventing infectious complications in orthognathic surgery

Introduction: Nonsyndromic cleft lip with or without cleft palate (NSCLP) is a common birth defect with substantial clinical and social impact. Folate deficiency is one of the factors that have been associated with increased risk for NSCLP. Polymorphisms in folate and homocysteine pathway genes may act as susceptibility factors. Objective: The objective of this study was to evaluate prevalence estimates of cystathionine beta-synthase (CBS) insertion of 68-bp (c.844ins68) polymorphisms and their correlation with NSCLP. Material and Methods: A total of 236 unrelated individuals from seven Indian populations and an additional 355 cases with NSCLP and 357 controls without NSCLP were included in this study. We investigated the CBS c.844ins68 polymorphism in all samples. Genotyping was performed with polymerase chain reaction and electrophoresis. The data were statistically analyzed using the chi-square test. Results: The CBS c.844ins68 allele is present in six of the seven populations analyzed, and allele frequencies range from 1.5% in Balija to 9.1% in Sugali populations. The CBS c.844ins68 polymorphism showed a significant protective effect on NSCLP at both genotype (WW versus WI: odds ratio [OR] = 0.54, 95% confidence interval [CI] = 0.31 to 0.95, P = .149) and allele levels (W versus I: OR = 0.56, 95% CI = 0.32 to 0.96, P = .033). Conclusions: The current study observed significant differences in the frequency of the CBS 844ins68 allele across populations. There is a significant association between CBS c.844ins68 polymorphism and cleft lip and palate in the Indian population. Additional studies are warranted to identify the functional variants in the genes controlling homocysteine as etiological contributors to the formation of oral clefts. Publication type: Journal: Article Source: EMBASE Full text: Available The Cleft palate-craniofacial journal : official publication of the American Cleft Palate-Craniofacial Association at Cleft Palate-Craniofacial Journal 13.Title: Cleft lip and palate: A 30-year epidemiologic study in North-East of Iran Citation: Iranian Journal of Otorhinolaryngology, 2015, vol./is. 27/78(35-41), 2251-7251;2251-726X (2015) Author(s): Hasanzadeh N., Jahanbin A., Ezzati A., Kianifar H. Language: English Abstract: Introduction: Cleft lip and palate are among the most common congenital anomalies worldwide. This study was conducted in order to explore the incidence and related factors of cleft lip and/or palate (CL/P) among live births in Mashhad, North-Eastern Iran. Materials and Methods: In this cross-sectional study, records of 28,519 infants born between March 1982 and March 2011 at three major hospitals in Mashhad were screened for oral clefts. Clinical and demographic factors relating to diagnosed cases, including birth date, gender, birth weight, maternal age, number of pregnancies, type and side of cleft and presence of other congenital anomalies were recorded for analysis. Results: The overall incidence of CL/P was 1.9 per 1,000 live births. Cleft lip associated with cleft palate (CLP) was the most prevalent type of cleft (50%), followed by isolated cleft lip (35.2%) and isolated cleft palate (14.8%). A total of 92.6% of oral clefts were bilateral and 5.5% were located on the right side. In addition, clefts were found to be more common in male than female births (male/female ratio=2.3). The rate of associated congenital anomalies in CL/P newborns was 37%. No significant differences were observed in the incidence of oral clefts across three decades of study; except for CLP which was significantly more prevalent between 2002-2011 (P=0.027). There were no significant differences with regard to season of birth, associated anomalies or maternal age of affected newborns in the three time periods of the study. Furthermore, maternal age and number of pregnancies were not significantly different among the three types of cleft (P=0.43 and P=0.91, respectively). Although the mean birth weight of patients affected with isolated cleft palate was considerably lower than that of the other two types of cleft, the difference was not statistically significant (P=0.05). Conclusion: This study indicates a frequency of CL/P close to the findings in East Asian countries and higher than some previous reports from Iran, European and American countries. Ethnicity-related genetic factors may have a role in the conflicting results obtained from different populations. Publication type: Journal: Article Source: EMBASE 14.Title: Cleft lip and/or palate and auricular malformations Citation: Cleft Palate-Craniofacial Journal, January 2015, vol./is. 52/1(62-65), 1055-6656;1545-1569 (01 Jan 2015) Author(s): Suutarla S., Rautio J., Klockars T. Language: English Abstract: Objective: To study the relationship between cleft lip and/or palate and auricular malformations in Finnish patients with cleft. Design: Retrospective analysis of patients with an external ear malformation and either a cleft lip with or without a cleft palate (CL+/-P) or an isolated cleft palate (CP). Setting: Tertiary referral clinic. Patients: Review of hospital records of 100 patients from the register of 8200 patients with cleft in the Cleft and Craniofacial Centre at the Helsinki University Central Hospital. Main Outcome Measures: Proportions of variable auricular malformations among CL+/-P and CP patients. Results: Microtia is the most common auricular malformation among patients with cleft and is almost equally prevalent with both CL+/-P and CP. The prevalence of microtia increases as the severity of CL+/-P increases. The combination of microtia and CL+/-P or CP is frequently found with both oculo-auriculovertebral spectrum and Treacher Collins syndrome. Conclusions: Microtia seems to be the most common auricular malformation among patients with cleft. The prevalence of microtia seems to increase as the severity of CL6P increases, whereas in isolated CP microtia seems to occur independently. Publication type: Journal: Article Source: EMBASE Full text: Available The Cleft palate-craniofacial journal : official publication of the American Cleft Palate-Craniofacial Association at Cleft Palate-Craniofacial Journal 15.Title: Cleft lip-cleft palate in Zimbabwe: Estimating the distribution of the surgical burden of disease using geographic information systems. Citation: Laryngoscope, February 2015, vol./is. 125 Suppl 1/(S1-S14), 0023-852X;1531-4995 (2015 Feb) Author(s): Tollefson TT, Shaye D, Durbin-Johnson B, Mehdezadeh O, Mahomva L, Chidzonga M Language: English Abstract: OBJECTIVES/HYPOTHESIS: To evaluate the prevalence and unmet need for cleft lip-cleft palate reconstructive surgery by using incidence. Our hypotheses were that the age of presentation to screening clinics will decrease between 2006 and 2012, and the geospatial distribution of cases will expand to a more rural catchment area.STUDY DESIGN: Longitudinal cross-sectional/geospatial distribution study.METHODS: An online, secure database was created from intake forms for children with cleft lip-cleft palate (N=604) in Zimbabwe (2006-2012). Univariate analysis was completed. A linear regression model was fitted to test the time trend of a child's age at the time of presentation. Unique patient addresses (n=411) were matched. Maps presenting cleft diagnosis and presentation year were created with geographic information systems (GIS) software.RESULTS: The median age of presentation was greater for isolated cleft palate (4.2 years, n=106) than isolated cleft lip (1.5 years, n=251) and cleft lip-cleft palate (2.0 years, n=175). Cleft lip cases were mostly left sided with equal gender distribution. The overall age of presentation remained stable (P=.83). The age of children with isolated cleft palate decreased by 0.8 years per surgical trip (P=.01), suggesting the prevalence of unrepaired cleft palate is decreasing due to local and visiting surgeons. The catchment area extended to a less populous area, but clustered around Harare and Bulawayo.CONCLUSIONS: This study gives Zimbabwe-specific evidence that supports reports of the persistent OBJECTIVES/HYPOTHESIS: To evaluate the prevalence and unmet need for cleft lip-cleft palate reconstructive surgery by using incidence. Our hypotheses were that the age of presentation to screening clinics will decrease between 2006 and 2012, and the geospatial distribution of cases will expand to a more rural catchment area.STUDY DESIGN: Longitudinal cross-sectional/geospatial distribution study.METHODS: An online, secure database was created from intake forms for children with cleft lip-cleft palate (N=604) in Zimbabwe (2006-2012). Univariate analysis was completed. A linear regression model was fitted to test the time trend of a child's age at the time of presentation. Unique patient addresses (n=411) were matched. Maps presenting cleft diagnosis and presentation year were created with geographic information systems (GIS) software.RESULTS: The median age of presentation was greater for isolated cleft palate (4.2 years, n=106) than isolated cleft lip (1.5 years, n=251) and cleft lip-cleft palate (2.0 years, n=175). Cleft lip cases were mostly left sided with equal gender distribution. The overall age of presentation remained stable (P=.83). The age of children with isolated cleft palate decreased by 0.8 years per surgical trip (P=.01), suggesting the prevalence of unrepaired cleft palate is decreasing due to local and visiting surgeons. The catchment area extended to a less populous area, but clustered around Harare and Bulawayo.CONCLUSIONS: This study gives Zimbabwe-specific evidence that supports reports of the persistent burden of disease requiring attention. The GIS software provided data for the primary needs assessment, which will direct communication to healthcare providers and prospective patients outside of the current catchment area.LEVEL OF EVIDENCE: 3 Laryngoscope, 125:S1-S14, 2015.Copyright 2014 The American Laryngological, Rhinological and Otological Society, Inc. Publication type: Journal Article Source: MEDLINE 16.Title: Cleft palate reconstruction using collagen and nanofiber scaffold incorporating bone morphogenetic protein in rats Citation: Tissue Engineering Part A, January 2015, vol./is. 21/1-2(85-95), 1937-3341;1937-335X (01 Jan 2015) Author(s): Mostafa N.Z., Talwar R., Shahin M., Unsworth L.D., Major P.W., Doschak M.R. Language: English Abstract: Background: Absorbable collagen sponge (ACS) loaded with bone morphogenetic protein-2 (BMP-2) is approved for selected clinical applications; however, burst release limits its widespread use. Therefore, nanofiber (NF)-based scaffold with ACS backbone was developed to sustain release of loaded BMP-2 to improve the outcomes of bone grafting in a rodent model of cleft palate. Methods: BMP-2 was loaded on ACS scaffold and then NF hydrogel with different densities (1-2%) was added to sustain the BMP-2 release. The release profiles of BMP-2 from constructs with different NF densities were evaluated in vitro to explore the optimum NF density that could recapitulate physiological bone healing process. Subsequently, scaffold with the appropriate NF density was implanted into a rodent model of cleft palate. Wistar rats, with surgically induced maxillary cleft defects, were then assigned to one of the following groups (n=6/group): no scaffold (control), ACS, ACS+BMP-2, NF+ACS, and NF+ACS+BMP-2. Micro-computed tomography (muCT) was utilized to evaluate percent bone filling (%BF) at defect site as well as changes in anteroposterior and transverse dimensions of the maxilla at weeks 0, 4, and 8. Histological assessment of bone healing was performed at week 8. Results: In vitro release experiments showed that scaffolds containing 2% NF exhibited a release profile conducive to the natural stages of bone healing and, hence, it was utilized for subsequent in vivo studies. Bone healing occurred at the defect margins leaving a central bone void in the control, ACS, and NF+ACS groups over the 8-week study period. BMP-2-treated groups demonstrated higher %BF as compared with other groups at week 8 (p<0.05). Whereas the NF+ACS+BMP-2 group showed bone bridging of the defect as early as 4 weeks, which was not evident in ACS+BMP-2 group. In all groups, bone grafts did not disrupt anteroposterior and transverse growth of maxilla. Based on histological evaluations together with muCT data, NF+ACS+BMP-2 treatment resulted in clinically significant and consistent bone healing throughout the implanted scaffold when compared with the ACS+BMP-2 group. Conclusion: NF+ACS+BMP-2 constructs exhibited osteoinductive properties together with preparation simplicity, which makes it a novel approach for BMP-2 delivery for cleft palate reconstruction. Publication type: Journal: Article Source: EMBASE 17.Title: Co-occurrence of non-mosaic trisomy 22 and inherited balanced t(4;6)(q33;q23.3) in a liveborn female: Case report and review of the literature Citation: American Journal of Medical Genetics, Part A, December 2014, vol./is. 164/12(3187-3193), 15524825;1552-4833 (01 Dec 2014) Author(s): Kehinde F.I., Anderson C.E., Mcgowan J.E., Jethva R.N., Wahab M.A., Glick A.R., Sterner M.R., Pascasio J.M., Punnett H.H., Liu J. Language: English Abstract: Trisomy 22 is the third most common autosomal trisomy occurring in about 0.4% of all clinically recognized pregnancies. Complete non-mosaic trisomy 22 is extremely rare in live births. Most affected children die before one year of age. To date, only 29 liveborn cases have been reported and none has carried an additional genetic lesion. In this report, we describe the clinical presentation, cytogenetic, and cytogenomic findings in a liveborn female with complete non-mosaic trisomy 22 as well as a paternally inherited, balanced reciprocal chromosomal rearrangement t(4;6)(q33;q23.3). The proband manifested features commonly seen in individuals with non-mosaic trisomy 22 such as intrauterine growth retardation (IUGR), single umbilical artery, cranial abnormalities, short neck, cleft lip and palate, dysmorphic ears, hypoplastic nipples, digital malformation, congenital heart defects, dysplastic kidneys, and genital anomalies. In addition, she had lobar holoprosencephaly, aqueductal stenosis, and limb and eye problems that have not been associated with complete trisomy 22 in previous reports. She died at 35 days of age of complex heart disease and renal failure. We are hereby expanding the cytogenetic and clinical spectrum of this rare chromosome disorder. Clinical features of liveborn children with non-mosaic trisomy 22 are reviewed and compared to those in our proband. The impact of genomic content in relation to the survival of trisomies in humans is also discussed. Publication type: Journal: Article Source: EMBASE 18.Title: Common mutations of the methylenetetrahydrofolate reductase (MTHFR) gene in non-syndromic cleft lips and palates children in North-West of Iran Citation: Iranian Journal of Otorhinolaryngology, 2015, vol./is. 27/78(7-14), 2251-7251;2251-726X (2015) Author(s): Abdollahi-Fakhim S., Estiar M.A., Varghaei P., Sharafi M.A., Sakhinia M., Sakhinia E. Language: English Abstract: Introduction: Cleft lips and cleft palates are common congenital abnormalities in children. Various chromosomal loci have been suggested to be responsible the development of these abnormalities. The present study was carried out to investigate the association between the suspected genes (methylenetetrahydrofolate reductase [MTHFR] A1298C and C677T) that might contribute into the etiology of these disorders through application of molecular methods. Materials and Methods: This cross-sectional and explanatory study was carried out on a study population of 65 affected children, 130 respective parents and 50 healthy individuals between 2009 and 2012 at Tabriz University of Medical Sciences, IR Iran. After DNA extraction, amplification refractory mutation system-polymerase chain reaction (ARMS-PCR) and restriction fragment length polymorphism (RFLP)-PCR were used respectively to investigate the C677T and A1298C mutations for the MTHFR gene. Results: There was a significant difference in the rates of the C677T mutation when affected patients and their fathers were compared with the control group (odds ratio [OR]=0.44) (OR=0.64). However, there was no significant difference observed in the rate of this mutation between the patients' mothers and the control group (OR=1.35). In addition, the abnormality rate was higher in patients with the A1298C mutation and their parents, when compared with the control group. This abnormality rate was higher for the affected children and their fathers in comparison with their mothers (Fathers, OR=0.26; Mothers, OR=0.65; Children, OR=0.55). No significant difference was seen in the rate of the polymorphism C677T in its CC, when the affected children and their parents were compared with the control group. However, there was a significant difference in the A1298C mutation. Conclusion: An association was seen between the A1298C mutation and cleft lip and cleft palate abnormalities in Iran. However, there seems to be a stronger relationship between the C67TT mutation and these abnormalities in other countries, which could be explained by racial differences. Moreover, this association was more notable between the affected children and their fathers than their mothers. The findings in this study may be helpful in future studies and screening programs. Publication type: Journal: Article Source: EMBASE 19.Title: Compound heterozygosity of low-frequency promoter deletions and rare loss-of-function mutations in TXNL4A causes Burn-McKeown syndrome. Citation: American Journal of Human Genetics, December 2014, vol./is. 95/6(698-707), 0002-9297;1537-6605 (2014 Dec 4) Author(s): Wieczorek D, Newman WG, Wieland T, Berulava T, Kaffe M, Falkenstein D, Beetz C, Graf E, Schwarzmayr T, Douzgou S, Clayton-Smith J, Daly SB, Williams SG, Bhaskar SS, Urquhart JE, Anderson B, O'Sullivan J, Boute O, Gundlach J, Czeschik JC, van Essen AJ, Hazan F, Park S, Hing A, Kuechler A, Lohmann DR, Ludwig KU, Mangold E, Steenpas L, Zeschnigk M, Lemke JR, Lourenco CM, Hehr U, Prott EC, Waldenberger M, Bohmer AC, Horsthemke B, O'Keefe RT, Meitinger T, Burn J, Ludecke HJ, Strom TM Language: English Abstract: Mutations in components of the major spliceosome have been described in disorders with craniofacial anomalies, e.g., Nager syndrome and mandibulofacial dysostosis type Guion-Almeida. The U5 spliceosomal complex of eight highly conserved proteins is critical for pre-mRNA splicing. We identified biallelic mutations in TXNL4A, a member of this complex, in individuals with Burn-McKeown syndrome (BMKS). This rare condition is characterized by bilateral choanal atresia, hearing loss, cleft lip and/or palate, and other craniofacial dysmorphisms. Mutations were found in 9 of 11 affected families. In 8 families, affected individuals carried a rare loss-of-function mutation (nonsense, frameshift, or microdeletion) on one allele and a low-frequency 34 bp deletion (allele frequency 0.76%) in the core promoter region on the other allele. In a single highly consanguineous family, formerly diagnosed as oculo-oto-facial dysplasia, the four affected individuals were homozygous for a 34 bp promoter deletion, which differed from the promoter deletion in the other families. Reporter gene and in vivo assays showed that the promoter deletions led to reduced expression of TXNL4A. Depletion of TXNL4A (Dib1) in yeast demonstrated reduced assembly of the tri-snRNP complex. Our results indicate that BMKS is an autosomal-recessive condition, which is frequently caused by compound heterozygosity of low-frequency promoter deletions in combination with very rare loss-of-function mutations. Copyright 2014 The American Society of Human Genetics. Published by Elsevier Mutations in components of the major spliceosome have been described in disorders with craniofacial anomalies, e.g., Nager syndrome and mandibulofacial dysostosis type Guion-Almeida. The U5 spliceosomal complex of eight highly conserved proteins is critical for pre-mRNA splicing. We identified biallelic mutations in TXNL4A, a member of this complex, in individuals with Burn-McKeown syndrome (BMKS). This rare condition is characterized by bilateral choanal atresia, hearing loss, cleft lip and/or palate, and other craniofacial dysmorphisms. Mutations were found in 9 of 11 affected families. In 8 families, affected individuals carried a rare loss-of-function mutation (nonsense, frameshift, or microdeletion) on one allele and a low-frequency 34 bp deletion (allele frequency 0.76%) in the core promoter region on the other allele. In a single highly consanguineous family, formerly diagnosed as oculo-oto-facial dysplasia, the four affected individuals were homozygous for a 34 bp promoter deletion, which differed from the promoter deletion in the other families. Reporter gene and in vivo assays showed that the promoter deletions led to reduced expression of TXNL4A. Depletion of TXNL4A (Dib1) in yeast demonstrated reduced assembly of the tri-snRNP complex. Our results indicate that BMKS is an autosomal-recessive condition, which is frequently caused by compound heterozygosity of low-frequency promoter deletions in combination with very rare loss-of-function mutations. Copyright 2014 The American Society of Human Genetics. Published by Elsevier Inc. All rights reserved. Publication type: Journal Article, Research Support, Non-U.S. Gov't Source: MEDLINE Full text: Available American journal of human genetics at Salisbury District Hospital Healthcare Library Full text: Available American journal of human genetics at American Journal of Human Genetics, The 20.Title: Comprehensive treatment approach for bilateral cleft lip and palate in an adult with premaxillary osteotomy, tooth autotransplantation, and 2-jaw surgery. Citation: American Journal of Orthodontics & Dentofacial Orthopedics, 01 January 2015, vol./is. 147/1(114-126), 08895406 Author(s): Kokai, Satoshi, Fukuyama, Eiji, Sato, Yutaka, Hsu, Jui-Chin, Takahashi, Yuzo, Harada, Kiyoshi, Ono, Takashi Language: English Publication type: journal article Source: CINAHL 21.Title: Demineralized bone matrix for alveolar cleft management Citation: Craniomaxillofacial Trauma and Reconstruction, December 2014, vol./is. 7/4(251-257), 1943-3875;19433883 (25 Dec 2014) Author(s): Madrid J.R.P., Gomez V., Mendoza B. Language: English Abstract: The aim of this article is to describe the results of the use of demineralized bone matrix putty in alveolar cleft of patients with cleft lip and palate. We performed a prospective, descriptive case series study, in which we evaluated the results of the management of alveolar clefts with demineralized bone matrix. Surgery was performed in 10 patients aged between 7 and 26 years (mean 13 years), involving a total of 13 clefts in the 10 patients. A preoperative cone beam computed tomography (CBCT) was taken to the patients in whom the width of the cleft was measured from each edge of the cleft reporting values between 5.76 and 16.93 mm(average, 11.18 mm). The densities of the clefts weremeasured with a CBCT, 6 months postoperative to assess bone formation. The results showed a register of gray values of 1,148 to 1,396 (mean, 1,270). The follow-up was conducted for 15 to 33 months (mean, 28.2 months). The results did not show satisfactory bone formation in the cleft of patients with the use of demineralized bone matrix. Publication type: Journal: Article Source: EMBASE 22.Title: Difference in maxillary sinus volumes of patients with cleft lip and palate. Citation: International Journal of Pediatric Otorhinolaryngology, December 2014, vol./is. 78/12(2234-6), 01655876;1872-8464 (2014 Dec) Author(s): de Rezende Barbosa GL, Pimenta LA, Pretti H, Golden BA, Roberts J, Drake AF Language: English Abstract: BACKGROUND AND OBJECTIVE: Sinus disease is noted to be common in patients with cleft lip and palate. Many have wondered if anatomic differences are a cause or at least a contributor of this. In this sense, comparisons of sinus volumes of patients with different craniofacial clefts may be helpful to determine possible differences from normal. Thus, the present study aimed to evaluate and compare the maxillary sinus volume of patients with unilateral (UCLP) and bilateral (BCLP) cleft lip and palate to control, i.e. non-cleft patients, using cone beam computed tomography (CBCT) images.METHODS: The sample consisted of 30 subjects with UCLP, 15 with BCLP and 15 control individuals (non-cleft). Each maxillary sinus was assessed three-dimensionally, segmented and its volume was calculated. The comparison between right and left sinus was performed by Student t-test, and the differences between the control and cleft groups were calculated using ANOVA.RESULTS: No statistical differences were found when the sides were compared (p>0.05). In relation to the assessment among groups, all comparisons had statistically significant differences (p<0.05), with the UCLP group presenting the lowest sinus volume.CONCLUSION: UCLP individuals present maxillary sinuses with smaller volumes, without differences found between the cleft and non-cleft side. BCLP subjects also present a reduction in the volume when compared to a control sample, but the average sinus volume is larger than in UCLP patients.Copyright 2014 Elsevier Ireland Ltd. All rights reserved. Publication type: Journal Article Source: MEDLINE 23.Title: Do orofacial clefts represent different genetic entities? Citation: Cleft Palate-Craniofacial Journal, January 2015, vol./is. 52/1(115-120), 1055-6656;1545-1569 (01 Jan 2015) Author(s): Reiter R., Brosch S., Ludeke M., Fischbein E., Rinckleb A., Haase S., Schwandt A., Pickhard A., Maier C., Hogel J., Vogel W. Language: English Abstract: Objective: To contribute to the understanding of potential genetic differences between different cleft types. Method: Analysis of family history concerning cleft type and search for cleft-type-specific associations in candidate genes performed in 98 individuals from 98 families. Results: In a given family, the cleft type of a second case was more often identical to the index case than expected by chance. Each type of cleft (cleft lip [CL], cleft lip and palate [CLP], cleft palate only [CP], and submucous cleft palate only [SMCP]) was associated with different genes. Conclusion: Family history indicates some specificity of cleft types. The observed phenotype-genotype associations were compatible with this interpretation in that significant associations occurred with disjoint sets of genes in each cleft type. These observations indicate that CL, CLP, CP, and SMCP might represent genetically different entities. Publication type: Journal: Article Source: EMBASE Full text: Available The Cleft palate-craniofacial journal : official publication of the American Cleft Palate-Craniofacial Association at Cleft Palate-Craniofacial Journal 24.Title: Does the use of particulate bone graft increase the incidence of postoperative infection in surgery for craniosynostosis? Citation: Cleft Palate-Craniofacial Journal, January 2015, vol./is. 52/1(e14-e17), 1055-6656;1545-1569 (01 Jan 2015) Author(s): Muzaffar A.R., Nguyen T.B., Baker L., Warren A.J. Language: English Abstract: Objective: The use of particulate bone graft (PBG) has become an accepted technique for filling cranial defects created during cranial vault expansion for craniosynostosis. However, the use of PBG may be a risk factor for postoperative infection. The aim of this study was to compare the rate of postoperative infection in patients who received particulate bone graft (PBG+) with that in patients who did not (PBG-). Design: An Institutional Review Board-approved, retrospective, cohort study of consecutive patients was performed. Twenty-seven consecutive patients in the PBGgroup were compared with 21 consecutive patients in the PBG+group. The two cohorts were assessed for incidence of surgical-site infection. Results: Statistical analysis was performed using the Fisher exact probability test. Surgical site infection occurred in none of the PBGpatients (0%) versus one of the PBG+ patients (4.76%). This difference in infection rates between the two cohorts was not statistically significant (P = .4375). Conclusions: Although there may be concern that PBG could serve as a facilitative medium for bacterial growth, this study demonstrates no statistically significant increase in infection rates with its use. Particulate bone grafting of cranial defects resulting from cranial vault expansion in craniosynostosis remains a useful and valuable technique. Publication type: Journal: Article Source: EMBASE Full text: Available The Cleft palate-craniofacial journal : official publication of the American Cleft Palate-Craniofacial Association at Cleft Palate-Craniofacial Journal 25.Title: Effects of nasal port area on perception of nasality and measures of nasalance based on computational modeling Citation: Cleft Palate-Craniofacial Journal, January 2015, vol./is. 52/1(110-114), 1055-6656;1545-1569 (01 Jan 2015) Author(s): Bunton K. Language: English Abstract: Objective: This study examined the relation between nasal port area, nasalance, and perceptual ratings of nasality for three English corner vowels, /i/, /u/, and /a/. Design: Samples were simulated using a computational model that allowed for exact control of nasal port size and direct measures of nasalance. Perceptual ratings were obtained using a paired stimulus presentation. Participants: Four experienced listeners. Main Outcome Measures: Nasalance and perceptual ratings of nasality. Results: Findings show that perceptual ratings of nasality and nasalance increased for samples generated with nasal port areas up to and including 0.16 cm2 but plateaued in samples generated with larger nasal port areas. No vowel differences were noted for perceptual ratings. Conclusions: This work extends previously published work by including nasal port areas representative of those reported in the literature for clinical populations. Continued work using samples with varied phonetic context and varying suprasegmental and temporal characteristics are needed. Publication type: Journal: Article Source: EMBASE Full text: Available The Cleft palate-craniofacial journal : official publication of the American Cleft Palate-Craniofacial Association at Cleft Palate-Craniofacial Journal 26.Title: Evidence of olfactory deficits as part of the phenotypic spectrum of nonsyndromic orofacial clefting. Citation: Journal of Craniofacial Surgery, January 2015, vol./is. 26/1(84-6), 1049-2275;1536-3732 (2015 Jan) Author(s): May MA, Sanchez CA, Deleyiannis FW, Marazita ML, Weinberg SM Language: English Abstract: Improved understanding of the phenotypic spectrum associated with nonsyndromic orofacial clefting (OFC) has the potential to inform efforts to uncover the etiology of this complex trait. Prior studies report that individuals with OFC are characterized by impaired olfactory ability. In this study, we test whether olfactory dysfunction extends to the unaffected parents of children with OFC. The University of Pennsylvania Smell Identification Test was used to measure olfactory ability in a sample of 60 unaffected mothers and fathers with cleftaffected children. The proportion of deficit was compared with reference data obtained from published sexand age-specific norms on more than 2700 individuals. The proportion of deficit was significantly higher in unaffected parents compared with baseline control subjects (41.7% vs 12.6%; P < 0.001). Of unaffected fathers, 41.7% displayed evidence of deficit compared with 15.1% of male control subjects (P = 0.001), whereas 41.7% of mothers exhibited deficits compared with 10.4% of female control subjects (P < 0.001). Olfactory deficits are present at a high proportion in the unaffected parents of individuals with OFC. This suggests that the deficits observed in affected cases may not simply be a secondary consequence of surgical repair and may instead be an informative phenotype reflecting underlying etiology. Publication type: Journal Article Source: MEDLINE 27.Title: Fracture of the vomero-premaxillary junction in a repaired bilateral cleft lip and palate patient Citation: Craniomaxillofacial Trauma and Reconstruction, December 2014, vol./is. 7/4(302-305), 1943-3875;19433883 (25 Dec 2014) Author(s): Zwahlen R.A., Jayaratne Y.S.N., Htun S.Y., Butow K.-W. Language: English Abstract: Although dental trauma is common in bilateral cleft lip and palate (BCLP), patients' reports on bony fractures of the vomero-premaxillary junction cannot be found. The aimof this report is to illustrate clinical findings and the technique of fracture fixation in a child suffering from a fractured vomero-premaxillary junction as well as subsequent columella lengthening. A 4-year-old girlwith a repaired BCLP presented with an open mucosal laceration and fractured vomeropremaxillary junction.Open reduction and fixation of the dislocated premaxilla was performed under general anesthesia. Fractured bone pieces of the vomero-premaxillary junction were removed and sharp bone edges at the vomer and the premaxilla were grinded. The repositioned premaxilla was fixed to the lateral alveolar arches with two mucoperiosteal sutures on each side. Additional columella lengthening was performed 2 years later. All family memberswere very happy about the new aesthetics of the girl. Although rare, fractures of the vomeropremaxillary junction present several challenges to clinicians related to anatomical, physiological, and psychological issues. Immediate and minimal invasive treatment strategies are recommended when managing such cases. Publication type: Journal: Article