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The aim of the work was a comprehensive assessment of the cytokine system and peripheral blood osteocalcin with the establishment of features of their interconnections in children with congenital cleft lip and palate (CCLP) in comparison with corresponding controls at different age periods. Levels of IL17, IL4, IL6, IL1β, IFNγ and osteocalcin were analyzed by enzyme immunoassay in the peripheral blood of 80 children (0–12 months, 1–3 years, 4–9 years, 10–15 years) with CCLP and age-appropriate control of healthy individuals (40 people). An analysis of the obtained data shows that in children with CCLP we revealed significant differences between pro-inflammatory (IL1β, IL6, IL17), regulatory (IFNγ), anti-inflammatory (IL4) cytokines and osteocalcin compared with controls. Differences were found in the content of IL17, IFNγ, IL4 and osteocalcin in healthy children and in children with CCLP in postnatal ontogenesis. Cytokine deregulation of immunosteogenesis in CCLP, leading to a significant deficit of osteocalcin in the first year of life due to imbalance of the cytokine profile: discordant IL17, IFNγ and IL4 were detected. Obtained data are undoubtedly important in the future for developing new strategies for targeted therapy aimed at normalizing osteocalcin levels at different age periods in children with CCLP.

Congenital cleft lip and palate is one of the most common congenital anomalies in children. It has significant medical and social influence on the self-realization of these patients in society. This review of various researches' results from different countries and territories of the Russian Federation (according to the MEDLINE and eLIBRARY.ru databases) provides information on prevalence rate of this pathology among children of our country and worldwide. The role of medical care organization remains unknown among all the presented results of the studies about the role of risk factors of congenital cleft lip and palate development (such as: inheritance, lifestyle, environment).

It is known that children with congenital cleft lip and palate are suffering from recurrent respiratory infections, which worsen the state of their health, and also complicate the results of reconstructive surgical treatment. The aim of the study was to detect defects of mucosal immunity in children with congenital cleft lip and palate, suffering from recurrent respiratory infections, and to create the program of local interferon corrective therapy with an assessment of its effectiveness. The studies included 56 children from the age of 1 to 3 years. Three groups of children were formed: group 1 – 26 children with congenital cleft lip and palate (antibiotic therapy); group 2 — 30 children with congenital cleft lip and palate (antibiotic therapy + local interferon therapy), group 3 — the control group. The clinical examination included a medical history, an assessment of the symptoms of recurrent episodes of acute respiratory infections and exacerbations of chronic infections. Microbiological studies were performed using standard methods. The status of local immunity was detected: the concentrations of secretory IgA, cytokines IL-17, IL-4, IL-6, IL-1β, IFNγ in the oral fluid were tested by ELISA. Results of the study established that in group 1 and group 2 clinical criteria of immunodeficiency with an infectious syndrome were revealed: repeated acute respiratory viral infections from 10 or more times a year, complicated by frequent exacerbations of chronic bacterial infection (up to 10 or more per year). Assessment of the state of local immunity in children with congenital cleft lip and palate revealed a lack of sIgA compared with the control group. Before treatment in group 2 oral fluid level of IL-17, IL-6 were statistically significant increase (p < 0.05); the results of the study also established increase in the level of IL-1β and a decrease in anti-inflammatory IL-4 and regulatory IFNγ relative to the control group (p > 0.05). After complex treatment with the inclusion of local interferon therapy in group 2 the appearance of sIgA, increase in the concentration of IL-4, IL-1β and a decrease IL-17 in oral fluid were observed (p > 0.05). The concentrations of IL-6, IFNγ did not change (p > 0.05). After treatment in group 2 there were a decrease in exacerbations of chronic upper respiratory tract infection and in frequency of acute respiratory viral infections compared with group 1 (p < 0.05). Positive clinical efficacy of local interferon therapy (the gel of recombinant IFNα2b in combination with oxidants — Viferon gel) in the process of staged rehabilitation of children with congenital cleft lip and palate has a protective clinical effect in reducing the frequency of acute respiratory viral infections, reducing the number of postoperative complications, reducing hospital stay, duration of antibacterial therapy and the number of exacerbations of chronic bacterial infection.

The aim of the present study is to present a multidisciplinary approach in the prevention of abandonment of children with congenital cleft lip and palate and the role of the nurse in it. Methods: Based on a survey, the readiness of the nurse to participate in a multidisciplinary team in the care of children with congenital cleft lip and palate was established. Results: Over 2/3 (71.10%) of the respondents believe that congenital cleft lip and palate is a socially significant problem for our society. A significant proportion of the surveyed medical professionals (89.60%) indicated that it had happened in their practice to try to persuade parents to take care of a child with a congenital cleft lip and palate, with 92.7% stating that they never advised parents to abandon a child born with this type of abnormality. The cooperation of the members of the interdisciplinary team allows for the creation of a model of long-term treatment: ie. from pregnancy to birth, from early childhood to school and in adolescence to young age. The role of nurses in this multidisciplinary team is related to providing care for patients with congenital cleft lip and palate during the treatment process, as well as solving various problems related to growth (the condition before and after surgery, physical and psychosocial development and others). Conclusion: The nursing care system actively promotes holistic care and support for patients with congenital cleft lip and palate and their families. The role of the nurse is to ensure a smooth transition from diagnosis in prenatal diagnosis to birth and then throughout the path of treatment and ongoing care in the community. [ABSTRACT FROM AUTHOR]

The aim of the present study is to present the advantages of early diagnosis of congenital cleft lip and palate in the prevention of abandonment of children in foster homes. Methods: An anonymous survey surveyed the opinions of 70 parents of children with congenital cleft lip and palate. Results: Prenatal diagnosis was performed in only 20.0% of pregnancies, and 24.3% of cases had a family history. Although there is a risk factor for the birth of a child with a congenital cleft lip and palate in the presence of a family burden, only in 7.1% of cases a prenatal diagnosis of the fetus was performed. When considering the behavior of parents in relation to the presence of risk factors, it was found that in 85.7% of cases prenatal diagnosis was performed only in parents of Bulgarian origin, the remaining 14.3% are for parents of Turkish origin. There is no practice of conducting prenatal diagnosis for parents of Roma origin, although 23.5% of cases of birth of children with congenital anomalies have a family burden, often on the part of the father. Conclusion: The application of 3D and 4D in the early diagnosis of congenital cleft lip and palate will help the psychological preparation of parents for the birth of a child with a congenital anomaly. This will help to avoid the initial shock and the reaction of abandoning the child. [ABSTRACT FROM AUTHOR]

The aim of this study was to define and analyze the reproducibility of occlusal relationships according to the results of occlusogram in jaw closure using quantitative analysis of occlusion in adult patients with congenital cleft lip and palate before and after their prosthesis with different versions of dentures and types of their constructive features. Materials and methods. The study was conducted on 37 patients with congenital cleft lip and palate, 11 (29.73 %) of whom had right-sided clefts, 11 (29.73 %) -- left-sided and 15 (40.54 %) -- bilateral. The number of occlusal contact points was measured for all patients before the treatment and after the orthopaedic rehabilitation. Research results. Significant differences were found between the number of occlusal contact points before (unusually small number) and after orthopaedic treatment (significant increase), regardless of the type of cleft (p < 0.001). Such conditions in the oral cavity significantly complicate the tactics of orthopaedic rehabilitation, which affects the need to find more complex options for combinations of fixed and removable orthopaedic structures. Conclusion. Based on the conditions and objectives of this study, the application of the basic principles of a multidisciplinary approach determine the possibility of rehabilitation of such patients by orthopedic methods by making different versions of orthopedic structures. Adequate and high-quality prosthesis for defects and deformations of the teeth rows and occlusion in patients with CCLP leads to improved occlusal relationships and increase in the number of occlusal contact points. [ABSTRACT FROM AUTHOR]

Purpose of the study: To study the correlation of the middle part of the face with congenital cleft lip and palate after surgical procedures. Material and research methods. 630 children of the I and II periods of childhood with CCLP at the age of 3 to 12 years were examined. Among them, 390 (61.9%) boys, 240 (38.1%) girls who underwent surgical manipulation depending on the severity of the anomaly of the lip and palate in the Department of Maxillofacial Surgery at the Bukhara Children's Multidisciplinary Medical Center in Bukhara in the period from 2009 by 2018. Results and discussion. To solve this goal, a morphometric study was carried out and morphometric parameters of the craniofacial region of children of the I and II period of childhood with CCLP were obtained, clinical and anthropometric methods were used, followed by statistical processing of the data. When performing this work, the methodology of anthropometric studies of children was used on the methodological recommendation of N. Kh. Shomirzaev, S. A. Ten and S. I. Tukhtanazorova (1998). Conclusion. In order to increase the efficiency of the physical development of special children, that is, children with CCLP, it is necessary after surgical interventions to conduct a continuous anthropometric measurement of the craniofacial region of children by communicating with specialists as pediatricians, therapists, orthopedists dentists and maxillofacial surgeons. Only in this case can the desired result be achieved in accordance with the principle of the golden ratio. [ABSTRACT FROM AUTHOR]

The problem of rehabilitation of children with congenital cleft lip and palate (CCLP) is a difficult task and doesn’t lose its relevance. Children with CCLP often suffer from repeated acute viral and bacterial infections of the respiratory tract and upper respiratory tract, which leads to a forced delay in surgical, orthodontic treatment, adequate speech therapy and complications after staged surgical operations. The development of inflammatory processes in children with CCLP is associated with anatomical and topographic features that facilitate the penetration of pathogenic microflora in oral and nose mucosa and, consequently, negative changes in the immune system (IS). The key cells of IS in maintaining homeostasis and ensuring oral health are neutrophil granulocytes (NG). NG dysfunctions in CCLP interfere with the elimination of pathogens and support their persistence. This can occur against the background of previously existing defects in the functioning of the NG system and is aggravated by the significant pathogenicity and massiveness of the impact of various infectious agents. Full diagnostics of NG dysfunctions is necessary for the further implementation of their timely immune correction and prevention of the development of pathological chronic inflammation in response to the pathogenic microflora long-term on the mucous membrane of the mouth and nose. For this purpose study was conducted of the functional activity and phenotypic characteristics of NG in children with CCLP at different stages of complex rehabilitation. Blood samples of 56 children with CCLP 1-3 years (n = 20, group 1), 4-6 years (n = 20, group 2), and 7-12 years (n = 20, group 3) at different stages of complex rehabilitation and 30 conditionally healthy children (control groups) of the corresponding age was studied. A violation of the microbiocenosis of the mucous membranes of the oral and nasal cavities was revealed, which may be a cause or a consequence of a decrease in antibacterial immunity, first of all NG dysfunctions. Common for all age groups children with CCLP NG dysfunction was found: the appearance of NG expressing CD14 receptors that are absent in children of all three control groups, which indicates the presence of viral and bacterial load; defects of phagocytosis associated with a decrease in the number of actively phagocytic NG, impaired NG capture functions; impaired NADPH oxidase release with partial or complete blockade of the response to additional antigenic load, even in the absence of acute clinical manifestations. Comparative analysis of the studied indicators of the expression level of the receptors CD64, CD16, CD32, CD14 NG in children with CCLP demonstrates different equipment, which determines the inconsistency of the phagocytic and microbicidal function of NG in different age periods. Thus, an increase in the expression of these membrane markers, especially CD64 and CD14, in older age groups is accompanied by more significant defects in phagocytic and killing functions of NG, which is associated not only with recurrent viral respiratory infections, but also with a high frequency of associated bacterial infections of the respiratory system and ENT – organs. Revealed NG dysfunctions in children with CCLP of various age groups indicate their inability to implement adequate anti-infective protection, which can lead to atypically occurring viral – bacterial infections and the occurrence of various, including purulent complications in the postoperative period, which requires the development of targeted immunotherapy, included in the program of comprehensive rehabilitation in children with CCLP and aimed at restoring impaired NG functions.

Difficulty in nasal breathing is the most common complaint of children with ССLP. The feeling of difficulty in nasal breathing is subjective and depends on many causes and characteristics of the child’s body. Despite the continuous improvement of diagnostic methods, the problem of evaluating the functions of the nasal cavity remains relevant. Modern computer technology contributes to the emergence of new non-invasive, atraumatic methods that safely evaluate the function of the nose. These methods include anterior active rhinomanometry – PARM. Purpose of the study. To determine the peculiarities of these PARM in children with ARH, depending on the forms of secondary and residual deformities of the nose after cheiloplasty and NGN after uranoplasty. The study involved 59 children with CCLP who were under observation at the Department of Pediatric Maxillofacial Surgery at the TGSI Clinic, which underwent cheilo- and uranoplasty. All patients, depending on the shape and localization of the deformation, were divided into two main and control groups: 1 group comprised 31 patients with secondary and residual deformities of the nose after cheiloplasty, 2 group consisted of 28 patients with secondary and residual deformities of the palate after uranoplasty; 3 group – control included 21 healthy children. The use of computer rhinomanometry – PARM in patients with ARH helps to more reliably determine the presence and degree of nasal obstruction, as well as to control it in the dynamics of the treatment process.

Treatment and rehabilitation of children with cleft lip and palate, who suffered from acute recurrent viral and bacterial respiratory tract and ENT-organs infections is one of the most complicated tasks. The local therapy by interferon was used both before and after surgical treatment: lubrication of the nasal passages and oral mucosa were carried out during 40 days ( 10 days before and 30days after surgical treatment). The priority in treating children with such diseases is given to the gradually increasing efficacy of rehabilitation and lowering post-operative complications and restoring the immune system functional activity.

The aim of the work was a comprehensive assessment of the cytokine system and peripheral blood osteocalcin with the establishment of features of their interconnections in children with congenital cleft lip and palate (CCLP) in comparison with corresponding controls at different age periods. Levels of IL17, IL4, IL6, IL1β, IFNγ and osteocalcin were analyzed by enzyme immunoassay in the peripheral blood of 80 children (0–12 months, 1–3 years, 4–9 years, 10–15 years) with CCLP and age-appropriate control of healthy individuals (40 people). An analysis of the obtained data shows that in children with CCLP we revealed significant differences between pro-inflammatory (IL1β, IL6, IL17), regulatory (IFNγ), anti-inflammatory (IL4) cytokines and osteocalcin compared with controls. Differences were found in the content of IL17, IFNγ, IL4 and osteocalcin in healthy children and in children with CCLP in postnatal ontogenesis. Cytokine deregulation of immunosteogenesis in CCLP, leading to a significant deficit of osteocalcin in the first year of life due to imbalance of the cytokine profile: discordant IL17, IFNγ and IL4 were detected. Obtained data are undoubtedly important in the future for developing new strategies for targeted therapy aimed at normalizing osteocalcin levels at different age periods in children with CCLP. [ABSTRACT FROM AUTHOR]

Today, congenital cleft lip and palate (CCLP) is the most common congenital malformation of the maxillofacial area. According to different authors, the incidence of the defect among infants is 1 per 500--1000 depending on the region. In most cases, CCUPP is not difficult to diagnose; it is detected in the maternity hospital, and child with its parents is sent to a specialized institution for surgical treatment. However, there is a type of isolated cleft palate which may be very difficult to diagnose due to absence of evident defect of the palate. This is hidden (submucosal) congenital cleft palate. [1, 7].

The authors describe a history case of severe congenital dentofacial anomaly with congenital cleft lip, palate and alveolar ridge, associated with somatic disease. The diagnosis was confirmed histologically. The surgical treatment was performed after the careful presurgical preparation due to severe general condition of the child. The indication to the surgical treatment was a significant enlargement of the tumor mass since the child’s birth. The tumor filled the oral cavity and blocked oropharynx almost completely.

The congenital cleft lip and palate (LP) is one of the most common malformations of the face and jaws, and it is among the most severe defects in terms of the severity of the anatomical and functional disorders. [ABSTRACT FROM AUTHOR]

Objective: Is to evaluate the advantage of Contractubex gel with regards to influence on vascularisation, pigmentation, thickness, surface size, configuration, and elisticity of postsurgical scars of children (after cheilorinoplasty) in comparison to absence of systematized topical treatment., Material and Methods: Into the prospective, non-interventional, observational, multi-centered, in parallel groups, open, controlled study were included 60 patients aged 2,5 months and older with postsurgical scars after first cheilorinoplasty after 7-14 day after operation. Patients were randomized into 2 groups of 30 patients in each. I group - patients get applications of Contractubex gel 3 times a day (in the morning, in the afternoon, in the evening) in accordance with patient information leaflet. II group - control group with no regular therapy of of postsurgical scars (without treatment or without application of oils and gels with anticsarring action). The period of medicine usage - 9 months and more for each patient, the each patient observation duration is 18 months., Results: After analysis of the primary as well as secondary efficacy criteria (total grade based on POSAS scale, reported by investigator/parent) after 3, 6, 12, 18 months of observation in both groups a positive statistically significant dynamics was registered. At the same time in the Contractubex group results were statistically significantly better than in the control group. Positive dynamics was achieved quickier in the main group than in the contol group and was to observe already after 3 months of therapy, during the whole treatment and observation phase, and after 18 months of therapy. Additionally conducted photodocumentation of postsurgical scar development dynamics in terms of the study confirms positive effect of surgery and absence of visual data regarding keloids or hyperthrophic scars formation in patients in both groups. Adverse events, i. a. pain, itch, burning, long-run hyperemia were not registered during the whole period os study., Conclusion: The conducted study has shown high efficacy and safety of Contractubex usage for the treatment of postsurgical scars of children with with congenital cleft lip and palate (from 2,5 months old). The statistically significant advantage of the therapy with Contractubex was demonstrated in comparison with the control group (with no regular topical treatment). The obtained results allow to recommend Contractubex gel as an effective and safe medicine for the treatment of scarring after surgeries for kids directly after sutures removal.

The aim of the work was a comprehensive assessment of the system of cytokines and peripheral blood osteocalcin with the establishment of features of their interconnections in children with congenital cleft lip and palate (CCLP) in comparison with the corresponding controls at different age periods. In the peripheral blood of 80 children (0-12 months, 1-3 years, 4-9 years, 10-15 years) with osteocalcin and IL17, IL4, congenital cleft lip and palate and age-appropriate control of healthy individuals (40 people) IL6, IL1β, IFNγ by enzyme immunoassay. An analysis of the data obtained with CCLP revealed significant differences in the dynamics of the relationship between pro-inflammatory (IL1β, IL6, IL17), regulatory (IFNγ), anti-inflammatory (IL4) cytokines and osteocalcin compared with controls. The patterns of changes and effects of IL17, IFNγ, IL4 and osteocalcin in healthy children and in children with congenital cleft lip and palate in postnatal ontogenesis were established. Cytokine dysregulation of immunosteogenesis in CCLP, leading to a significant deficit of osteocalcin in the first year of life due to an imbalance of the cytokine profile: discordant IL17, IFNγ and IL4 were detected. Thus, the data obtained are undoubtedly important in the future for developing new strategies for targeted therapy aimed at normalizing osteocalcin levels at different age periods in children with congenital cleft lip and palate.

The purpose : to compare the types of cytograms of exudate from the middle ear between patients with exudative otitis media (EOM) with congenital clefts of the lip/palate (CCLP) and without CCLP, determining the stages of chronic disease and the significance of surgery on the middle ear., Patients and Methods: Two clinics was parallel conducted a cytological examination of exudate of the middle ear in children. The first group consisted of 30 patients aged 2 to 17 years with EOM without CCLP (n=54 ears). The 2nd group included 17 patients aged 1 year 4 months to 10 years with EOM with CCLP (n=34 ears)., Results: In the 1st group, in 61% of cases (n=33), an inflammatory-regenerative type of cytogram was detected, in 39% (n=21) - a regenerative, inflammatory type of cytogram was not detected. In the 2nd group, in 82.4% of cases (n=28), an inflammatory type of cytogram was observed, in 14.7% (n=5) - an inflammatory-regenerative type, in 2.9% (n=1 ear) - a regenerative type., Conclusion: With CCLP, the inflammatory nature of the cytogram of the resulting exudate from the middle ear is more common, which is characterized by signs of destruction of the mucous membrane, decay and degradation of the basal and cell membranes. Patients with CCLP often suffer from EOM. They are more likely to development of chronic purulent otitis media, including with cholesteatoma. Destructive changes in the mucous membrane of the middle ear are found in children of different ages. Taking into account the analysis of cytograms of the exudate of the middle ear with CCLP, the imposition of long-term ventilation tubes is justified.

Multi-stage therapy of children with congenital diseases of the maxillofacial region requires a multidisciplinary team of specialists coordinated consistently conducted treatment, not only providing a complete reconstruction of the maxillary bones, but also improving the quality of life of children. In our study, it was found that the most significant independent predictors of the total indicator of quality of life are indicators of structures and functions of the maxillofacial region, as well as the level of activity and participation of children in real life situations and the level of parental compliance.

Congenital malformations of the maxillofacial area - congenital cleft lip and palate (CCLP) due to their frequency, the severity of anatomical and functional disorders, the difficulty of social adaptation of patients, economic aspects are one of the most important problems of medicine. It is established that for timely stage surgical treatment of children with IAPC the emphasis is on the somatic status of the child, anti-infective resistance, the ability to safely tolerate surgery, which is important for the restoration of anatomical defects, communication functions and psychosomatic health. Children with CCLP are at risk for increased occurrence of postoperative complications, since upper respiratory tract infection and exacerbation of chronic respiratory tract diseases and ENT organs is a contraindication to surgical intervention. The study of immune status revealed deep violations of antiviral and antibacterial immunity in children with CCPC aged from 6 to 12 years. A program of combine interferon- and immunotherapy has been created. Positive clinical and immunological efficacy of combine interferon-(gel Viferon - recombinant IFNα2b in combination with antioxidant) and immunotherapy in the rehabilitation of children with CCPC aged 6 to 12 years was demonstrated.