UTJECAJ OROFACIJALNIH RASCJEPA NA KVALITETU ŽIVOTA OPERIRANE DJECE ; THE IMPACT OF OROFACIAL CLEFTS ON QUALITY OF LIFE IN OPERATED CHILDREN

Media type: E-Book

Title: UTJECAJ OROFACIJALNIH RASCJEPA NA KVALITETU ŽIVOTA OPERIRANE DJECE ; THE IMPACT OF OROFACIAL CLEFTS ON QUALITY OF LIFE IN OPERATED CHILDREN

Contributor: Vuletić, Marko [VerfasserIn]

imprint: [Erscheinungsort nicht ermittelbar]: Sveučilište u Zagrebu. Stomatološki fakultet. Zavod za oralnu kirurgiju.; University of Zagreb. School of Dental Medicine. Department of Oral Surgery., 2018

Language: Croatian

Origination:

University thesis: Dissertation, Sveučilište u Zagrebu. Stomatološki fakultet. Zavod za oralnu kirurgiju.; University of Zagreb. School of Dental Medicine. Department of Oral Surgery., 2018

Footnote:

Description: Orofacijalni rascjepi najčešće su prirođene malformacije koje zahvaćaju kraniofacijalne strukture. Djeca rođena s ovom vrstom malformacije imaju poteškoća s govorom, sluhom, dentalnim nepravilnostima i karakterističnim promjenama izgleda nosa i usne koje utječu na sva područja zdravlja. U literaturi se navodi kako orofacijalni rascjepi imaju velik utjecaj na psihološki razvoj pacijenata, ali i njihovih obitelji. U Hrvatskoj nisu objavljeni radovi koji se bave ovom problematikom pa su zbog toga potrebna istraživanja koja bi ispitala utjecaj orofacijalnih rascjepa na kvalitetu života operirane djece i njihovih roditelja. Za potrebe ovog rada izrađeni su originalni anketni upitnici kojima se ispitivao utjecaj orofacijalnih rascjepa na kvalitetu života operirane djece i njihovih roditelja. Istraživanje je provedeno na Kliničkom zavodu za oralnu kirurgiju, Klinike za kirurgiju lica, čeljusti i usta, Kliničke Bolnice Dubrava, Zagreb, a obuhvatilo je 73 ispitanika, odnosno djece u dobi 11 – 18 godina koja imaju jedan oblik operiranog orofacijalnog rascjepa i jednak broj njihovih roditelja/skrbnika. Zahvaljujući ovom radu, izrađeni su originalni upitnici specifični za procjenu estetskih i funkcijskih rezultata liječenja, odnosno za kvalitetu života operiranog djeteta i njegovih roditelja. Prikazani rezultati pokazuju gledišta djece i roditelja na kvalitetu života te estetske i funkcijske čimbenike s najvećim utjecajem na kvalitetu života. Na temelju analiziranih odgovora, vidljivo je da djeca s rascjepom imaju lošiju kvalitetu života u usporedbi s njihovim vršnjacima bez rascjepa te da orofacijalni rascjep ne umanjuje kvalitetu života samih roditelja. Estetski čimbenici koji najviše utječu na kvalitetu života djece rođene s rascjepom usne i nepca su izgled nosa i usne, a funkcijski čimbenici koji najviše utječu na kvalitetu života su dentalna malokluzija i poteškoće s govorom. ; Introduction: Orofacial clefts are the most common congenital malformations that affect craniofacial structures. Disjunction of skin, muscles, bones and cartilages represents an aesthetic and functional problem. Clefts can be a result of a large number of syndromes or non-syndromic, i.e. isolated, but in both cases, they are divided into cleft lip, cleft lip and palate or isolated cleft palate. Children born with this type of malformation have difficulties with talking, hearing, dental irregularities and characteristic changes in the appearance of the nose and lip, which affect all domains of health. Studies show that orofacial clefts have a major influence on psychological development of the patient and their families. The treatment of children with clefts is comprised of a large number of specialists whose activities are intertwined through the period of growing up, and includes a maxillofacial surgeon who coordinates other team members, a neonatologist, an anaesthesiologist, a paediatrician, an orthodontist, an oral surgeon, an otorhinolaryngologist-audiologist, a logopedist, a psychologist, a psychiatrist, and a paediatric dentist. It is necessary to understand the embryonic development of the nose, lip and palate between the 4th and 10th gestational week in order to grasp the formation of the orofacial cleft. The development of a normal palate is explained by the fusion of facial extensions, i.e. the penetration of mesoderm into the primary and secondary palate. According to His's theory of facial extensions (1892), orofacial clefts are a consequence of inhibition of growth and binding of embryonic facial extensions. The incidence of orofacial clefts, according to the latest data, is about 1 out of 700 children born in the world. In Croatia, according to Magdalenić-Meštrović's research from 2005, the incidence is somewhat higher, and that is 1 in 581 born children. Cleft lip with or without cleft palate is more common in the male sex, and isolated cleft palate in the female sex, regardless of ethnicity. If the ratio of the sexes only in the white race is taken into consideration, then cleft lip with or without cleft palate is more common in the male sex in the ratio of 2:1. Epidemiological and experimental data suggest that harmful environmental influences may have a significant effect on the formation of cleft lip and/or palate in the form of exposure to the mother's tobacco smoke, alcohol, nutritional deficiency, viral infections, medical preparations and other teratogens at work and at home in the early months of pregnancy. Procedures and protocols for treating children with a cleft lip and palate can be extremely different within and among developed countries. Cleft treatments aim at correcting the broken anatomical relationship and establishing a normal function of the broken tissue and surrounding structures. Irregularities regarding the facial appearance, speech, maxillofacial and dento-occlusal development, hearing, and psychosocial status are attempted to be corrected, i.e. alleviated by various invasive and non-invasive therapeutic procedures. Most maxillofacial surgeons operate the cleft lip after the third month of age. This observes the anaesthetic rule of ten" when a child is at least 10 weeks of age, has haemoglobin above 10 dg/L and weight above 5000 g (10 pounds). The surgical procedure of closing the soft palate in complete clefts is most commonly performed between the 3rd and 6th month of age, at the same time as the lip operation is performed. The malformation on the hard palate is corrected in the second operation around the child's second year. In cases of isolated cleft palates, the closure is also performed in two operations

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