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Novel non-surgery treatment for cleft palate debuts

By Sola Ogundipe

Renewed hope for a better life has emerged for babies born with cleft palates in Nigeria and other countries of the world thanks to a breakthrough treatment and corrective discovery by American scientists.

Even as the first clinical trials of the novel procedure are planned for early 2011, hopes are high that the new procedure may be available in Nigeria before the end of next year.

The study is the first to be carried out using the Offspec instrument at the recently opened second target station at ISIS. Offspec is the world’s most advanced neutron instrument for studying new surface structures and can be used for a number of applications including biological membranes and patterned materials for data storage.

Clefts are one of the most common birth defects (about one in every 700-800 Nigerian babies are affected). Currently in severe cases radical surgery is required to correct the problem, and future complications tend to occur as the child grows into an adult. Babies born with cleft palates usually have problems feeding, and may have speech difficulties in later life, as well as issues with their hearing, dentition and facial growth.

The severest cases often have the least favourable outcomes and unfortunately these are the most challenging children to treat surgically. The new study shows how fundamental knowledge about the structure of materials can be used to develop new technology.

But preliminary results from the new procedure utilising a hydrogel material using the Science and Technology Facilities Council’s ISIS neutron source show that treatment for severe cleft palates could be carried out without the need for complex surgery.

Cleft palates are currently repaired by surgically repositioning the available palatal mucosa, the tissue structure at the roof of the mouth, in order to cover the gap in the palate. However, if the cleft defect is too wide there may be insufficient local tissue available to close the gap without undertaking quite radical surgery. It is these severe cases that can cause future complications for infants as they develop into adults – particularly with speech and facial growth problems.

A team of researchers at the University of Oxford, the John Radcliffe Hospital in Oxfordshire, and the Georgia Institute of Technology has used ISIS to look at hydrogel on the molecular level to try and gather enough information to develop materials that could be used for a potential new treatment.

ISIS provided high level of structural detail needed to assess the new material and gives unique and accurate results that can’t be obtained with any other technique.

The new potential treatment for these severe cases involves inserting a small plate made of an anisotropic hydrogel material (similar to that used in contact lenses) under the mucosa of the roof of the mouth of the patient.The hydrogel gradually expands as fluid is absorbed, encouraging skin growth over and around the plate  a process known as ’tissue expansion’. When sufficient skin has been generated to repair the palatal cleft, the plate is removed and the cleft is repaired by using this additional tissue.

The success of the preliminary results of self-inflating anisotropic hydrogel tissue expanders mean clinical trials in this area are expected to take place early in 2011.


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