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Brandon R Cardon, Michael P Anderson, Robert S Glade
OBJECTIVE: To determine the safety of ibuprofen used for postoperative pain control following palatoplasty in pediatric patients. DESIGN: Retrospective chart review. SETTING: Tertiary care, pediatric hospital. PARTICIPANTS: Patients who received ibuprofen for postoperative pain control after palatoplasty. MAIN OUTCOME MEASURES: Number of doses of ibuprofen given during hospitalization and the presence of postoperative primary or secondary bleeding following palatoplasty...
January 1, 2018: Cleft Palate-craniofacial Journal
Sherif M Askar, Mohammad W El-Anwar, Ali Awad
BACKGROUND: Retropalatal region might be considered the most common site of obstruction in patients with snoring and OSA. We aimed at presentation of two combined techniques: modified anterior palatoplasty (MAP) and bilateral double suspension suture (DSS). METHODS: This prospective study was conducted on OSA patients with retro-palatal collapse only that was confirmed by nasoendoscopy during Muller's maneuver and drug induced sleep endoscopy. MAP and DSS were performed for all patients...
May 18, 2018: Sleep & Breathing, Schlaf & Atmung
Sherif M Askar, Amal S Quriba, Elham M Hassan, Ali M Awad, Ahmad A Bessar
OBJECTIVE: The role of hyoidthyroidpexia (HTP) surgery in the management of patients with obstructive sleep apnea (OSA) is well described with good reported outcomes. The effect of HTP on other laryngeal functions is not well discussed. This study was designed to evaluate voice and swallowing outcomes after HTP. PATIENTS AND METHODS: This study was applied on a selected group of OSA patients. HTP (as a sole procedure) was performed in 17 patients and 14 patients had simultaneous palatal procedures (e...
May 15, 2018: Folia Phoniatrica et Logopaedica
Rana Farhadi, Robert D Wallace
OBJECTIVE: This study aimed to analyze our outcomes of primary premaxillary ostectomy and setback combined with lip adhesion as the first stage in repair of the bilateral cleft lip with fly-away premaxilla. METHODS: This retrospective study included all patients who required primary premaxillary setback by a single surgeon to achieve successful lip repair between 2011 and 2017 at a tertiary children's hospital. All patients had bilateral cleft lip and complete cleft palate with significant premaxillary protrusion...
May 14, 2018: Annals of Plastic Surgery
Kristopher M Day, Narayanan M Nair, Larry A Sargent
INTRODUCTION: Liposomal bupivacaine (LB) is a long-acting local anesthetic reported to decrease postoperative pain in adults. The authors demonstrate the safe use of LB in pediatric patients with improved pain control following palatoplasty. MATERIALS AND METHODS: Retrospective patient series of all single-surgeon palatoplasty patients treated at a tertiary craniofacial center from August 2014 to December 2015 were included. All patients received 1.3% LB intraoperatively as greater palatal nerve and surgical field blocks in 2-flap V-Y pushback palatoplasty...
May 14, 2018: Journal of Craniofacial Surgery
K P Pang, E B Pang, K A Pang, B Rotenberg
This study seeks to determine the objective and subjective success rates of anterior palatoplasty and its variants for the treatment of obstructive sleep apnoea (OSA). A systematic review with two independent searches of Medline, PubMed, Cochrane Library and Evidence Based Medicine Reviews was performed to identify publications relevant to OSA and anterior palatoplasty. All relevant studies published before 30 June 2015 were included. Six studies were included in the systematic review. The numbers of patients in each paper ranged from 13 to 77 (total = 240), and mean age ranged from 21 to 51 years...
February 2018: Acta Otorhinolaryngologica Italica
Sunil Richardson, Rakshit Vijay Khandeparker, Ajit Kumar Raghuvaram, Ram Mohan
About one-third of patients with transsphenoidal basal encephaloceles have associated congenital anomalies, including cleft palate. Moreover, they are often plagued by symptomatic exacerbations in the form of upper respiratory obstructions, cerebrospinal fluid leaks, meningitis, etc., with few patients being asymptomatic. We herein present a rare asymptomatic case of transsphenoidal basal encephalocele in an 18-month-old child with cleft palate and highlight a modified version of two-flap palatoplasty.
April 2018: Journal of the Korean Association of Oral and Maxillofacial Surgeons
Andrew Simpson, Osama A Samargandi, Alison Wong, M Elise Graham, Michael Bezuhly
OBJECTIVE: The current review and survey aim to assess the effectiveness of acellular dermal matrix (ADM) in the repair of cleft palate and oronasal fistula and to evaluate the current trends of ADM use in palate surgery. DESIGN: A systematic review of English articles was conducted using MEDLINE (1960 to July 1, 2016), the Cochrane Controlled Trials Register (1960 to July 1, 2016), and EMBASE (1991 to July 1, 2016). Additional studies were identified through a review of references cited in initially identified articles...
January 1, 2018: Cleft Palate-craniofacial Journal
Joon Hyun Kwon, Jeong Woo Lee, Jung Dug Yang, Ho Yun Chung, Byung Chae Cho, Kang Young Choi
This study investigated the effects of Furlow palatoplasty on children with submucous cleft palate (SMCP) and identified surgical indications by comparing SMCP and control patients. Twenty-three SMCP children (average age 28.9 months) who were nonsyndromic and underwent surgery between April 2010 and December 2016 were included. Facial computed tomography (CT) was performed preoperatively and at least 1 year postoperatively after a language test. Facial CT measurements were taken for 140 children aged 0-6 years without deformities (control group)...
March 29, 2018: Journal of Cranio-maxillo-facial Surgery
Rami S Kantar, Michael J Cammarata, William J Rifkin, Natalie M Plana, J Rodrigo Diaz-Siso, Roberto L Flores
BACKGROUND: Fiscal constraints are driving shorter hospital lengths of stay. Outpatient primary cleft lip surgery has been shown to be safe, but outpatient primary cleft palate surgery remains controversial. This study evaluates outcomes following outpatient versus inpatient primary cleft lip and palate surgery. METHODS: The American College of Surgeons National Surgical Quality Improvement Program Pediatric database was used to identify patients undergoing primary cleft lip and palate surgery between 2012 and 2015...
May 2018: Plastic and Reconstructive Surgery
Takashi Hitosugi, Masanori Tsukamoto, Takeshi Yokoyama
Klippel-Feil syndrome (KFS) is a complex syndrome of osseous and visceral anomalies that include the classical clinical triad of short neck, limitation of head and neck movement and low posterior hairline. It may also be associated with anomalies of the genitourinary, musculoskeletal, neurologic and cardiac systems. We experienced surgery for a case of KFS complicated with cleft palate and ankyloglossia. This boy underwent palatoplasty with a push-back method at 19 months of age, and frenumectomy at 31 months...
May 2017: Masui. the Japanese Journal of Anesthesiology
Anantanarayanan Parameswaran, Muruganand V Ganeshmurthy, Yashoda Ashok, Manikandhan Ramanathan, Anthony F Markus, Hermann F Sailer
PURPOSE: Children undergoing cleft palate repair have pain, dysphagia, and wound irritation in the immediate postoperative phase that may compromise surgical outcomes. This trial evaluates the efficacy of the sphenopalatine ganglion block (SPGB) in optimizing intraoperative hemodynamics and postoperative analgesia in children undergoing primary palatoplasty. MATERIALS AND METHODS: The study was designed as a prospective, double-blind, randomized controlled trial comparing the use of SPGB with general anesthesia (GA) (study group) versus the use of only GA (control group)...
March 30, 2018: Journal of Oral and Maxillofacial Surgery
Rajgopal R Reddy, Srinivas Gosla Reddy, Anusha Chilakalapudi, Swapnika Kokali, Ewald M Bronkhorst, Ann W Kummer, Stefaan J Bergé, Anne Marie Kuijpers-Jagtman
BACKGROUND: Is one or two-stage palatoplasty more effective preventing fistula formation and hypernasality in patients with complete unilateral cleft lip and palate? METHODS: This parallel blocked randomized controlled trial included 100 patients with non-syndromic complete unilateral cleft lip and palate with a repaired cleft lip, divided into 2 groups of 50 each. Group A had one-stage palatoplasty at age 12-13 months while group B had two-stage palatoplasty with soft palatoplasty at age 12-13 months and hard palatoplasty at age 24-25 months...
March 28, 2018: Plastic and Reconstructive Surgery
Terumi Okada Ozawa, Luciana Lais Savero Reis, Renata Mayumi Kato, Diógenes Laercio Rocha, Renata Sathler, Daniela Gamba Garib
OBJECTIVE: To evaluate the aesthetics of nasolabial appearance and facial profile of children with unilateral cleft lip and palate (UCLP) submitted to 2-stage palate repair with vomerine flap. DESIGN: Retrospective. SETTING: Single center. PATIENTS: Forty patients with UCLP, mean age of 7.81 years of both sexes, rehabilitated at a single center by 1 plastic surgeon. INTERVENTIONS: Lip and anterior palate repair with nasal alar repositioning was performed at 3 to 6 months of age by Millard technique and vomer flap, respectively...
January 1, 2018: Cleft Palate-craniofacial Journal
Amy Morgan, Mary O'Gara, Claudia Crilly Bellucci, Sebastian Linde, Meredith Albert, Arthur Curtis, Pravin Patel, Kathleen A Kapp-Simon
OBJECTIVE: The objective of this study was to investigate the impact of international adoption (IA), age at palatoplasty (PR age), and velopharyngeal sufficiency (VPS) on articulation outcomes. DESIGN: This was a cross-sectional, prospective, observational study. SETTING: Outpatient hospital clinic. PARTICIPANTS: Fifty-one IA and 65 not-adopted (NA) children between the ages of 3 and 9 with nonsyndromic cleft palate with or without cleft lip...
January 1, 2018: Cleft Palate-craniofacial Journal
Colonel Priya Jeyaraj
Introduction: Despite the improvement in surgical techniques in cleft palate surgery, oronasal fistulas continue to remain a challenge, usually the result of residual palatal and alveolar clefts and post-palatoplasty defects. The tongue flap is an extremely versatile, sturdy, reliable and efficient means of closure of anterior as well as posterior, unilateral and bilateral palatal defects, effectively functionally obliterating the oronasal communication, owing much of its success to its highly vascular structure, good mobility, texture match, central location and low donor site morbidity...
June 2018: Journal of Maxillofacial and Oral Surgery
Murat Kara, Mert Calis, Canan Akyuz, Figen Ozgur
Hemangiomas are the most common tumors of childhood with an average incidence of 10%. It is unusual for hemangiomas, which are already rarely seen isolated on the palate, to coexist with cleft palate as in the authors' patient. Four months old baby was admitted with isolated Veau 2 cleft palate and a red-purple colored raised lesion involving almost the whole right side of the hard palate. Magnetic resonance imaging revealed intensive contrasting solid nodule with a lobulated contour that was covering the right half of the hard palate, measuring 2...
March 30, 2018: Journal of Craniofacial Surgery
Sudhir Bhandari, Bhavita Wadhwa Soni, Shiv Sajan Saini
The most imminent issue to be addressed in a child born with cleft lip and/or palate is restoration of normal feeding. Early surgical treatment for cleft repair is crucial but may need to be postponed until certain age and weight gain is attained in an infant. When other feeding interventions fail in these children, prosthetic obturation of the defect with feeding instructions in the interim period is indicated to ward off the prevailing concerns. However, the entire prosthetic management presents a significant challenge with respect to the child's age, scope of iatrogenic injury to the delicate oral tissues, and potential for life-threatening situation during the procedures...
January 2018: Journal of the Indian Society of Pedodontics and Preventive Dentistry
Logan Carr, Megan Gray, Brad Morrow, Morgan Brgoch, Donald Mackay, Thomas Samson
OBJECTIVE: This study aimed to determine whether intraoperative acetaminophen was able to decrease opioid consumption, pain scores, and length of stay while increasing oral intake in cleft palate surgery. DESIGN/SETTING/PATIENTS: One hundred consecutive patients with cleft palate who underwent a von Langenbeck or 2-flap palatoplasty and intravelar veloplasty at a tertiary medical center by the 2 senior authors from 2010 to 2015 were reviewed. INTERVENTIONS: Three intraoperative treatment groups were analyzed: intravenous (IV) acetaminophen, per rectal (PR) acetaminophen, and no acetaminophen...
January 1, 2018: Cleft Palate-craniofacial Journal
Qun Lou, Hongping Zhu, Yi Luo, Zhibo Zhou, Lian Ma, Xiaoran Ma, Yuan Fu
OBJECTIVE: To investigate the age effects of cleft palate repair on middle ear function and hearing level in patients who underwent cleft palate repair at different ages by audiologic examination. METHODS: Medical histories were gathered in detail, and audiologic tests (ie, tympanometry and pure tone hearing threshold) were conducted in 126 patients after palatoplasty. The patients were divided into the following 4 groups according to their ages when they underwent cleft palate repair: group I (0-3 years, 73 patients), group II (4-7 years, 29 patients), group III (8-11 years, 16 patients), and group IV (12 years and older, 8 patients)...
January 1, 2018: Cleft Palate-craniofacial Journal
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