Cleft Palate Cran J
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Cleft Palate Cran J · Jun 2015
Is There an Increasing Regionalization of Surgical Repair of Craniosynostosis Procedures Into Teaching Hospitals? Implications of Regionalization.
The objective of the present study is to examine whether surgical repairs for craniosynostosis have been regionalized to teaching hospitals over the 8-year period from 2003 to 2010. ⋯ An increasing proportion of surgical repairs of craniosynostosis are performed in teaching hospitals, suggesting there is an increasing concentration of these complex surgical procedures in select centers. As more longitudinal data become available, the relative benefits and drawbacks associated with regionalization of surgical repairs of craniosynostosis should be examined.
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Cleft Palate Cran J · Mar 2015
Perioperative risk factors in patients with 22q11.2 deletion syndrome requiring surgery for velopharyngeal dysfunction.
Objective : To determine the prevalence of cardiac, cervical spine, and carotid artery abnormalities in patients with 22q11.2 deletion syndrome (22q11.2DS) undergoing surgery for velopharyngeal dysfunction (VPD), associations between the presence of these abnormalities, and whether these abnormalities caused changes in surgical management or perioperative complications. Design : Retrospective review. Setting : Tertiary pediatric hospital. ⋯ The presence of one anomaly was not predictive of any other finding, and there were no complications related to the heart, cervical spine, or carotid arteries. Conclusions : Anomalies of the heart, cervical spine, and cervical vasculature occur frequently in 22q11.2DS, vary drastically in severity, and are impossible to predict based on other features of the syndrome. Preoperative diagnosis of these comorbidities with routine imaging can minimize the risk of avoidable surgical complications.
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Cleft Palate Cran J · Mar 2015
Modification of the dingman mouth gag for better visibility and access in the management of cleft palate.
Palatal and pharyngeal surgeries often require wide visibility and access. Various mouth gags and retractors have been devised and many modifications suggested to optimize these surgeries. The Dingman mouth gag, one of the commonly used retractors, offers a lot of advantages in terms of good mouth opening, tongue retraction, self-retaining cheek retractors, and anchorage for sutures, but it has a main limitation in that it allows only limited visibility of the anterior palate and alveolus. Hence, a modification of the Dingman mouth gag is presented for better visibility of and accessibility to the anterior palate.
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Cleft Palate Cran J · Nov 2014
Comparative Study Observational StudyNonsynostotic cranial deformity: a six-month matched-pair photogrammetric comparison of treated and untreated infants.
Objective : To photogrammetrically objectify changes in nonsynostotic craniofacial deformity in orthotically treated versus untreated infants. Design : A statistical retrospective pairwise comparison of two respective three-dimensional (3D) photo scans of 80 children performed in a 6-month time lag. Patients : Two comparable samples of children (40 treated, 40 untreated) with nonsynostotic cranial deformity. ⋯ Conclusions : Helmet therapy may be less appropriate for the correction of brachycephaly than for cranial asymmetry. Nonsynostotic cranial deformity shows some spontaneous correction. Photogrammetry presents an accurate method to objectify craniofacial changes in early infancy.
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Cleft Palate Cran J · Sep 2014
Use of safety measures, including the modified world health organization surgical safety checklist, during international outreach cleft missions.
International surgical outreach missions have become increasingly common within the surgery community. Untoward events in this setting, although rare, can be prevented by careful planning and the use of quality assurance guidelines designed to prevent such complications. The surgical safety checklist is widely accepted in most developed health care practices, but is used variably by international mission groups. This article outlines the quality assurance guidelines used, including a modified World Health Organization safety checklist and illustrated patient instruction forms, to provide a standardized means of delivering sound surgical care in the setting of short-term international cleft lip and/or palate missions.