Incidence of Secondary Lip Correction for Children With Unilateral Cleft Lip: A Single-Center Retrospective Study
Conclusions The overall revision rate was 9.6%, which is relatively lower than that in other cleft centers. However, the repair technique and cleft care program should not be evaluated using the revision rate only. Various factors, including surgeons' preference, contribute to the indications for revision, and these factors can change with age. We plan to follow up the patients until our completion of the cleft care program and report the final revision rate.
Conclusions Although plastic surgery trainees endorse gradual operative autonomy overall, a majority of final-year trainees do not perceive supervision only independence in the majority of core procedures queried. Faculties perceive higher trainee operative autonomy than trainees for most procedures. Discordant approaches to case logging were identified both among trainees and between trainees and faculties. Standardization may improve both progression and assessment of operative autonomy in plastic surgery training.
Abstract OBJECTIVE: To evaluate the effect of an American Cleft Palate-Craniofacial Association (ACPA)-approved multidisciplinary team on velopharyngeal insufficiency (VPI) diagnosis and treatment. DESIGN: Retrospective cohort setting; tertiary children's hospital patients; children with cleft palate repair identified through procedure codes. MAIN OUTCOME MEASURES: Velopharyngeal insufficiency diagnosis was assigned based on surgeon or team assessment. Age at diagnosis and surgery was recorded. Difference in age and rate of VPI diagnosis and surgery was analyzed with t test. Multivariate linear and logis...
Conclusion: The authors’ research showed that the effect of zigzag palatoplasty works well in the repair of nasal mucosa myometrium and can be used as an optional method for functional repair of cleft palate.
We evaluated data collected by the American Board of Plastic Surgery to understand unilateral cleft lip (UCL) practice patterns in the US during the past 5 years.
Patients affected by unilateral cleft lip (UCL) often have an accompanying nasal deformity due to the inferior and lateral displacement of the lower lateral cartilage on the cleft side. Despite primary cleft rhinoplasty (performed at the time of cleft lip repair), residual nasal asymmetry commonly results, potentially requiring secondary rhinoplasty. We hypothesized that early cleft lip repair (ECLR) during the neonatal period has the potential to mitigate the cleft nasal deformity while allowing for a longer period of symmetrical growth.
Cleft lip and palate (CLP) is the most common congenital birth defect of the head and neck. Infants with CLP experience difficulties with feeding, leading to low weight gain and failure to thrive.1 At our institution, a paradigm shift has occurred where children with unilateral cleft lip defects are repaired in the late neonatal to early infantile period.2 Before the introduction of early cleft lip repair (ECLR), wide complete cleft lip defects were treated with adjuvant nasoalveolar molding (NAM) and repaired at the age of 3-6 months.
Optimal correction of the cleft nasal deformity has historically been a technical and intellectual challenge to the craniofacial surgeon. The deformity is unique in that multiple tissue types are adversely affected, from bone through the vestibule, cartilage, and external skin. While attitudes and surgical approaches have evolved over decades, several important considerations are factored into the surgeon ’s decision to perform a rhinoplasty at the time of cleft repair, such as the potential for interruption of significant local growth centers, scarring, and the ultimate aesthetic outcome following the patient’...
Over the last 3 years, a shift at our institution has taken place in which patients originally designated for nasoalveolar molding (NAM) as an adjunct to cleft lip repair (repair after 3 months) have instead undergone early cleft lip repair (ECLR) (2-5 weeks of life) without NAM. After implementing the ECLR program at CHLA, only a small subset of patients still undergo NAM with the standard surgical timing of repair. The financial and social impact of this potential paradigm shift has not been studied.
Orofacial clefts are a prevalent birth defect that affects approximately 7.75 neonates out of every 10 000 live births. The optimal timing for repair of the cleft lip has yet to be objectively validated and previous supporting evidence guiding ideal timing may be outdated (Kobus et al. 2014). Earlier repair takes advantage of the high degree of plasticity within the nasal cartilage and maxilla as a result of high concentrations of circulating maternal estrogen in the infant (Kenny et al. 1973). Accomplishing the operative repair of the cleft lip in infancy has the capacity to decrease restrictive scar formation, improve ae...
CONCLUSION: To keep the projection point on the affected side of cleft lip and the surrounding vermilion border as one curve structure is important in maintaining the natural shape of the Cupid's bow. PMID: 32990053 [PubMed - as supplied by publisher]