Secondary Cleft Rhinoplasty in 1720 Patients: Are National Practices Consistent With Guidelines?

Secondary Cleft Rhinoplasty in 1720 Patients: Are National Practices Consistent With Guidelines? Cleft Palate Craniofac J. 2019 Oct 08;:1055665619879830 Authors: Chouairi F, Torabi SJ, Gabrick KS, Persing JA, Alperovich M Abstract OBJECTIVE: To assess the timing, type, and associated adjunct procedures for secondary cleft rhinoplasty nationally. DESIGN: Data were extracted from a national database of all secondary cleft rhinoplasty procedures (Current Procedural Terminology [CPT] codes 30460 and 30462). Frequency statistics were utilized to analyze demographics, comorbidities, surgical procedures, and timing. Chi-squared analysis and Fisher exact test were used for analysis. SETTING: National Surgical Quality Improvement Program-Pediatric Database. PARTICIPANTS: A total of 1720 patients met inclusion criteria for secondary cleft rhinoplasty repair. INTERVENTIONS: No relevant intervention. MAIN OUTCOMES AND MEASURES: Age, demographics, comorbidities, and associated procedures. RESULTS: Over 5 consecutive years, 1720 patients underwent secondary cleft lip rhinoplasty nationally. Mean patient age was 9.3 ± 5.3 years. Unilateral cleft rhinoplasty patients were older (9.0 years) than bilateral patients (7.8 years; P = .001). Rib grafting was performed in 6.3% of patients at a mean age of 10.6 years with a higher proportion of Asian and female patients. Auricular grafts were more commonly performed by otolaryngology than pl...
Source: The Cleft Palate-Craniofacial Journal - Category: ENT & OMF Authors: Tags: Cleft Palate Craniofac J Source Type: research

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Despite the improvement of primary repair of nasal deformities during the management of cleft lip in infancy, this does not exclude the need for revision rhinoplasty in adulthood for complete patients’ rehabilitation. The purpose of this study was to evaluate the aesthetic outcome of secondary rhinoplasty using costal cartilage grafts in patients with unilateral cleft lip nasal deformity. Twenty patients who were operated at earlier ages for correction of cleft lip and had a residual unilateral cleft lip nasal deformity were included in this study. Costal cartilage rib grafts were harvested; carved and used for maxil...
Source: Journal of Craniofacial Surgery - Category: Surgery Tags: Clinical Studies Source Type: research
Conclusions: Significant nasal correction can be achieved by means of reconstruction of nasal foundation, without nasal tip dissection. Preservation of tissue planes may allow for easier secondary revision, if necessary. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.
Source: Plastic and Reconstructive Surgery - Category: Cosmetic Surgery Tags: Pediatric/Craniofacial: Original Articles Source Type: research
CONCLUSIONS: Posterior cleft dimensions can be a modest indicator for the prognosis of velopharyngeal function at age 5 years, when the soft palate is closed first, independently on the timing of hard palate repair. Antero-posterior palatal length seems to protect from velopharyngeal insufficiency and hypernasality. However, the association found was significant but low. PMID: 31505955 [PubMed - as supplied by publisher]
Source: The Cleft Palate-Craniofacial Journal - Category: ENT & OMF Authors: Tags: Cleft Palate Craniofac J Source Type: research
Conclusions: Our method of combining labial muscle reconstruction through a personalized, small incision effectively corrects microform cleft lip deformity with minimal scar burden.
Source: Journal of Craniofacial Surgery - Category: Surgery Tags: Clinical Studies Source Type: research
Tessier No 3 facial cleft (oro-nasal-ocular clefts) is the rarest and most challenging of all the Tessier clefts. Reports on Tessier No 3 clinical findings, surgical techniques, and outcomes are varied due to the scarcity of patients and the wide range of phenotypic findings. The authors present our experience of 2 children born with Tessier No 3 clefts who were both managed at the Arkansas Children's Hospital. Our purpose is to add knowledge on this rare craniofacial cleft by providing detailed soft tissue findings, skeletal findings, operative techniques, early postoperative outcome, and suggestions of a treatment protoc...
Source: Journal of Craniofacial Surgery - Category: Surgery Tags: Clinical Studies Source Type: research
Conclusion: A functional and aesthetic reconstruction of a full-thickness iatrogenic conchal defect was achieved with excellent results using a local posterior flap, and 2 anteriorly based bookend flaps for closure. To the best of the authors’ knowledge, this report is the first to describe a single-stage reconstruction of an iatrogenic defect in the concha as a complication of conchal cartilage harvesting.
Source: Journal of Craniofacial Surgery - Category: Surgery Tags: Brief Clinical Studies Source Type: research
This study presents a systematic review of randomized controlled trials (RCTs) in cleft and craniofacial surgery. All studies reporting on RCTs in cleft and craniofacial surgery were identified on PubMed using the search terms “cleft,” “velopharyngeal insufficiency,” “velopharyngeal dysfunction,” “nasoalveolar molding,” “gingivoperiosteoplasty,” “Pierre Robin sequence,” “craniofacial,” “craniosynostosis,” “craniofacial microsomia,” “hemifacial microsomia,” “hypertelorism,” “Le Fort,&rdqu...
Source: Journal of Craniofacial Surgery - Category: Surgery Tags: Original Articles Source Type: research
Conclusion: Findings suggest an increase in the number of surgeons, but the training, scope, and standard of care remain relatively limited. Audit and assessment of the practice should also become points of emphasis.
Source: Nigerian Journal of Clinical Practice - Category: Rural Health Authors: Source Type: research
The cleft lip is a complex and varying deformity that requires an elaborate treatment plan. Surgical strategies vary from one center to another. In particular, the treatment – surgical technique and especially its timing – of the nasal deformity are a point of controversy (Henry et al., 2014). This prospective study on early cleft nose surgery is designed to evaluate the effect of primary microsurgical repair of the cleft nose deformity.
Source: Journal of Oral and Maxillofacial Surgery - Category: ENT & OMF Authors: Tags: 2017 Pediatric, Cleft and Craniofacial Surgery Open Forum Source Type: research
Cranial Maxillofac Trauma Reconstruction DOI: 10.1055/s-0037-1601429Care for patients with cleft lip and palate is best managed by a craniofacial team consisting of a variety of specialists, including surgeons, who are generally plastic surgeons or otolaryngologists trained in the United States. The goal of this study was to compare the surgical approaches and management algorithms of cleft lip, cleft palate, and nasal reconstruction between plastic surgeons and otolaryngologists.We performed a retrospective analysis of the American College of Surgeons' National Surgical Quality Improvement Program Pediatric database betwe...
Source: Craniomaxillofacial Trauma and Reconstruction - Category: ENT & OMF Authors: Tags: Original Article Source Type: research
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