Abstract:
:The optimal management of the cleft lip and palate patient from birth to completion of treatment presents a formidable challenge to the plastic surgeon and the associated health care system. The multidisciplinary team approach for the management of these patients is widely accepted. However, a paucity of literature exists discussing specific protocol management, interventions, and the long-term outcomes of patients who have completed a strict treatment protocol with a consistent multidisciplinary team. The aim of this study was to present the details of the specific management protocol at the Australian Craniofacial Unit for cleft lip and palate patients and to present a group of patients who have completed this specific protocol and discuss the details of their long-term care. During a 28-year period from 1974 to 2002, the records of 337 patients treated for unilateral cleft lip and palate were evaluated. Of these 337 patients, 22 have completed the same specific protocol management. The same surgeon (David, the senior author) has been responsible for performing all operative interventions and for overseeing the care of each of the 22 patients, ensuring that the treatment protocol has been executed appropriately and without deviation. The interventions and outcomes were analyzed on the basis of speech, hearing, nasal airway, occlusion, psychosocial adjustment, and appearance. Because of the large volume of data and potential differences in outcomes, the authors' intention is to present this as part I of a four-part series beginning with unilateral cleft lip and palate. The results of isolated cleft palate, isolated cleft lip, and bilateral cleft lip and palate will be presented as parts II, III, and IV, respectively. Speech results were assessed as normal speech, mild abnormality, or severe abnormality by objective measures, and intervention for velopharyngeal insufficiency was noted. Seventeen patients were rated as having normal speech. Four patients were rated as having mild speech abnormality, one patient was rated as having severe speech abnormality, and seven patients required surgery for velopharyngeal insufficiency. Hearing results were measured objectively, and good hearing results were obtained in 18 cases. Five patients required tympanoplasty. All patients required alveolar bone grafting. The high Le Fort I osteotomy was performed in six cases. Bimaxillary surgery was performed in one case. Of all the patients assessed from birth to maturity, 13 required between three and five surgical interventions, and nine required six operations or more. Further details and photographs of preoperative and postoperative examples are provided.
journal_name
Plast Reconstr Surgjournal_title
Plastic and reconstructive surgeryauthors
Schnitt DE,Agir H,David DJdoi
10.1097/01.prs.0000105332.57124.89subject
Has Abstractpub_date
2004-03-01 00:00:00pages
805-17issue
3eissn
0032-1052issn
1529-4242journal_volume
113pub_type
杂志文章abstract::This pilot study investigated the feasibility of Google Glass to assist visualization of fluoroscopic images during percutaneous pinning of hand fractures. Cadavers were used to compare total time to pin each fracture and total number of radiographs per fracture from a mini C-arm. A FluoroScan monitor was used for rad...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0000000000001453
更新日期:2015-08-01 00:00:00
abstract::Historically at The Hospital for Sick Children in Toronto, pharyngeal flap pharyngoplasty has been the treatment of choice for treatment of velopharyngeal insufficiency, regardless of velopharyngeal closure pattern. The authors hypothesize that pharyngeal flap pharyngoplasty is more effective in treating velopharyngea...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章,评审
doi:
更新日期:2005-01-01 00:00:00
abstract::Currently, spinal cord stimulation is used to treat ischemia and ischemic pain, with the best results observed in vasospastic cases. It was earlier demonstrated that spinal cord stimulation may attenuate experimentally induced vasospasm in an island flap in the rat. The present study was designed to investigate whethe...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199904040-00018
更新日期:1999-04-01 00:00:00
abstract::The possibility of raising the cutaneous island of the latissimus dorsi musculocutaneous flap without muscle based on only one cutaneous perforator is presented in this paper. An anatomic study performed in 40 fresh cadaver specimens injected with colored latex demonstrated that the vertical intramuscular branch of th...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199512000-00014
更新日期:1995-12-01 00:00:00
abstract::Treatment of nasal deformity and obstruction requires analysis, planning, and precise execution of rhinoplasty techniques. When performed well, rhinoplasty is a powerful tool for achieving appealing nasal morphology and optimizing function. This article aims to highlight an open approach to septorhinoplasty using a nu...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0000000000006687
更新日期:2020-04-01 00:00:00
abstract:LEARNING OBJECTIVES:After reading this article, the participant should be able to: 1. Clinically describe various cutaneous neoplasms. 2. Identify the corresponding histopathologic findings. 3. Discuss the optimal treatment approach for each entity. SUMMARY:Cutaneous neoplasms are broadly viewed as benign, premalignan...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章,评审
doi:10.1097/PRS.0b013e3181d6e89a
更新日期:2010-05-01 00:00:00
abstract::The Maintenance of Certification module series is designed to help the clinician structure his or her study in specific areas appropriate to his or her clinical practice. This article is prepared to accompany practice-based assessment of preoperative assessment, anesthesia, surgical treatment plan, perioperative manag...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0b013e318204aeb2
更新日期:2011-02-01 00:00:00
abstract:LEARNING OBJECTIVES:After reading this article, the participant should be able to: 1. Describe the anatomical malformations found in unilateral cleft lip deformity. 2. Discuss current methods of measuring the deformity and subsequent outcomes. 3. Discuss preoperative assessments, workup, and the use of early interventi...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章,评审
doi:10.1097/PRS.0000000000000721
更新日期:2014-12-01 00:00:00
abstract::Poorly healing mandibular fractures and osteotomies can be troublesome complications of craniomaxillofacial trauma and reconstructive surgery. Gene therapy may offer ways of enhancing bone formation by altering the expression of desired growth factors and extracellular matrix molecules. The elucidation of suitable can...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-200005000-00018
更新日期:2000-05-01 00:00:00
abstract::A modification of the insertion level of Orticochea flaps is proposed. The purpose of the modification is to place the pharyngoplasty at a higher site, in the area of attempted velopharyngeal contact. The site of velopharyngeal contact can be identified using lateral radiographic techniques. A success rate of 93 perce...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-198406000-00003
更新日期:1984-06-01 00:00:00
abstract:BACKGROUND:Liposuction of the neck has an established role in selected patients undergoing cervicoplasty. Some authors have suggested a role for subplatysmal fat removal. Observations in the anatomy laboratory suggested the presence of discrete regions of subplatysmal fat. This information may be useful during surgical...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0b013e3181de2453
更新日期:2010-08-01 00:00:00
abstract:BACKGROUND:Today, minimally invasive procedures are becoming more popular because of the fast recovery. Rhinoplasty is a common facial plastic surgery procedure that can be associated with significant postoperative morbidities, especially periorbital edema and ecchymosis. The aim of this review is to summarize the resu...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章,评审
doi:10.1097/PRS.0000000000002101
更新日期:2016-05-01 00:00:00
abstract::In a number of congenital, developmental, and postoperative conditions, many patients have a difference in the vertical and anteroposterior position of the ears. On correction of this deformity, the most difficult problem is the low and anterior location of the external auditory canal. To overcome this unyielding limi...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199912000-00006
更新日期:1999-12-01 00:00:00
abstract::Despite the existence of basic clinical standards in plastic surgery, specific guidelines for body contour photography have not been detailed previously. In this report we propose standard and supplemental views for positioning of the subject for suction-assisted lipectomy and body contour surgery. Also demonstrated a...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199707000-00034
更新日期:1997-07-01 00:00:00
abstract::An animal model was developed to determine the ability of capacitively coupled electrical fields to enhance onlay bone graft survival in the craniofacial skeleton. Fifteen male New Zealand white rabbits were divided into control and stimulated groups. Blocks of iliac bone were transplanted as onlay grafts to the mandi...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-198810000-00003
更新日期:1988-10-01 00:00:00
abstract:BACKGROUND:Le Fort III osteotomy represents the foundation of surgical correction for midface hypoplasia. One serious complication of Le Fort III osteotomy is severing the internal maxillary artery or its branches during osteotome advancement for pterygomaxillary dysjunction. This study sought to characterize the relev...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0000000000003084
更新日期:2017-03-01 00:00:00
abstract::Of the nearly 90,000 implant-based breast reconstructions performed in the United States, the majority use internal soft-tissue support. Aesthetically, these constructs may allow for better positioning of prosthesis, improve lower pole expansion, and increase projection. They may have particular utility in direct-to-i...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章,评审
doi:10.1097/PRS.0000000000003950
更新日期:2017-11-01 00:00:00
abstract::Seventy-four patients were referred to the senior author because of presumed velopharyngeal incompetence without cleft palate. As a result of an extensive preoperative evaluation that included assessment of articulation patterns, nasal emission, oronasal resonance, and general speech intelligibility, 57 of the 74 pati...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-198402000-00010
更新日期:1984-02-01 00:00:00
abstract::A series of 40 free groin flap transfers is reviewed and analyzed with regard to the factors influencing success or failure. Emphasis is placed on the patterns of venous anastomosis used, and the use of autogenous vein grafts in the arterial limb. The series was too small to establish that any one of the 4 types of ve...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-197907000-00007
更新日期:1979-07-01 00:00:00
abstract::A very rare case of congenital skin tube pedicle with congenital constriction band syndrome was presented. Only one report concerning this bizarre abnormality could be found in the available literature, and no consideration of its etiology has previously been published. In our case, the skin tube was accompanied by th...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199204000-00029
更新日期:1992-04-01 00:00:00
abstract::The suitability of the thigh as a donor site for a new free flap was examined in 100 cadavers. It was found that the vastus lateralis muscle can be used to form a myocutaneous or fasciomuscular flap, the raising of which causes no technical problems and leads to no functional and only minor aesthetic impairments. Depe...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:
更新日期:1992-03-01 00:00:00
abstract::The literature regarding reconstruction of large scalp wounds with free tissue transfer consists mostly of case reports and small series, and none of the published reports focus on the particular problems of the oncology patient. Here the authors describe their experience with 37 flaps in 32 patients, all of whom requ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-200205000-00008
更新日期:2002-05-01 00:00:00
abstract::Contemporary studies and observations have left no doubt that occlusive dressings are superior to open treatment after laser resurfacing. The currently available occlusive dressings, however, are time-consuming to apply, often dislodge shortly after application, and most require reapplication. The authors report a cro...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/01.PRS.0000021884.52700.B2
更新日期:2002-09-15 00:00:00
abstract:BACKGROUND:Acellular dermal matrix is frequently used in implant-based breast reconstruction to cover the inferior aspect of the breast pocket. Its performance profile remains equivocal. The authors studied whether adding it in implant-based immediate breast reconstruction improved outcomes when compared with non-acell...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0b013e31822b6637
更新日期:2011-11-01 00:00:00
abstract::After a very cautious dissection, the crossing of cartilages is going to produce a "spring effect" which, in pushing them to the right position, will consequently correct the pinch. This is a simple procedure, indicated only for nose tips or, if associated with other techniques, to correct secondary rhinoplasty patien...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:
更新日期:1989-10-01 00:00:00
abstract:UNLABELLED:This technique represents a surgical adjunct for the management of chronic, localized pain in patients who continue to have pain despite exhaustive prior evaluation and treatment. The patient-guided approach was used in 10 patients referred with "intractable pain" and yielded good to excellent results in all...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章,评审
doi:10.1097/PRS.0b013e318221dc12
更新日期:2012-01-01 00:00:00
abstract::We have devised a new method for secondary commissuroplasty after reconstruction of the lower lip using Estlander's method with both aesthetically and functionally satisfactory results. This method consists of forming two equilaterally triangular mucosal flaps on the vermilion and a small triangular skin flap in the n...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199210000-00025
更新日期:1992-10-01 00:00:00
abstract::Orbitofacial dermoids in the pediatric population represent a diverse group of lesions. Because of their variability in both clinical presentation and contiguous structure involvement, a thorough understanding of their surgical-pathologic anatomy is imperative. In this retrospective review of 84 lesions in 84 patients...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199306000-00005
更新日期:1993-06-01 00:00:00
abstract::Correcting facial asymmetry is a difficult problem for plastic surgeons. From 1991 to 1996, the authors treated 53 cases of mandibular angle resection, 13 of which were of patients with an asymmetrical lower face. On the basis of these experiences, the authors highlight two important points in dealing with the asymmet...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:
更新日期:1999-09-01 00:00:00
abstract:BACKGROUND:The accepted surgical correction of Tessier no. 3 and no. 4 craniofacial clefts is the use of interdigitating skin flaps along the line of the facial cleft, which frequently results in unsightly facial scars, poor skin color match, and an unnatural facial expression. The authors report their technique of mid...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0b013e31824ec310
更新日期:2012-06-01 00:00:00