Thursday, June 23, 2011

Cleft palate, cleft lip and cheilo-palato-schizis - Surgical therapy

Unilateral cleft lip plasty.Unilateral cleft lip repair is usually performed in the first year of life.To the rule of 10: hemoglobin above 10 g, age over 10 weeks, weighing 10 kg. Patients who meet these criteria can better tolerate general anesthesia. All surgical procedures involve the application of local flaps for reconstruction and closure of defects.Prechirurgicale orthodontic interventions.
They use an applicator to reposition segments palace in normal alignment. The tape is placed over the cheeks and prolabiumul patient with bilateral deshizatura. They have the ability to convert a complete an incomplete cleft. In addition, realignment of the segments decreases preoperativa wound tension and the incidence of wound dehiscence.
Plasty cleft lip bilateral.This defect is unique because the control and postoperative results are affected by premaxilar segment status and degree of symmetry and completeness of the deformity. Target intervention includes correcting cleft nasal deformity and to establish a normal relationship between remaxilar and alveolar arches. Orthodontics prechirurgicala is useful to realign the maxillary arch and premaxila and to minimize voltage cleft closure.
Plasty cleft palate.The purpose of this procedure include palate defect closure and getting a normal spoken language, have a normal dental occlusion and facial growth and palate normal. Time of surgery remains controversial. Opinions are that although the most common early palate closure is associated with higher spoken language and better hearing would affect normal facial growth. In most centers, therapeutic intervention is practiced at the age of 12-18 months.
Complications of surgery include:-Obstruction is the most important respiratory complication during the immediate postoperative result and tongue prolapse in the neck by the patient is sedated as long as the anesthesia, intraoperative placement of a foreign language clips can be helpfulIntraoperative bleeding, is a common complication due to rich vascularization of the palace, can be dangerous in children because they have low blood reserved, epinephrine injection is performed in the palace and compresses oxymetazoline-hydrochloric-Palate fistulae or wound dehiscence can occur in the near postoperative or late, with an incidence of 34%, they occur at high tension in sutureMedium-facial abnormalities that occur in the interventions at an early age, when the girl was not fully developed, appearing through jaw growth restriction.
Therapeutic techniques include the use of the future of bone proteins to induce bone morfogenice.

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