The Cleft palate-craniofacial journal : official publication of the American Cleft Palate-Craniofacial Association
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Cleft Palate Craniofac. J. · Sep 2002
A local perspective on the initial management of children with cleft lip and palate by primary care physicians.
To evaluate the frequency and referral patterns, need for continuing education, and information given to parents of children with cleft lip and palate by local primary care physicians. ⋯ There is a necessity to educate local primary care physicians who manage children with cleft lip and palate regarding cleft information for parents, referral guidelines, the cleft team concept, and the role of primary physicians.
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Cleft Palate Craniofac. J. · Mar 2002
Case ReportsAirway obstruction following palatoplasty: analysis of 247 consecutive operations.
Between February 1987 and September 1997, 247 patients underwent primary repair of a cleft of the secondary palate by one surgeon, using the double-opposing Z-plasty (Furlow) technique. This retrospective study reviews perioperative and postoperative airway compromise among these patients. The purposes of this study were to identify factors associated with airway obstruction following palatoplasty and to analyze the management of those patients. Although infants experiencing airway problems following Wardill-Kilner and Von Langenbeck palatoplasty have been described, airway complications in a group of Furlow repair patients has not been previously reported. ⋯ Patients with cleft palate with the Pierre Robin sequence or other additional congenital anomalies had an increased risk of airway problems following palatoplasty. Awareness of this risk permits identifying those patients prior to surgery so that they can be monitored and managed appropriately, minimizing the likelihood of major complications or death.
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The search for the ideal bone substitute began hundreds of years ago, and continues today. While numerous choices have been proposed and tested, with varying degrees of success, there remain many challenges related to the use of bone substitutes in craniofacial reconstruction. This paper presents a review of the history of bone substitute research, a discussion of currently popular materials, and elucidation of the challenges to be faced as we approach the new millennium.
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This prospective study looked at the postoperative hemorrhage risk associated with the use of diclofenac following cleft palate repair. ⋯ The use of the nonsteroidal anti-inflammatory drug, diclofenac, for postoperative analgesia is well established for many types of surgery. The authors find that twice daily diclofenac rectal suppositories provide very good analgesia postcleft palate repair. This, combined with supplemental oral paracetamol, obviates the need for opiates, resulting in alert infants who feed well and are suitable for early discharge.