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Early Cleft Lip Repair Revisited: A Safe and Effective Approach Utilizing a Multidisciplinary Protocol
- Source :
- Plastic and Reconstructive Surgery Global Open
- Publication Year :
- 2017
- Publisher :
- Wolters Kluwer Health, 2017.
-
Abstract
- Background: The optimal timing for cleft lip repair has yet to be established. Advances in neonatal anesthesia, along with a growing body of literature, suggesting benefits of earlier cleft lip and nasal repair, have set the stage for a reexamination of current practices. Methods: In this prospective study, cleft lip and nasal repair occurred on average at 34.8 days (13–69 days). Nasal correction was achieved primarily through molding the nasal cartilage without the placement of nasal sutures at the time of repair. A standardized anesthetic protocol aimed at limiting neurotoxicity was utilized in all cases. Anesthetic and postoperative complications were assessed. A 3-dimensional nasal analysis compared pre- and postoperative nasal symmetry for unilateral clefts. Surveys assessed familial response to repair. Results: Thirty-two patients were included (27 unilateral and 5 bilateral clefts). In this study, the overall complication rate was 3.1%. Anthropometric measurements taken from 3-dimensional-image models showed statistically significant improvement in ratios of nostril height (preoperative mean, 0.59; postoperative mean, 0.80), nasal base width (preoperative mean, 1.96; postoperative mean, 1.12), columella length (preoperative mean, 0.62; postoperative mean, 0.89; and columella angle (preoperative mean, 30.73; postoperative mean, 9.1). Survey data indicated that families uniformly preferred earlier repair. Conclusions: We present evidence that early cleft lip and nasal repair can be performed safely and is effective at improving nasal symmetry without the placement of any nasal sutures. Utilization of this protocol has the potential to be a paradigm shift in the treatment of cleft lip and nasal deformity.
- Subjects :
- medicine.medical_specialty
business.industry
Neonatal anesthesia
030206 dentistry
Surgery
Cleft lip repair
stomatognathic diseases
03 medical and health sciences
0302 clinical medicine
Multidisciplinary approach
medicine
otorhinolaryngologic diseases
Original Article
030223 otorhinolaryngology
business
Subjects
Details
- Language :
- English
- ISSN :
- 21697574
- Volume :
- 5
- Issue :
- 6
- Database :
- OpenAIRE
- Journal :
- Plastic and Reconstructive Surgery Global Open
- Accession number :
- edsair.doi.dedup.....7a868ffcd46bd171f3f41c31048b2fa1