The management of sagittal craniosynostosis has evolved over the decades as teams seek to refine their surgical approaches to idealize head shape with the least possible morbidity. Here, the authors identify the incidence of raised intracranial pressure (ICP) and its risk factors, requiring secondary surgical intervention after cranial vault remodeling (CVR) procedure at a single tertiary referral craniofacial unit. A retrospective case-control study was performed on the patients with isolated non-syndromic sagittal craniosynostosis. All patients who underwent CVR in our unit and had a minimum of 1.5 years follow-up were included. One hundred and eighty-four patients (134 male and 50 female) who underwent primary CVR surgery for isolated sagittal craniosynostosis were included. Thirteen patients (7.07%) had clinical evidence of late raised ICP resulting in repeat CVR procedures. Higher incidence of raised ICP in patients who had primary surgery before 6 months than after or at 6 months of age (P ¼ 0.001). There were 23.5%, 5.6%, 3.2%, and 1.9% of secondary raised ICP patients who underwent the primary

Objective: To evaluate the speech outcomes after primary cleft palate repair in a single tertiary medical institution of Thailand.Materials and Methods: A prospective cohort study was performed. Patients who had cleft palate with/without cleft lip and underwent primary cleft palate repair were included. Speech assessment was performed using the Pittsburgh weighted speech score (PWSS) by a speech-language pathologist.Results: Forty patients (21 males and 19 females) who underwent primary cleft palate repair at Siriraj Hospital were included. The median age at the time of speech evaluation was 7 years. The median age at primary cleft palate surgery was 12 months. The predominant cleft palate type was Veau 3 (47.5%). Oronasal fistula occurred 40%. Two-flap palatoplasty and intravelar veloplasty were the most common procedures. Median PWSS was 7, in which the competence velopharyngeal mechanism was found 5%, borderline competence 10%, borderline incompetence 32.5%, and incompetence velopharyngeal mechanism 52.5%. Among the velopharyngeal incompetence group, articulation disorder was the most common disorder with median score of 3. Besides, the median scores for hypo/hyper-nasality, nasal emission, phonation, and facial grimace disorder were 1, 2, 0 and 0, respectively. There was no statistically significant association between velopharyngeal incompetence and cleft types, age at primary surgery, type of operation, the width of cleft palate and prevalence of postoperative oronasal fistula or otitis media effusion.Conclusion: Velopharyngeal incompetence has been commonly identified after cleft palate repair in our institute. The articulation disorder is the most common characteristic.

To compare the success rates of split-thickness skin graft (STSG) survival for gauze-based and foam-based Negative-Pressure Wound Dressing (NPWDs). MATERIALS AND METHODS: A single-center, prospective, cohort study was conducted to compare the STSG survival rates of gauze-based and foam-based NPWDs at Days 7 and 30 post-surgery. Sixty-nine patients underwent STSG and NPWD procedures. In all, 79 wounds required dressing: 42 had a foam-based NPWD applied, while the remaining 37 wounds had a gauze-based NPWD. Wall-suctioned, continuously negative pressure was applied at-100 mmHg for 7 days. RESULTS: At Day 7, the median graft survivals of the foam-and gauze-based NPWDs were 89.74% and 87.63%, respectively. At 30 days, the median graft survival for the foam-and gauze-based NPWDs were 95.2% and 92.01%, respectively. There was no statistical difference in the graft survival of the 2 groups. The success rate of graft survival for the gauze-based NPWD proved to not be inferior to that of foam-based NPWD. CONCLUSION: Gauzed-based NPWD is non-inferior to foam-based NPWD in terms of STSG survival. Gauze can be used as an alternative NPWD for STSG immobilization.