Algotithm of Children`s Rehabilitation With Cleft Lip and Palate in the Region With Ecotoxicants

Subject. Surgical methods for eliminating congenital clefts of the upper lip and palate are widely presented in the specialized literature and correspond to the variety of types of lesions of the maxillofacial region. At the same time, international and domestic experience, research results on these issues emphasize the need for continuous improvement of surgical and rehabilitation techniques to eliminate them. In most cases, the use of these developments follows the path of detailing and updating existing classical technologies. Purpose ― to present a surgical method for removal of a congenital asymmetric cleft of the palate with a deficit of its own tissues. Methodology. There was carried out a retrospective analysis of the results of surgical correction of congenital cleft palate in 497 patients (2015―2019). Was selected a group of 53 people having complex variants of the cleft of the sky. Results. Was presented a method for surgical removal of an asymmetric cleft of the palate according to the severity of the defect and the age of the child. Was proposed the technique of using "titanium silk" with asymmetric clefts of the sky with a deficit of their own tissues. Conclusions: The choice of optimal methods for surgical elimination of complex options for cleft palate should be patient-oriented and can form a new tactic of surgical aid, taking into account preliminary interdisciplinary counseling. The use of "titanium silk" as an additional material for uranoplasty in cases of wide splitting of the hard and soft palate (more than 1.5-2 cm) ensures reliable elimination of the defect at any age of the patient and creates a favorable condition for the completion of the systemic rehabilitation complex. A multifactorial mechanism for choosing the method of surgical elimination of complex variants of palatal clefts should be implemented in a specialized clinic, taking into account many years of experience.

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Surgical Tactics for Eliminating Complex Variants of Congenital Cleft Palate

Rogozhina

Blohina

Бимбас

2020

Actual Problems in Dentistry

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Analysis of Results and Complications Uranoplasty in Children With Congenital Cleft Lip and Palate

Chuykin

Davletshin

Kuchuk

et al. 2020

Actual Problems in Dentistry

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Subject. Study of the results and complications of uranoplasty in children with congenital cleft lip and /or palate in the first year after surgical treatment. The goal is to determine the frequency of surgical and speech complications after uranoplasty in children with congenital cleft lip and/or palate in regions with a petrochemical industry and without industrial ecotoxicants. Methodology. After the uranoplasty, 80 children with various forms of cleft palate were examined at the Republican Children's Clinical Hospital. Comprehensive examination included the use of clinical (examination, palpation, percussion ― assessment of surgical status) and functional (electromyography, rheography, magnetic resonance imaging, nasopharyngoendoscopy, speech therapy speech assessment using a sound identification system) research methods. Results. Children with congenital cleft lip and/or palate born and living in regions with petrochemical ecotoxicants more often (37.5 %) have complications after uranoplasty than children from regions without petrochemical ecotoxicants (18.8 %). They have a higher prevalence of palatopharyngeal insufficiency, the frequency of fistulas of the soft and hard palate, and the need for secondary surgical intervention, more often they experience difficulties in restoring speech functions. Conclusions. Due to the presence of somatic diseases and disorders in blood counts at the preoperative stage, more pronounced postoperative complications are noted in the group of children with congenital cleft lip and/or palate from regions with the petrochemical industry, which indicates a violation of their reparative regeneration after uranoplasty. This is the rationale for the development and application of a method for the prevention of postoperative complications, which will be included in the rehabilitation algorithm to improve the physiological and speech functions of children after uranoplasty in a region with a petrochemical industry.

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Specific Features of Dental Status of Children With Congenital Lip and Palate in a Region With Petrochemical Ecotoxicants

Chuykin

Akatyeva

Makusheva

et al. 2021

Actual Problems in Dentistry

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Subject. Dental examination and identification of the features of the dental status of children with congenital cleft lip and palate, born and living in the region with industrial ecotoxicants. Objectives. To study the dental morbidity in children with congenital cleft lip and palate living in a region with industrial ecotoxicants, compare the data with a group of children with congenital cleft lip and palate from an ecologically safe region. Methods. The article presents the results of a dental examination of 195 children with congenital cleft lip and palate, including 108 children aged 3 years, 87 children aged 6 years. Children were divided into two groups depending on the place of birth and residence: 113 children were born and lived in regions with a developed petrochemical industry, 82 children from relatively ecologically safe regions. In the examined children, the prevalence and intensity of dental caries, malformations of hard dental tissues, periodontal diseases, dentoalveolar anomalies, and the hygienic state of the oral cavity were assessed. To determine the intensity of dental caries in children of 3 years old, the index "KPU" was used, in children of 6 years old - the index "KPU+kp". The hygienic state of the oral cavity was assessed by the Fedorov-Volodkina index (1968), the periodontal condition in children of 6 years old was assessed by the KPI index (Leus P.A., 1988). Results. Our data indicate that children from regions with the petrochemical industry have higher rates of dental caries intensity in the age groups of 3 and 6 years, there is a decrease in the resistance of the tooth enamel, and periodontal diseases are more common. Conclusions. The results of the study made it possible to obtain clinical and dental data characterizing the negative impact of industrial petrochemical ecotoxicants on the condition of the dentition in children with congenital cleft lip and palate, which is the rationale for the development of methods for optimizing and increasing the effectiveness of therapeutic and prophylactic measures in this group of patients.

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Algotithm of Children`s Rehabilitation With Cleft Lip and Palate in the Region With Ecotoxicants

Cited by 8 publications

References 2 publications

Surgical Tactics for Eliminating Complex Variants of Congenital Cleft Palate

Surgical Tactics for Eliminating Complex Variants of Congenital Cleft Palate

Analysis of Results and Complications Uranoplasty in Children With Congenital Cleft Lip and Palate

Specific Features of Dental Status of Children With Congenital Lip and Palate in a Region With Petrochemical Ecotoxicants

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