Cleft Lip and/or Palate

Brydon, Carolyn A.; Conway, Julia C; Kling, Russell E.; Mehta, Lakshmi; Jabs, Ethylin Wang; Taub, Peter J.

doi:10.1097/scs.0000000000000883

Cited by 16 publications

(6 citation statements)

References 43 publications

(81 reference statements)

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“…CL and CP repairs are associated with increased complications compared to other pediatric otolaryngologic procedures in the United States, 35,36 which our data corroborated. These complications relate to high‐tension closures and the moist, high bacterial colonization of the mouth 35,37 . While CL/CP repair complications are more prevalent than for T&As, they are more predictable than complications like posttonsillectomy bleeding 38,39 .…”

Section: Discussionsupporting

confidence: 79%

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Pediatric Otolaryngology Short‐Term Mission Outcomes at a Surgical Mission Hospital in Guatemala

Richard

Sanchez²,

Amado³

et al. 2023

Otolaryngol.--head neck surg.

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ObjectiveThe frequency of humanitarian surgical mission trips has grown over recent decades. Unfortunately, research on patient outcomes from these trips has not increased proportionately. We aim to analyze the safety and efficacy of surgeries in a low‐ and middle‐income country missions‐based surgery center in Guatemala City, Guatemala, and identify factors that influence surgical outcomes.Study DesignRetrospective cohort study.SettingGuatemalan surgery center is called the Moore Center.MethodsPediatric patients underwent otolaryngology surgery between 2017 and 2019. All patients required follow up. We analyzed the effect of patient, surgical, and geographic factors on follow up and complications with univariate and multivariate analyses.Results A total of 1094 otolaryngologic surgeries were performed between 2017 to 2019, which comprised 37.4% adenotonsillectomies, 26.8% cleft lip (CL)/cleft palate (CP) repairs, 13.6% otologic, and 20% “other” surgeries. Patients traveled on average 88 km to the center (±164 km). Eighty‐nine percent attended their first follow up and 55% attended their second. The 11% who missed their first follow up lived farther from the center (p < .001) and had a higher ASA classification (p < .001) than the 89% who did attend. Sixty‐nine (6.3%) patients had 1 or more complications. CL/CP surgery was associated with more complications than other procedures (p < .001). Of 416 tonsillectomies, 4 patients (1%) had a bleeding episode with 2 requiring reoperation.ConclusionThis surgical center models effective surgical care in low‐resource areas. Complications and follow‐up length vary by diagnosis. Areas to improve include retaining complex patients for follow up and reducing complications for CL/CP repair.

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Section: Discussionsupporting

confidence: 79%

“…These complications relate to high-tension closures and the moist, high bacterial colonization of the mouth. 35,37 While CL/CP repair complications are more prevalent than for T&As, they are more predictable than complications like posttonsillectomy bleeding. 38,39 Consistent follow-up is, therefore, essential to identify and manage them.…”

Section: Discussionmentioning

confidence: 99%

Pediatric Otolaryngology Short‐Term Mission Outcomes at a Surgical Mission Hospital in Guatemala

Richard

Sanchez²,

Amado³

et al. 2023

Otolaryngol.--head neck surg.

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“…Unilateral CLJ is also most common in humans and laboratory rodents [26, 27]. In six CLJ affected Japanese Brown cattle, three had unilateral CLJ, one had bilateral CLJ and two had median CLJ [11].…”

Section: Discussionmentioning

confidence: 99%

“…Right-sided CLJ were more frequent than left-sided in the present study. Rieke [25] observed 33.3 % right-sided CLJ and 21.7 % left-sided CLJ which is in contrast to humans and laboratory animals having a majority of left sided CLJ [26, 27]. …”

Section: Discussionmentioning

confidence: 99%

Phenotypic classification of variability of non-syndromic congenital cleft lip and jaw in Vorderwald × Montbéliarde cattle

et al. 2015

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BackgroundNon-syndromic congenital cleft lip and jaw (CLJ) is a condition reported in several cattle breeds, but a detailed classification system does not exist for cattle. The objective of the present study was to describe the phenotypic variability of this orofacial malformation in Vorderwald × Montbéliarde cattle. For this purpose, a classification system of CLJ was developed on examination of five orofacial structures: (1) lips, (2) the processus (proc.) nasalis of the os incisivum, (3) the dental plate with adjacent segments of the hard palate, (4) the facial bones (os incisivum, os maxillare, os nasale and os palatinum) and (5) the mandibles. Each structure was given a score reflecting the degree of the lesion from absent (score 0) to severe.ResultsNine cases were included in the study and they shared absence of the abaxial rostral part of the processus (proc.) nasalis of the os incisivum, partial loss of the rugae palatinae and the dental plate. A sigmoid curvature of the rostral lower jaw as well as a lateral deviation of the face and rostral lower jaw was highly variable in their expression. These deformations were present in eight of nine cases. In addition to the complete CLJ, three animals had an incomplete CLJ on the contralateral site with variable defects of the rostral part of the proc. nasalis of the os incisivum.ConclusionsA complete CLJ is obviously accompanied by a loss of parts of the proc. nasalis of the os incisivum. Extent and localization of the missing parts of the proc. nasalis were similar in all cases. A precise classification of the various CLJ forms is necessary.Electronic supplementary materialThe online version of this article (doi:10.1186/s13028-015-0177-0) contains supplementary material, which is available to authorized users.

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“…As noted above, the few global initiatives for surgical services, outside of the strengthening of cesarean delivery integrated into maternal health systems, have generally been “siloed,” i.e., restricted to services for single clinical conditions, with resources mobilized only to provide a single type of operation in remote, resource-constrained communities. Single-issue surgical service initiatives in LMICs have targeted conditions such as clubfoot, cleft palate, cataracts, hydrocephalus, and genital fistulas [ 5 – 8 ].…”

Section: Introductionmentioning

confidence: 99%

Demand and capacity to integrate pelvic organ prolapse and genital fistula services in low-resource settings

2018

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Introduction and hypothesisThere is a need for expanded access to safe surgical care in low- and middle-income countries (LMICs) as illustrated by the report of the 2015 Lancet Commission on Global Surgery. Packages of closely-related surgical procedures may create platforms of capacity that maximize impact in LMIC. Pelvic organ prolapse (POP) and genital fistula care provide an example. Although POP affects many more women in LMICs than fistula, donor support for fistula treatment in LMICs has been underway for decades, whereas treatment for POP is usually limited to hysterectomy-based surgical treatment, occurring with little to no donor support. This capacity-building discrepancy has resulted in POP care that is often non-adherent to international standards and in non-integration of POP and fistula services, despite clear areas of similarity and overlap. The objective of this study was to assess the feasibility and potential value of integrating POP services at fistula centers.MethodsFistula repair sites supported by the Fistula Care Plus project were surveyed on current demand for and capacity to provide POP, in addition to perceptions about integrating POP and fistula repair services.ResultsRespondents from 26 hospitals in sub-Saharan Africa and South Asia completed the survey. Most fistula centers (92%) reported demand for POP services, but many cannot meet this demand. Responses indicated a wide variation in assessment and grading practices for POP; approaches to lower urinary tract symptom evaluation; and surgical skills with regard to compartment-based POP, and urinary and rectal incontinence. Fistula surgeons identified integration synergies but also potential conflicts.ConclusionsIntegration of genital fistula and POP services may enhance the quality of POP care while increasing the sustainability of fistula care.Electronic supplementary materialThe online version of this article (10.1007/s00192-018-3561-2) contains supplementary material, which is available to authorized users

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Cleft Lip and/or Palate

Cited by 16 publications

References 43 publications

Pediatric Otolaryngology Short‐Term Mission Outcomes at a Surgical Mission Hospital in Guatemala

Pediatric Otolaryngology Short‐Term Mission Outcomes at a Surgical Mission Hospital in Guatemala

Phenotypic classification of variability of non-syndromic congenital cleft lip and jaw in Vorderwald × Montbéliarde cattle

Demand and capacity to integrate pelvic organ prolapse and genital fistula services in low-resource settings

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