Experience with the High Attached Pharyngeal Flap

Owsley, John Q.; Lawson, Lucy I.; Miller, Earl R.; Blackfield, Harry M.

doi:10.1097/00006534-196609000-00008

Cited by 23 publications

(5 citation statements)

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“…Finally, we did not perform any other associated simultaneous procedures such as fistula repair or alveolar bone grafting. Similar studies reported a low incidence of OSA following posterior pharyngeal flap 12, 14, 25, 28, 31…”

Section: Discussionsupporting

confidence: 89%

Reply:

Mangia¹,

Andriulli²

2008

Hepatology

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ical response (SVR) was comparable between the standard group (45.1%) and the variable group (48.8%). Patients with rapid virological response (RVR; HCV-RNA-negative at weeks 4) achieved a high SVR rate with either standard 48-week (87.0%) or abbreviated 24-week (77.2%) treatment, respectively. However, only 26.7% of patients attained an RVR, indicating the urgency of increasing RVR rate to ensure treatment efficacy. Although the RVR rate in the study by Mangia et al. was substantially higher than those in previous reports from Europe and the United States (10%-22.6%), 2-5 it was considerably lower than that of our recent study in Taiwan (43.5%). 6 Similarly, the RVR rate of patients with HCV-2 was noticeably higher in Taiwanese patients (86.7%) 7 than in whites (71.1%). 8 Several factors have been predictors of an RVR for HCV-1, such as lower viremia, 1,5,6 young age, 1,5,9 and HCV-1b. 2 However, these factors are unchangeable. Recently, ribavirin dose, 2 low body weight, 9 and the first 4 weeks of weight-based ribavirin exposure with a cut-off point of 13 mg/kg/day 5 have been associated with the achievement of an RVR. These findings suggest the role of weight-based ribavirin exposure, an adjustable factor, in achieving an RVR. Table 1 summarizes the relationship among ribavirin dose, body weight, and RVR rate in patients with HCV-1 in recent large clinical trials. A regimen with the standard dose of ribavirin (1000-12000 mg/day) had a considerably higher rate of RVR (22.6%-43.5%) than that with a lower dose of ribavirin (800 mg/day, 10%-21.6%). Moreover, a negative linear trend was observed between the body weight and the chance of attaining an RVR in either the lower or standard ribavirin groups. A study by Loustaud-Ratti et al. demonstrated that plasma concentration of ribavirin after the first dose, expressed by ribavirin area under the concentration-time curves (AUC 0-12h ), was associated with RVR. 10 These observations highlight the potential role of weight-based ribavirin exposure during the first 4 weeks of combination therapy on the achievement of an RVR. Because RVR is the most important single predictor of an SVR, further prospective studies are encouraged to explore the crucial dose of weight-based ribavirin exposure during first 4 weeks for achieving an RVR to maximize the treatment efficacy.

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Section: Discussionsupporting

confidence: 89%

Reply:

Mangia¹,

Andriulli²

2008

Hepatology

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“…18,22,[33][34][35] The velum was split in the midline from the uvula to approximately halfway to the hard palatal junction. Trapezoidshaped nasal mucosal flaps were incised and sepVolume 125, Number 1 • Pharyngeal Flap Speech Outcomes arated from the oral mucosa of the velum.…”

Section: Operative Techniquementioning

confidence: 99%

Pharyngeal Flap Outcomes in Nonsyndromic Children with Repaired Cleft Palate and Velopharyngeal Insufficiency

Sullivan

Marrinan²,

Mulliken³

2010

Plastic and Reconstructive Surgery

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“…(3) Speech Disability. This is due to palatal scarring and removal of the adenoid buttress (Owsley et al, 1966;Gibb, 1969), and injury to the blood supply to the uvula (Girgis, 1966). This is particularly liable to occur in cases with submucous or complete cleft of the palate.…”

Section: Complications Following Removalmentioning

confidence: 99%

“…The presence of the allergic diathesis usually means that the cause of most of the symptoms such as blockage and colds, is allergy. (1) Adenoids: (a) To assist closure of the post nasal space, particularly in the •wide square type (Owsley et al, 1966;Lubit, 1967;Maran et al, 1971). The atrophy of the adenoids by early teens is compensated for by the growth of the palate.…”

mentioning

confidence: 99%

The T's and A's problem—Assessment and reassessment

Gray

1977

J. Laryngol. Otol.

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Experience with the High Attached Pharyngeal Flap

Cited by 23 publications

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Pharyngeal Flap Outcomes in Nonsyndromic Children with Repaired Cleft Palate and Velopharyngeal Insufficiency

The T's and A's problem—Assessment and reassessment

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