2005, Number 4
Rev Mex Cir Pediatr 2005; 12 (4)
Closure of the nasal floor with a primary unilateral cleft palate with a closed anatomic closure technique at the base of the nose
Pérez-González A, Ayuso-Arce A, Hernández-Arrazola D, Cantu BZOI
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Language: Spanish
References: 22
Page: 185-194
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ABSTRACT
Closure of the base of the nose in patients with unilateral primary cleft palate with the technique of anatomic closure of the base of the nose.Introduction: At the present time cleft lip and palate is one of the most controversive disease, furthermore there are many books, magazines and congress of these pathologies. The higher incidence of cleft lip and palate is preponderant, other wise of the clinical variants at multiplicity of his interdisciplinary treatment. In 1979 was published at the Hospital General de Mexico one article of the integral treatment of cleft palate, this article make especial emphasys of one stage of surgical procedure at 3 months of life, due to a vomerian flap to close the base of the nose and queiloplasty with procedures that we told before, the incidence the oronasal cleft has alowest and significative aperence of 74% to 18.7%. Actually, this treatment is in use in certains hospital. Till 1994 to the present time, the anatomic closure of the base of the nose is used to prevent the residuals oronasal clefts, and to avoid the utilization of the vomer in the closure of the base of the nose and the nasal deformities.
Objetive: to evaluate the cosmetic and functional results of the surgical procedure of closure of the base of the nose.
Material and methods: We used a prospective, clinic and longitudinal study of 3 years of duration time. The universe of the study was all the patients with cleft lip and palate who underwent to our institution in a period of time since april of the 2001 to april 2004, and all the patients who camed to the program of estramural surgery at the same time, with 3 months to 3 years of life; with hemoglobin at least of 10g. The variabilities of the study was: independient: surgical procedure; anatomic closure of the base of the nose. Dependent: postoperative complications, nose asimetry and, nasovestibular fistula. We used in all the patients anatomic closure of the base of the nose, queiloplasty and nasal plasty. We took anteroposterior and basals photos of the preoperative times at the 3 and 6 months postsurgical procedure. Also we took presurgical photos of the face, anerrest photo of the mouth and nose of each patient at the 6 month postsurgical procedure and at the first year of the operation. All the patients was clinical revisted at the first third, sixth, and eleventh months posterior to the surgery.
Results: We included 40 patients, 28 boys and 12 girls with a mean of 11 months of life, in wich we make a surgical procedure of primary palate in a first time of surgery with queiloplasty with advanced and rotational flaps, nasal plasty, and closure of the base of the nose, the follow up of the patients was of 18 months none of the patients at the present time has a nasovestibular cleft, and discrepance of the asimetry of the base of the nose. Was an average of 1mm.
Conclusiones: We concluded thath are surgical procedure of the closure of the base of the nose don’t present nasovestibular cleft and the cosmetic results are better with a lowest surgical procedures for the correction of the sequels.
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