Objective: To evaluate and compare the effect of memory palatal split screw (Memorax) to that of conventional Hyrax rapid palatal expanders on nasal and pharyngeal airway volumes, which were measured and recorded by Cone beam computed tomography (CBCT). Materials and Methods: This study was conducted over 14 subjects of adolescent patients with bilaterally constricted maxillary arches, the sample contained 12 females and 2 males, with age ranged from 12ys to 15ys, with a mean of 13.6 ± 1.4. The sample was divided into two age matched groups, the Memorax group (N=7) subjects with a mean age of 13.5 ± 0.4, received the memory palatal split screw appliance (Memorax). The Hyrax group (N=7) subjects with a mean of 13.4 ± 1 were received the conventional Hyrax palatal expander. For all subjects taking part in the study, maxillofacial CBCTs and NOSE questionnaire records were taken before expansion (T 1 ) and after 3 months at the time of removal of the expanders (T 2 ). Data were explored for normality using Kolmogorov-Smirnov test of normality. Paired t test was used to compare mean values of before and after treatment. Independent (unpaired) test was used to compare between the two groups. Results: Memorax showed a significant increase in nasal airway volume as well as naso-, palato-and total pharyngeal airway volume. While Hyrax showed a non-significant decrease in the palatopharyngeal airway volume. Both groups showed a non-significant difference in the glossopharyngeal airway volume as well as in the NOSE questionnaire results. Conclusion: Memorax could be used in patients suffered from symptomatic nasal obstruction due to bilateral maxillary constriction, in order to improve their breathing as a primary purpose as well as treating malocclusion. It also may be advantageous because it shortens the maxillary expansion period, provides additional expansion in the retention period and generates light forces relative to the conventional Hyrax screw.

Background Rectoperineal fistula is a congenital low anorectal malformation that is presented with constipation and straining at stool. There is argument as regarding name, diagnosis and surgical treatment. Objectives to estimate the incidence of postoperative constipation among patients with rectoperineal fistula treated with anorectoplasty using Krickenbeck classification for postoperative outcomes. Patients and Methods The study was conducted between January 2018 and August 2018. The study included patients with rectoperineal fistula who underwent sagittal anorectoplasty (SARP) in the last five years in two tertiary hospitals; Ain Shams University Children Hospital and Banha Specialized Children Hospital. We excluded patients who underwent operations other than SARP and patients having Currarino syndrome and sacral anomaly like hemisacrum and caudal regression. Krickenbeck classification was used for assessment of constipation before and after operation. A simple questionnaire was used for follow up assessment. Results The study included 30 patients (19 female and 11 male). Their age at time of repair ranged from 3m to 78 months with a median age of 7.5 months. Rate of constipation in patients with rectoperineal fistula after SARP was 39%, while improvement rate was 65%. 14 patients out of 23 having preoperative constipation (61%) were treated from constipation, and one patient (4%) got improved regarding constipation grade and frequency, while remaining 8 patients (35%) were still having the same degree of constipation. There were 7 children who had no constipation before and after repair. These results were statistically significant as measured using McNemar test. Postoperative soiling was recorded in 7 patients; all of them had pseudo-incontinence (ORSI). Conclusion Rectoperineal fistula patients can gain benefit from SARP not just cosmetically, but also functionally (65% of constipated patients got improved).