Cleft Lip and Palate

Shaye, David A.; Liu, C. Carrie; Tollefson, Travis Tate

doi:10.1016/j.fsc.2015.04.008

Cited by 58 publications

(13 citation statements)

References 128 publications

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“…In published case reports of CA, muscle relaxants were suggested to provide airway safety. [12][13][14] There were no signs of difficult intubation in patients with bilateral CA. Three patients were Cormack and Lehane grade 3 after direct laryngoscopy with a Macintosh blade.…”

Section: Discussionmentioning

confidence: 85%

Anesthesia management in patients with choanal atresia

Boran

Sarıca

2019

Baylor University Medical Center Proceedings

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In this retrospective study, we reviewed the anesthesia management of patients with choanal atresia (CA). Fourteen patients undergoing surgery for CA between June 2007 and September 2018 were evaluated for age, gender, CA side, complications, American Society of Anesthesiologists score, duration of anesthesia, and presence of any additional anomalies. Six patients (42%) had bilateral atresia, and 8 (58%) had unilateral atresia. Various congenital anomalies were present in 50% of patients with bilateral atresia. Three patients were intubated with a C-MAC D pediatric blade because their Cormack-Lehane grade was 3 or 4. Though sevoflurane was used for all patients, total intravenous anesthesia was used for two patients with unilateral atresia. All patients were followed postoperatively while intubated except one patient with bilateral atresia. There was no need for postoperative intubation of any patients with unilateral atresia. In conclusion, clinicians should be aware of perioperative and postoperative complications in patients with CA, bilateral atresia, and accompanying congenital anomalies in the neonatal period. Total intravenous anesthesia can be chosen instead of inhalation anesthesia in appropriate cases, but sevoflurane can be used safely in the induction of anesthesia.

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Section: Discussionmentioning

confidence: 85%

Anesthesia management in patients with choanal atresia

Boran

Sarıca

2019

Baylor University Medical Center Proceedings

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“…The available literature ranges from expert opinion to multi-year field studies, but not all treatment techniques receive equal consideration, which makes them hard to compare due to the lack of data [ 12 , 16 ]. The current standard in cleft osteoplasty is largely dominated by the manual execution of the surgical steps.…”

Section: Discussionmentioning

confidence: 99%

A Holistic Approach for the Identification of Success Factors in Secondary Cleft Osteoplasty

Schröder

Maiwald

Reinicke³

et al. 2022

JPM

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Cleft lip and palate belong to the most frequent craniofacial anomalies. Secondary osteoplasty is usually performed between 7 and 11 years with the closure of the osseus defect by autologous bone. Due to widespread occurrence of the defect in conjunction with its social significance due to possible esthetic impairments, the outcome of treatment is of substantial interest. The success of the treatment is determined by the precise rebuilding of the dental arch using autologous bone from the iliac crest. A detailed analysis of retrospective data disclosed a lack of essential and structured information to identify success factors for fast regeneration and specify the treatment. Moreover, according to the current status, no comparable process monitoring is possible during osteoplasty due to the lack of sensory systems. Therefore, a holistic approach was developed to determine the parameters for a successful treatment via the incorporation of patient data, the treatment sequences and sensor data gained by an attachable sensor module into a developed Dental Tech Space (DTS). This approach enables heterogeneous data sets to be linked inside of DTS, archiving and analysis, and is also for future considerations of respective patient-specific treatment plans.

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“…A multitude of clinical problems are associated with cleft patients, including deficient facial growth, malocclusion, and respiratory, feeding, and speech complications [ 4 ], requiring a comprehensive and multi-disciplinary approach for their care. Bone graft surgery is an essential step in the comprehensive treatment of cleft patients.…”

Section: Introductionmentioning

confidence: 99%

Local vs. systemic administration of bisphosphonates in rat cleft bone graft: A comparative study

et al. 2018

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A majority of patients with orofacial cleft deformity requires cleft repair through a bone graft. However, elevated amount of bone resorption and subsequent bone graft failure remains a significant clinical challenge. Bisphosphonates (BPs), a class of anti-resorptive drugs, may offer great promise in enhancing the clinical success of bone grafting. In this study, we compared the effects of systemic and local delivery of BPs in an intraoral bone graft model in rats. We randomly divided 34 female 20-week-old Fischer F344 Inbred rats into four groups to repair an intraoral critical-sized defect (CSD): (1) Control: CSD without graft (n = 4); (2) Graft/Saline: bone graft with systemic administration of saline 1 week post-operatively (n = 10); (3) Graft/Systemic: bone graft with systemic administration of zoledronic acid 1 week post-operatively (n = 10); and (4) Graft/Local: bone graft pre-treated with zoledronic acid (n = 10). At 6-weeks post-operatively, microCT volumetric analysis showed a significant increase in bone fraction volume (BV/TV) in the Graft/Systemic (62.99 ±14.31%) and Graft/Local (69.35 ±13.18%) groups compared to the Graft/Saline (39.18±10.18%). Similarly, histological analysis demonstrated a significant increase in bone volume in the Graft/Systemic (78.76 ±18.00%) and Graft/Local (89.95 ±4.93%) groups compared to the Graft/Saline (19.74±18.89%). The local delivery approach resulted in the clinical success of bone grafts, with reduced graft resorption and enhanced osteogenesis and bony integration with defect margins while avoiding the effects of BPs on peripheral osteoclastic function. In addition, local delivery of BPs may be superior to systemic delivery with its ease of procedure as it involves simple soaking of bone graft materials in BP solution prior to graft placement into the defect. This new approach may provide convenient and promising clinical applications towards effectively managing cleft patients.

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Cleft Lip and Palate

Cited by 58 publications

References 128 publications

Anesthesia management in patients with choanal atresia

Anesthesia management in patients with choanal atresia

A Holistic Approach for the Identification of Success Factors in Secondary Cleft Osteoplasty

Local vs. systemic administration of bisphosphonates in rat cleft bone graft: A comparative study

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