Técnicas cirúrgicas correntes para fissuras lábio-palatinas, em Minas Gerais, Brasil

Abstract

Cl eft lip and palate (CL/P) are the most common congenital anomalies of the craniofacial region. Aim: to evaluate the surgical techniques used in CL/P treatment in a craniofacial deformities ward, in Minas Gerais. Materials and Methods: In this retrospective study, carried out between 2002 and 2007, we studied 109 individuals with non-syndromic CL/P submitted to treatment. The aspects analyzed (personal identification, classification of CL/P and surgical treatment performed) were obtained from patient charts, and then we built a database and ran statistical analyses through the SPSS 13.0 software. Followed by descriptive analysis of the surgical procedures depending on the type of CL/P found. Results: Among the 109 patients, 65.1% were males and 34.8% females. We found that 45% of patients had cleft lip and palate, 37.6% cleft lip only and 17.4% cleft palate only. The surgical techniques employed were predominantly those from Millard and Spina for cheiloplasty, McComb for rhinoplasty and, Veau and Van Langenbeeck for palatoplasty. Conclusions: This study is the first to address treatment procedures for individuals with CL/P in the state of Minas Gerais. For unilateral CL/P we predominantly used the association of McComb, Veau and Millard techniques, respectively, for rhinoplasty, palatoplasty and cheiloplasty, in 76.9% of the patients.

Avaliação da idade materna, paterna, ordem de paridade e intervalo interpartal para fissura lábio-palatina

“…Distribution of birth order in the "case" and "control" groups. institution where this study was held, showed were similar results to the ones hereby presented 16 . Maternal age is considered a risk factor for numerous chromosomal alterations; however, there is no consensus whether or not it represents a risk factor for CLP.…”

“…This same study showed a greater occurrence of CLP followed, respectively of CL and CP alone. Recently, a study carried out in the same institution where this study was held, showed were similar results to the ones hereby presented 16 .…”

Surgical treatment of cleft lip

“…15 . Since the initial work of Malgaine and Mirault in the nineteenth century, the techniques and surgical maneuvers for rehabilitation of fissures were developed to provide a better functional and aesthetic repair, but there is no consensus on the ideal method 16 .…”

“…A retrospective study 16 conducted in Minas Gerais on surgical techniques for repair of cleft lip and palate showed the predominance of the Millard technique for unilateral lip repair and of the technique of Spina and Millard for bilateral ones 16 . The most used technique for repair of cleft palate is the one of Veau, who has two disadvantages, Table 1 Table 1 Table 1 Table 1 Table 1 23 .…”

“…The difficulty in standardizing the groups of patients with cleft lip and palate is due to heterogeneity, which affects the comparative validity of the data and results, a factor that hinders the coordination and development of multicenter studies. Likewise, it was observed that the lack of standardization is due to multiple factors, including the difficulty of conducting longitudinal studies that prove the effectiveness of the surgical techniques used in the treatment of different clinical forms 16 .…”