RESUMEN
OBJECTIVE: The aim of this study was to present a measuring tool, in the form of a dual-rating grid, for preoperative appearance and postoperative results in the treatment of labionasal clefts. METHODS: This study was carried out on 43 children with partial unilateral clefts, operated on using a derivation of Millard's technique. The preoperative initial severity score (ISS) was the sum of points each corresponding to a precise anatomic anomaly. A severe cleft was given a rating of 6, and a mild cleft a rating of 1. The postoperative results score (PRS) was the sum of points corresponding to residual or acquired anatomic anomalies: a good result was given 0.5, and a poor result 3.5. Each score was a mark given separately and agreed on by two surgeons. To compare the rating grids, the correlation between the ISS and the PRS was calculated. RESULTS: Twenty-four patients had an ISS less than 5; 19 patients had an IGS more than or equal to 5. Marks for the PRS were between 0.5 and 3.5 with the majority at 1 to 1.5. CONCLUSION: This study demonstrates the coherent connection between these two pre- and postoperative rating grids.
Asunto(s)
Labio Leporino/cirugía , Fisura del Paladar/cirugía , Evaluación de Resultado en la Atención de Salud , Cirugía Bucal/normas , Cara/anatomía & histología , Humanos , Lactante , Recién Nacido , Pronóstico , Valores de Referencia , Índice de Severidad de la EnfermedadRESUMEN
The present in vivo study was undertaken to evaluate the patency rate and histological appearance of 30 venous anastomoses and 30 carotid anastomoses in Wistar rats using a laser. An argon laser was used with the following parameters: power, 100 mW; time, 3 seconds; continuous mode; spot, 200 microns (fluence, 950 J/cm2; irradiance. 320 W/cm2). The macroscopic appearance and patency rate were evaluated at different postoperative intervals (30 days and 60 days). In the venous group, the patency rate was 100% with no saccular pseudo-aneurysm. In the arterial group, the patency rate was 93% with three saccular pseudo-aneurysms and two thromboses. Histological studies noted slight and transitory modifications of the media in the arterial group. In the venous group, the modifications appeared under the endothelium. Since the procedure was similar in both groups, the lack of pseudo-aneurysm formation in the venous group can be explained by a lower intravascular pressure.
Asunto(s)
Terapia por Láser , Microcirugia/métodos , Procedimientos Quirúrgicos Vasculares/métodos , Animales , Ratas , Ratas Wistar , Técnicas de Sutura , Grado de Desobstrucción VascularRESUMEN
Eleven patients were followed at the multidisciplinary facial cleft department from 1963 to 1993. Nine had orodigitofacial (ODF) I syndrome (Papillon-Leage, 1954) and two had ODF II syndrome (Mohr, 1941). The authors observed seven median clefts of the upper lip, eight atypical cleft palates, nine lingual tumors, ten polylobed tongues, four ankyloglossia. All vestibular frenula were hypertrophied. Facial analysis showed five facial hypertelorisms, eight epicanthal folds, ten anomalies of the forehead. Nasal anomalies were constant with ten alar hypoplasia and four nasal curves. Syndactyly was the most frequent anomaly of the hand. Seven patients were mentally retarded. Transmission of ODF I is by X-linked dominant variable expression; ODF II is autosomal recessive. The difference in transmission means a precise diagnosis is necessary. Bilateral duplication of the great toe is characteristic of type II, but not pathognomonic. Hair and cutaneous anomalies suggest type I. The authors proposed a surgical treatment involving three operating steps.
Asunto(s)
Síndromes Orofaciodigitales/patología , Niño , Preescolar , Labio Leporino/patología , Labio Leporino/cirugía , Fisura del Paladar/patología , Fisura del Paladar/cirugía , Cara/anomalías , Deformidades Congénitas del Pie/patología , Deformidades Congénitas del Pie/cirugía , Deformidades Congénitas de la Mano/patología , Deformidades Congénitas de la Mano/cirugía , Humanos , Lactante , Recién Nacido , Discapacidad Intelectual , Anomalías de la Boca/patología , Anomalías de la Boca/cirugía , Síndromes Orofaciodigitales/cirugía , Lengua/anomalías , Lengua/cirugíaRESUMEN
The aim of this study was to determine efficient parameters for an argon laser (spot diameter = 200 microns) to obtain and reproduce vessel anastomoses. It was performed in two groups of Wistar rats. In the first group (89 Laser impacts on 10 carotids), the fluence was continuously adjusted from 30 to 3,000 J/cm2 in order to determine efficient sets of parameters (power from 90-200 mW, pulse duration from 0.1 to 5 seconds, pulsed or continuous mode). In the second group, 30 end-to-end carotid anastomoses were performed. The results were evaluated by macroscopic thermal, and histological studies. The second group proved the efficiency of the selected parameters. Vessel welding was obtained with 100 mW, 3 seconds, continuous mode (fluence = 950 J/cm2, irradiance = 320 W/cm2) for a mean temperature of 77 degrees C corresponding to collagen denaturation. In the second group the patency rate was 93% (28/30) with three pseudo-aneurisms and two thromboses. Histological studies noted slight modifications of the media.