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Cleft palate repair in Mongolia: Modified palatoplasty vs. conventional technique.

Abstract Cleft palate repair is preferentially completed between 6 and 18 months of age, facilitating essential speech and language development along with swallowing and feeding reflexes, and avoiding otitis media and hearing loss. In Mongolia patients often present in early adulthood for cleft lip and/or palate management. Wider defects are associated with older age groups and have higher rates of fistula formation and wound dehiscence. These complications encouraged a modified surgical technique for improved outcomes.
PMID
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Authors

Mayor MeshTerms
Keywords

Cleft lip/palate

fistula rate

modified palatoplasty

wider defect

Journal Title annals of maxillofacial surgery
Publication Year Start




PMID- 23482408
OWN - NLM
STAT- PubMed-not-MEDLINE
DCOM- 20130314
LR  - 20130416
IS  - 2231-0746 (Print)
IS  - 2231-0746 (Linking)
VI  - 2
IP  - 2
DP  - 2012 Jul
TI  - Cleft palate repair in Mongolia: Modified palatoplasty vs. conventional
      technique.
PG  - 131-5
LID - 10.4103/2231-0746.101337 [doi]
AB  - CONTEXT: Cleft palate repair is preferentially completed between 6 and 18 months 
      of age, facilitating essential speech and language development along with
      swallowing and feeding reflexes, and avoiding otitis media and hearing loss. In
      Mongolia patients often present in early adulthood for cleft lip and/or palate
      management. Wider defects are associated with older age groups and have higher
      rates of fistula formation and wound dehiscence. These complications encouraged a
      modified surgical technique for improved outcomes. AIMS: Objectives of this study
      were to compare the efficacy of three established palatoplasty techniques with
      our mongolian technique. MATERIALS AND METHODS: A retrospective review of all
      palatoplasty cases, in non-syndromic cleft lip and/or palate patients, between
      January 1992 and November 2008 in Ulaanbaatar, Mongolia was performed. Exclusion 
      criteria included those suffering from an acute or chronic respiratory illness at
      presentation or in the recovery period. We compared three established techniques 
      with our modified technique. Outcome measures were duration of surgery, length of
      hospital stay and fistula rate. STATISTICAL ANALYSIS USED: Discrete data are
      reported as n (%), while continuous data are summarised as mean+/-SD. Differences
      in demographic, surgical and postoperative data were tested by independent t-test
      (continuous data) and Fisher's exact test (discrete data). RESULTS: Palatoplasty 
      was performed on 436 patients with an average age of 60 months. The modified
      palatoplasty technique had reduced surgical time (P value <0.01) and hospital
      stay (P value <0.01) and a 96% complication free wound recovery, compared with
      established techniques. Cleft lip and/or palate patients aged 42 months or older 
      were more likely to be from the countryside. CONCLUSIONS: 86.9% of patients
      presenting for cleft palate repair had palatoplasty later than the recommended
      age. Geographical predilection for children older than six years, were more
      likely to have cleft palate repair complications. We have shown the modified
      palatoplasty technique is a more efficient time saving surgical procedure with
      lower complication rates.
FAU - Gongorjav, N Ayanga
AU  - Gongorjav NA
AD  - Department of Maxillofacial Surgery, Maternal and Child Health Research Centre,
      Ulaanbaatar, Mongolia.
FAU - Luvsandorj, Davaanyam
AU  - Luvsandorj D
FAU - Nyanrag, Purevjav
AU  - Nyanrag P
FAU - Garidhuu, Ariuntuul
AU  - Garidhuu A
FAU - Sarah, E Gardiner
AU  - Sarah EG
LA  - eng
PT  - Journal Article
PL  - India
TA  - Ann Maxillofac Surg
JT  - Annals of maxillofacial surgery
JID - 101598423
PMC - PMC3591054
OID - NLM: PMC3591054
OTO - NOTNLM
OT  - Cleft lip/palate
OT  - fistula rate
OT  - modified palatoplasty
OT  - wider defect
EDAT- 2013/03/14 06:00
MHDA- 2013/03/14 06:01
CRDT- 2013/03/14 06:00
PHST- 2013/03/14 06:00 [entrez]
PHST- 2013/03/14 06:00 [pubmed]
PHST- 2013/03/14 06:01 [medline]
AID - 10.4103/2231-0746.101337 [doi]
AID - AMS-2-131 [pii]
PST - ppublish
SO  - Ann Maxillofac Surg. 2012 Jul;2(2):131-5. doi: 10.4103/2231-0746.101337.