Unilateral Cleft Lip and Nasal Repair: Techniques and Principles

The Mashhad University of Medical Sciences and the Sheikh Hospital in Mashhad sponsored a Cleft Lip and Palate Workshop 30 April – 1 May 2009. During the Workshop, 6 surgical cases were performed and televised live to the audience attending the conference. Two of those cases were unilateral cleft lip repairs. The surgical technique used to repair these patients by the primary author (JGM) is a hybrid technique. It has evolved over the last decade as a result of prior surgical literature as well as first hand observation of various surgical colleagues. The following manuscript describes the surgical technique used at the Cleft Workshop in a step-wise or atlas-like fashion. The technique portion of the paper describes the repair of the unilateral cleft lip and nasal deformity in roughly the order the first author typically performs the procedure. More importantly, the final section of the paper details the principles that form the foundation for the techniques described

Is hypertrophic pyloric stenosis a secondary disease?

Hypertrophic pyloric stenosis (HPS) is the most common gastrointestinal obstructive disease in infants which requires surgery. Typical presentation is at 4-6 weeks of life but can present very earlier or congenitally. Here we present 3 cases of HPS which presented in the first day of life with  co-existing malrotation, annular pancreas, and duodenal atresia. The exact etiology of HPS is not fully understood, however, genetic and  maternal factors, hormonal factors, abnormalities of various components of the pyloric  muscle, growth factors, extracellular matrix elements, nerve and ganglion cells synapses, nerve supporting cells, neurotransmitters and interstitial cells, drugs, and feeding have been implicated. In the HPS  concomitant with a distal obstruction, mean that these obstructions may role in  pathogenesis of HPS or may exacerbate other factors to produce HPS in a very early age or congenitally. The purpose of this manuscript is to present three cases of HPS in the fi rst day of life with other GI anomalies. We hypothesize that the etiology of some cases of HPS may be secondary to distal intestinal obstructions especially when it presents very early in life,or at least to concern a distal obstructions in this very early presentation.Key words: Etiology, GI anomaly, hypertrophic pyloric stenosi

Lip Commissure Reconstruction with the Facial Artery Muscular-Mucosal (FAMM) Flap: A Case Report of a Child with Electrical Commissural Injury: A Case Report of a Child with Electrical Commissural Injury

Electrical burn damages constitutes of 4% of all burn trauma. Approximately 20% of total electrical burn injuries occur in children. Most electrical injuries in children occur at home. When the child bites or chews an electrical cord, it results in oral and commissural injury. It is also noted that male children are predominantly affected with electric current injuries than female children. We introduce an immigrant 3-year-old boy admitted in the hospital one week after an electrical injury of the oral cavity due to biting a television cord. He had a necrotic lesion on his right oral commissure. There is controversy about the time and relevant management of mouth commissure injury. In this case, because of lack of parents’ consent, we did the reconstruction of his oral commissure very late without any molding intervention. There is more than 200 techniques in the management of lip and oral commissural injury; we used a Facial Artery Mucosal-Muscular (FAMM) flap for the repair with good result. Although with the improvement of burn care and its management outcomes, prevention is still the best way of minimizing the prevalence and severity of electric current burn injuries

Congenital sacral mesenchymal chondrosarcoma in a neonate: A case report and review of literature

Mesenchymal chondrosarcomas are rare malignant tumours in children, especially, in neonates. The authors present a case of congenital mesenchymal chondrosarcoma in a 1-day neonate located in sacrum. According to the authors′ literature searches, this case is the first congenital sacral mesenchymal chondrosarcoma. We also reviewed the papers published in English literatures

Unilateral Cleft Lip and Nasal Repair: Techniques and Principles

The Mashhad University of Medical Sciences and the Sheikh Hospital in Mashhad sponsored a Cleft Lip and Palate Workshop 30 April - 1 May 2009. During the Workshop, 6 surgical cases were performed and televised live to the audience attending the conference. Two of those cases were unilateral cleft lip repairs. The surgical technique used to repair these patients by the primary author (JGM) is a hybrid technique. It has evolved over the last decade as a result of prior surgical literature as well as first hand observation of various surgical colleagues. The following manuscript describes the surgical technique used at the Cleft Workshop in a step-wise or atlas-like fashion. The technique portion of the paper describes the repair of the unilateral cleft lip and nasal deformity in roughly the order the first author typically performs the procedure. More importantly, the final section of the paper details the principles that form the foundation for the techniques described

Tongue-tie Repair: Z-Plasty Vs Simple Release

Introduction: Ankyloglossia is a congenital anomaly in which the lingual frenulum is unusually short and thick, thus decreasing tongue mobility. In the context of the newborn or young infant it is a subject of ongoing controversy within and between medical specialties. The controversy involves not only the definition but also the management of this anomaly. A tight lingual frenulum is considered a minor malformation by some investigators. Usual treatments for ankyloglossia include speech therapy, as well as simple frenulotomy and frenuloplasty. The aim of this study was to compare the latter two methods with respect to postoperative results and complications. Materials and Methods: A total of 50 patients referred for surgical care were randomly assigned into two groups: simple release (frenulotomy ) or Z-plasty (frenuloplasty), and underwent a pre-surgical assessment. After 3 months, patients were followed with a scheduled interview and questionnaire comparing the outcomes of the two methods. The data were analyzed using SPSS version 18. Results: Surgery had a significant effect on all variables measured in our study (P<0.05). Z-plasty had a greater effect on articulation, breast pain, tongue movement and parent satisfaction than simple release (P<0.05). Z-plasty and simple release had the same effect on breast feeding, latching, and sucking. Conclusion: Z-plasty is the preferred surgical method to address tongue-tie due to a greater improvement in mother’s breast pain, pronunciation and speech, tongue movement, and parental satisfaction

Tongue-tie Repair: Z-Plasty Vs Simple Release

Introduction: Ankyloglossia is a congenital anomaly in which the lingual frenulum is unusually short and thick, thus decreasing tongue mobility. In the context of the newborn or young infant it is a subject of ongoing controversy within and between medical specialties. The controversy involves not only the definition but also the management of this anomaly. A tight lingual frenulum is considered a minor malformation by some investigators. Usual treatments for ankyloglossia include speech therapy, as well as simple frenulotomy and frenuloplasty. The aim of this study was to compare the latter two methods with respect to postoperative results and complications. Materials and Methods: A total of 50 patients referred for surgical care were randomly assigned into two groups: simple release (frenulotomy ) or Z-plasty (frenuloplasty), and underwent a pre-surgical assessment. After 3 months, patients were followed with a scheduled interview and questionnaire comparing the outcomes of the two methods. The data were analyzed using SPSS version 18. Results: Surgery had a significant effect on all variables measured in our study (