Raghavan Ullas, Vijayadev Vishwas, Rao Dipesh, Ullas Gautham
ENT, Doncaster Royal Infirmary, Doncaster, United Kingdom.
ENT HNS, RajaRajeswari Medical College and Hospital, Bangalore, Karnataka, India.
Facial Plast Surg. 2018 Dec;34(6):605-611. doi: 10.1055/s-0038-1676381. Epub 2018 Dec 28.
Cleft lip and palatal clefts are one of the most common birth defects with a global incidence of 1 in 700 live births. The majority of these orofacial clefts are nonsyndromic. However, a general screening for syndromes and other organ anomalies should always be performed as their association with orofacial clefts cannot be overlooked. With the recent progress in the knowledge of cleft repair, the procedures to correct cleft lip and palate though complex, have been simplified to allow improvisation in outcome and to achieve even better finesse of surgical result. The procedural complications and the pursuit of having near perfect esthetics and functionality, make this deformity a recipient of multiple procedures. This ensures that the patient is under the care of the treating surgeon for long term and allows the surgeon to follow-up on the result, not only to provide care but also to intercept any deviation in the desired outcome. Postoperative care of cleft lip and palate surgery is largely underdiscussed and a set of fixed guidelines will help the treating surgeon to provide the most comprehensive care to the cleft patients. The authors review the practices followed at their hospitals-a high volume cleft and craniofacial care center, a tertiary care multispeciality teaching hospital, and a community teaching and training hospital. The commonly followed practices with suitable evidence in postoperative care of these patients are enlisted here.
唇腭裂是最常见的出生缺陷之一,全球发病率为每700例活产中有1例。这些口腔颌面裂大多数是非综合征性的。然而,由于综合征与口腔颌面裂的关联不容忽视,因此应始终对综合征和其他器官异常进行全面筛查。随着唇腭裂修复知识的最新进展,尽管修复唇腭裂的手术复杂,但已得到简化,以改善手术效果并实现更精细的手术结果。手术并发症以及对近乎完美的美学和功能的追求,使得这种畸形需要接受多次手术。这确保患者长期接受主刀医生的治疗,并使医生能够跟踪手术结果,不仅提供护理,还能及时发现预期结果的任何偏差。唇腭裂手术的术后护理在很大程度上缺乏讨论,一套固定的指南将有助于主刀医生为唇腭裂患者提供最全面的护理。作者回顾了他们所在医院(一家大型唇腭裂和颅面护理中心、一家三级多专科教学医院以及一家社区教学和培训医院)所遵循的做法。本文列出了这些患者术后护理中常用且有适当证据支持的做法。