Management pattern and hospital charge of repairing cleft palate at Siriraj Hospital.

Management pattern and hospital charge for repairing cleft palate at Siriraj Hospital during 1996-1999 were studied retrospectively. From the examination of 100 patient records, four cases were excluded since no surgical correction was performed during hospitalization. Fifty-nine percent were female and the average age was 5.54 years old. Fever and otitis media were associated with two and three cases respectively. Other underlying diseases included hypothyroidism, patent ductus arteriosus and ventricular septal defect were found one in each case. The cleft palate was successfully repaired in all cases. Surgical correction was done in 84 percent of cases within the first five days of hospitalization. The average length of stay was 5.89 + 2.85 days and ranged from 2-20 days. The hospital charge for cleft palate repair was 7,031.22 + 1,365.33 Baht per case. This study illustrate that a small variation is practiced in the management of a reasonably straight forward condition and better preparation of the patients before hospitalization could reduce the hospital stay or avoid unnecessary hospitalization.

Treatment of zygomatic complex fracture with single mini-dynamic compression plate with screws.

During 1993 to 1994, 30 cases of minimally-displaced fracture of the zygomatic complex were treated with open reduction and rigid internal fixation with single 4-hole mini-dynamic compression plates (DCP) and screws at the zygomatico-frontal fracture site. The open reduction was done wth the aid of a bone hook inserted through a tiny stab incision at the zygomatic arch prominence. When good alignment was achieved, the zygomatico-frontal fracture site was fixed with only one 4-hole mini-DCP. The one-point fixation with this type of plate for minimally displaced zygomatic complex fractures reduces morbidity, operative time, and costs.

The application of fibrin glue layered collagenic fleece plastic surgery.

TachoComb in a collagen fleece layered with fibrin adhesive and has been used in various fields for intraoperative hemostasis. Our experience in plastic surgery including cranio-facial surgery and orthogenetic surgery was reported here. Out of ten cases, haemostatic effect was satisfactory in the surgical fields in nine cases. One case needed re-exploration to stop active bleeding of a vessel. No complication nor adverse effect of the material was observed.

Parascapular free flap for facial augmentation in progressive facial hemiatrophy.

Three cases of progressive hemiatrophy which werre treated by de-epithelialized parascapular free flaps are reported. This flap is accesble, easy to dissect and has constant anatomy of the nutrient vessels. The bulkiness of the flap is adequate for severe deformities.

Pierre robin anomalad with rare oblique lower lip cleft : A case report.

We report an unusual case of the Pierre Robin Anomalad who had not only triad of glossoptosis, micrognathia and incomplete cleft palate, but also had right sided choanal atresia, absebce of the right hard palate and a lower lip oblique cleft on the right side with small lobules along the cleft. The defects were corrected surgically twice when the infant was 11 and 18 months old with satisfactorily results.