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A retrospective analysis of 64 patients who had sustained maxillofacial fractures and were treated in Srinagarind Hospital , Khon Kaen University from August 1984 to July 1987 was undertaken. Male to female ratio was 7:1 The ages ranged from 4 to 60 years with the mean of 28.5 years. Most patients (59.38%) were admited to the hospital within 1 day following the injuries. The average hospital stay was 9.51 days. Motorcycle accidents accounted for the largest number of fractures (62.62%). There were 34 patients who lost consciousness immediately after the accidents and 13 patients had the history of alcohol consumption just before the accidents.Major and minor associated injuries occurred in 18.75% and 20.3% respectively. Types of facial fractures were mandible 49% , zygoma 26% , maxilla 15% , nasal bone 6% and orbit 4% , Most of the operative interventions were intermaxillary fixation and interosseous wiring. There were 24 morbidities and 2 mortalites in the series. One patient died from intraabdominal hemorrhage and another developed diabetes insipidus after head injury and finally died from respiratory failure.
ABSTRACT
Background : Infants born with a cleft lip-palate is facial deformity requires restoration of the integrity of the soft facial tissue. Interdisciplinary management provides the necessary integration of procedures, which will yield the most satisfactory results.Objective : To present a unique procedure combining pre-surgical orthopedic treatment and primary lip-nose repair for infants with unilateral complete cleft lip and palate.Design : A retrospective, descriptive study.Setting : Orthodontic Department, Faculty of Dentistry and Division of Plastic Surgery, Department of Surgery, Faculty of Medicine, Khon Kaen UniversityIntervention : First the patient received pre-operative orthopedic treatment. A passive obturator was used as an adjunct to aid feeding and guide growth of the lateral palatal segments. Combined primary lip and nasal reconstruction, were done during a single surgery.Result : The patient came to hospital with complete unilateral complete cleft lip and palate. A passive obturator with lip strapping was prescribed to resolve feeding problems and guide the growth of palatal segments. A one-stage surgery combining lip and nasal reconstruction was performed. The surgical lip and nose revision yielded good early aesthetics of the soft lip and nose tissue.Conclusion : Pre-surgical orthopedic treatment combined with primary lip-nose repair is an effective treatment of unilateral cleft lip and palate.Key words : Obturator, unilateral complete cleft lip and cleft palate, primary lip-nose reconstruction.
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Background : Infant born with cleft lip and cleft palate problem requires treatment to restore the integrity of facial soft tissueObjective : The objective of this article is to present a treatment procedure for the bilateral compleate cleft lip and cleft palate infant.Setting : Orthodontic Department, Faculty of Dentistry, Khon-Kaen University and Srinagarind Hospital, Faculty of Medicine, Khon-Kaen UniversityIntervention : The initial treatment used a presurgical orthopedic appliance. The surgical treatment comprised gingivoperiosteoplasty, primary lip and nasal reconstruction, all done in one-stage.Result : A better early facial soft tissue esthetics was achieved.Conclusion : A Thai male infant, aged 15 days, born in Khon-Kaen Province, came to Sringarind Hospital with the problem of complete bilateral cleft lip and cleft palate. An obturator with lip strapping was delivered in order to help with the feeding problem. At the same time, time, this appliance was used to mold the primary palate and lateral palatal segments into a better relationship, and to lessen the gap width of the cleft. The reduced distance between the prolabium and lateral lip segments helped decrease soft tissue tension during and after lip repair. Besides, a special appliance, the Naso-Alveolar Molding appliance (NAM) was used for this baby in order to help molding the alar cartilages and extending the columella length before the surgery. A one-stage surgery combining the gingivoperiosteoplasty, lip and nasal reconstruction was performed. The result of this coordinated treatment brought about better early esthetics of the soft tissue lip and nose.Key words : Nasoalveolar Molding Appliances. Bilateral Cleft Lip and Cleft Palate. Presurgical Orthopedics. Primary lip and nose reconstruction. Gingivoperios teoplasty
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Some epidemiological comparisons of congenital oral clefts, particularly relating to the Asian region, are recorded. There is need extend such studies to case control and cohort studies in order to be able to better determine etiological factors. Studies of different populations have show variability of genetic constitutions and variability of outcomes of their interactions with suspected teratogens. Examples of risks of occurrence in the development of oral clefts and other birth defects through interactions of gene and environmental factors are noted. Experiences in a few industrialized countries, so far, indicates that obtaining information about the nature of such interactions in population groups requires the establishment of central birth registries, including surveillance of human abortuses, linked with environmental monitoring
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Background : Incidence of births with cleft lip and palate varies geographically. There is no information about this issue at Srinagarind Hospital.Objective : To determine trends in birth incidence of cleft lip and palate at Srinagarind Hospital during 1900-1999 and clinical characteristics of affected pregnancies.Design : A retrospective descriptive study.Setting : Department of Obstetrics and Gynecology, Faculty of Medicine, Srinagarind Hospital, Khon Kaen University.Subjects: All 56 births affected by cleft lip and palate from 51,386 live births during 1900-1999.Main outcome Measures: Birth incidence of cleft lip and palate.Results : Among 50 cases of cleft lip and palate, there were 28 cases of cleft lip with cleft palate, 20 cases of isolated cleft lip and 8 case of isolated cleft palate. Birth incidence of cleft lip and palate was 1.1/1,000 live births with no upward and downward trend. Birth incidence of cleft lip with cleft palate, isolated cleft lip and isolated cleft palate were 0.5,0.4,0.2/1,000 live births respectively. Associated malformations were 17.95% and only 1.8% could be prenatally diagnosed.Conclusion: Birth incidence of cleft lip and palate at Srinagarind Hospital remained relatively stable. The increase of effectiveness in prenatal diagnosis of cleft lip and palate by ultrasound would be useful in counseling, prenatal care and preparation for neonatal care of these congenital anomalies.Key words : Cleft lip and palate, birth incidence.
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Objective: 1. To audit the management of surgical patients by computer system. 2. To collect the problems of data analysis for auditing the management of surgical patientsDesign: Retrospective, descriptive study.Setting: Department of surgical, Faculty of Medicine, Khon Kaen UniversitySubject: All in-patients of Department of Surgical within 1998.Data collection: Review from computer database.Measurement: Descriptive statistics.Result: Important factor, which can be retrieved from computer database, include age, sex, diagnosis, operation, result, hospital stay, and mortality rate. A total of 6,821 patients was admitted in Department of Surgery during January and December 1998. The male: female ratio was 0.98:1 (3,375:3,446). The mean age of male and female patients was 43.17 and 43.76 years, respectively. The average hospital stay was 9.53 days. There were 1,224 patients (17.94%) who had complications and 6,048 patients (88.67%) had good discharge status. The average hospital mortality was 1.92%Conclusions: Computerized audit of surgical patients can be done much faster than manual audit. The result is highly accurate but may have some mistakes. Misunderstanding, inappropriate coding, unclear wording and input error cause mistakes in the computerized patient records. Some important factors for auditing are not collected in the computer system.Keyword: (1) Computer (2) Audit (3)Surgical patients
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Background and Objective: Srinagarind Hospital is a tertiary hospital with high potential for medical care of patients with cleft lip and cleft palate so we need to study about statistic and trend of the types of the patients who receive the medical care which depends on the age and illness in order to prepare to be a center of medical care, to have excellent researches in the Northeast and the nearest regions, to plan for giving the medical care and to have complete service which will benefit for patients with cleft lip and cleft palate. This study aim to determine statistics and trend of admitted patients with cleft lip and cleft palate in Srinagarind Hospital regarding types of the disease, distribution, frequency and age of the operated patients.Methods: A retrospective descriptive study was done. All admitted patients with cleft lip and cleft palate in Srinagarind Hospital, Faculty of Medicine, Khon Kaen University during 1984-2007 were included. Results: The study result is found that the most patients is male patients with cleft lip and cleft palate were 56%. There were 32% cleft lip patients, 22% cleft palate patients and 46% cleft lip with cleft palate patients from 1,950 in patient cases that came 3,342 visits, the patient can came to received the treatment many time. The majority of the patients live in Khon kaen, Mahasarakham, and Kalasin were 55%, 25% and 17% respectively. During 1984-1992, the patients to received cheiloplasty treatment age 3-4 months were 14%, to received palatoplasty treatment age 9-12 months were 29%, and during 1993-2001, the patients to received cheiloplasty treatment age 3-4 months were 32%, to received palatoplasty treatment age 9-12 months were 52% and the patients received correction of cleft lip and cleft palate age 4-5 years were 15%. The trend of patients has been increasing by patient’s age; because of the mutidisciplinary team has developed a medical care tendency and work together to the concrete. In 2002, the referral system was developed and the treatment by multidisciplinary team and treatment protocol has absolutely and efficiency. Therefore, a patient to received cheiloplasty treatment aged 3-4 months were increasing 57%, to received palatoplasty treatment aged 9-12 months were 63%, and the patients received correction of cleft lip and cleft palate aged 4-5 year were 11%. Conclusion: The study result is found that cleft lip with cleft palate patients has come to received medical treatment by patient’s age increasing as follows Nation Health Security system plan. However, some patients received medical treatment late, such as to send a patient late, an intervening disease, to be in need a knowledge for the authorities, and the many patients to wait for treatment. This reason might be effect to patients who received the treatment late.Keywords: Cleft lip and cleft palate