ABSTRACT
Background@#The main purpose of primary cleft palate repair is to reconstruct anatomical structure with minimal impairment of maxillary growth and normalize velopharyngeal function and feeding process. One of the most common complications after the primary cleft palate repair is velopharyngeal insufficiency, which leads to the subsequent surgery. The velopharyngeal function assessment characterizes speech development in children. Researches noted that velopharyngeal insufficiency causes in 5-86% after primary cleft palate repair. Therefore, it is essential to choose an adequate primary surgical method for each particular type of cleft palate.@*Objective@#To compare velopharyngeal function using nasopharyngoscopy after primary CP repair@*Materials and Methods@#The patients who with congenital cleft palate and, underwent primary cleft palate repair in the Department of Maxillo-facial surgery of the National Centre for Maternal and Child Health and had velopharyngeal function assessment were recruited to the study. Patients with wound dehiscence and oronasal fistula postoperatively were excluded from the study. </br> Cleft palate was classified according to the Veau system and Golding-Kushner scale of nasopharyngoscopy was used to assess patient’s velopharyngeal function in order to associate with cleft types and the primary palatoplasty techniques. Pearson’s chi-squared analysis and Fisher exact test were used for statistical analysis. @*Results@#A total of 335 patients were included in the study. The mean age at primary palate repair was 22.9±13.6 months. There were 56, 42, 177, and 60 patients with Veau-I type, Veau-II type, Veau-III type and Veau- IV type respectively, whereas for primary palatoplasty 65 patients underwent Furlow technique, 148 patients – Mongolian technique, 108 patients – Two flap technique, 34 patients – Von Langenbeck technique.</br> Nasopharyngoscopy assessment of adequate velopharyngeal function was as followed as by “Furlow” technique in 89.4% cases, ”Mongolian” technique in 62.2% cases but by “Two flap” technique only in 48.1% and Von Langenbeck technique in 47.1% cases. @*Conclusion@#The Furlow and Mongolian techniques were superior for maintaining velopharyngeal function after primary palatoplasty.
ABSTRACT
Hemangiomas are common benign vascular tumors which about 70% to 80% of the lesions are found in the head and neck region. This study was conducted on 36 children with hemangioma who were referred to Orofacial Surgery Cabinet of Dental School of Health Sciences University of Mongolia and Orofacial Surgery Cabinet of National Center for Maternal and Child Health of Mongolia between 2013 and 2015.Of the 36 children referred for assessment, 72% were female, 55% were infants of 4 to 9 months old, and 83% of them were citizens. 58% of patients underwent cryotherapy,and 57% of patients underwent cryotherapy had 2 therapy sessions. 25% of patients receiver sclerotic therapy, and 67% of them had 2 therapy sessions. According to the locations of hemangiomas 30% of them were localized in infraorbital area. 72% of the participants are women and 55% are children age of 4-9 month which 83% of all participants were living in city. 58% of children with hemangioma are treated with cryotherapy which 57%of treatment finished by second visit. And 25% were treated by dehydration treatment which 67% were finished by second visit.
ABSTRACT
The timing and technique for palatoplasty is very controversial, recent literature advocates for early repair, between six and eighteen months of age, facilitating normal speech and language development, and avoiding hearing loss. It is using three main kinds of techniques for palatoplasty in the worldwide, two flap pushback, Furlow double opposing z-plasty, and two-step palatoplasty.Cases presenting later in life to the Mongolian National Center for Maternal and Child Healthprovide Mongolian surgeons′ with the challenge of wider defects which are difficult to manage successfully using traditional palatoplasty techniques.Oro-nasal fistula formation is an one of most documented postoperative complication, and it`s rate is reported between 6-42,3% in the literature. In Mongolia patients often present in older than recommended age for palatoplasty,it provide surgeons with the challenge of managing wider defects, which have higher rates of fistula formation and wound dehiscence. There were 30% of ONF in our practice. So, in 2000 we established new modified Mongolian technique for primary palatoplasty for improved outcomes across all age groups. And ONF rate reduced from 30% to 5.9 % in our department. Objective: To determine velopharyngeal function after primary palatoplasty by Mongolian method in connective with age at repair and cleft type.In our study were included over four year’s old patients, who underwent primary palatoplasty by Mongolian method at the authors` centre. We excluded syndromic cases, and patients who had an oronasal fistula postoperatively, and no cooperation with speech therapist. This study, we use video records of nasopharyngeoscopy to evaluate for cleft lip and palate patient’s velopharyngeal function associated with type of clefts, the timing of palate repair and cooperation with speech therapist.There were included totally 28 patients who are 4-23 years old (mean age 10.2 years) at the time of study, were performed primary cleft palate repair by Mongolian technique at NCMCH. The mean age at palate repair was 38 months (14 months-18 years). Overall, 39.2% (11) of patients were performed palate repair at 18≥ months old and 60.8% (17) patients were operated palate repair at 18< months. In the first group, VPI was demonstrated 27,3%, and in the second group 41,2%. Also, there were demonstrated VPI for 66,7% of Veau 1 type, 45,5% of Veau 3 type, and only 10% of Veau 4 type, after Mongolian method. Better velopharyngeal result for Veau 4 type and wide cleft palate after Mongolian method than other types. We should continue this study in wider screen for recognition this results.