Management of congenital cleft lip: an eight-year experience

From1988 to1996, 461 patients with congenital cleft lip underwent a total of 505 surgical procedures. Most of the patients were operated upon in their childhood, but 16% underwent surgery in their teens and early adult life. A unilateral deformity was present in 384 patients, 73 had a bilateral cleft while 4 patients had a median cleft. The epidemiological data was consistent with that reported in literature. Millard repair was the commonest procedure for unilateral clefts being used in 86% cases. For the bilateral clefts an Hagedorn or a Millard procedure was used. The overall complication rate was 3%, with 3 perioperative deaths in the series. Results were assessed at a minimum of 6 months post-operatively. In 79% of patients, a good result was obtained. Secondary/revisional surgery was required in 33[7.2%] patients. About 25% of patients with bilateral clefts had a fractured premaxilla and it is recommended that surgery be performed early in these patients. Patients with incomplete clefts had a slightly higher percentage [83.1%] of good results as compared to complete clefts [77.2%]. This indicates that the more severe the deformity, the poorer the results. It was shown that results have more to do with the attention to detail and skill of the individual surgeon rather than any specific technique

Agravos constitucionais da boca em pré-escolares da Rede Municipal de Ensino da Cidade de Säo Paulo / Offense constitutionalists of mouth in children of Rede Municipal de Ensino da cidade de Säo Paulo

Ao mesmo tempo em que interferem apenas discretamente no desenvolvimento intelectual, os agravos constitucionais da boca constituem importante fator na vida de correlaçäo de crianças pré-escolares. Na presente comunicaçäo, apresentam-se e discutem-se características detectadas em tais lesöes, em epidemiológico exploratório realizado em amostra de 2.549 crianças representativas da populaçäo das unidade de educaçäo pré-escolar da rede municipal de ensino da cidade de Säo Paulo. Foi constatada a ocorrência de 25 agravos constitucionais da boca, sendo seis fendas labiais e seis fendas palatinas. A discussäo de tais resultados é travada tanto a partir do interesse para com as variáveis epidemiológicas que encerram (como prevalência e distribuiçäo por sexo e faixa etária) como pelos aspectos nosográficos envolvidos, particularmente no que se refere a associaçöes com agravos constitucionais em outros segmentos corporais