Cleft lip and palate: the psychological burden of affected parents during the first three years of their children's lives.

The surgical treatment of cleft lip and palate (CLP) has been well described in the literature. Nevertheless, little is known about the psychological burden of affected parents. The aim of this study was to investigate the psychological burden in parents of children with CLP within the first 3 years of the children's lives. A standardized questionnaire (Parenting Stress Index, PSI) was administered to 33 parents of children with CLP to evaluate their psychological burden. The corresponding interview was conducted independent of any operative procedure during the yearly routine CLP consultation. Each participant's stress profile was assessed and compared with the average values of parents with non-cleft children. Psychological stress was substantially increased in all participants when compared to the parents of healthy children. This result was highly significant (P < 0.001). Parent depression (P < 0.001) and child-related requirements (P < 0.001) were the most critical subscales in the stress profile. Overall, the child-related burden was greater than the parent-related burden. These results indicate that parents of children with CLP have a higher level of psychological stress than parents of non-cleft children. This psychological stress might be reduced if addressed by specialist clinical psychologists in cleft-treating centres.

Reduction in perioperative blood loss using ultrasound-activated scissors during tumour surgery.

The aim of this study was to compare the effectiveness of Harmonic Focus+ scissors with the conventional surgical method regarding surgical blood loss and transfusion of blood products in the surgical treatment of head and neck tumours. In a retrospective study, the intraoperative blood loss, number of units of transfusion products given, operating time, and inpatient length of stay of 74 patients with squamous cell carcinoma were compared. Patients who underwent classic tumour surgery were compared with a group treated with Harmonic Focus+ scissors. A significantly lower intraoperative blood loss (496.15⬰ml vs 1096.0⬰ml, respectively; P⬰=⬰0.002) and shorter operation time (436.89 minutes vs 493.13 minutes, respectively; P⬰=⬰0.030) were achieved using the Harmonic Focus+ scissors when compared to the classic tumour surgery. Additionally, fewer units of blood products needed to be transfused (administration of red cell concentrates, P⬰<⬰0.001) and the length of stay in the intensive care unit was shorter for patients treated with the Harmonic Focus+ scissors (P⬰=⬰0.009). The study results indicate that the use of Harmonic Focus+ scissors during surgery for cancer of the oral cavity and pharynx is a safe and cost-effective method. This is of paramount importance during a pandemic when medical resources are scarce, including access to blood reserves.