Evaluation of patients after different types of secondary cleft palate repair.

The aim of this retrospective study was to evaluate results of four different surgical approaches to palatoplasty and to demonstrate which type showed the lowest number of cases with the need for secondary surgeries. The results of 227 patients who underwent cleft palate surgical repair over a 13-year period (2000-2012) were included. The incidence rates of oronasal fistula, velopharyngeal insufficiency with the need of pharyngeal flap and pharyngoplasty were examined. The need for revision surgery was found in 48 patients (21.1 %). A significantly higher rate of cases with the need for secondary correction was found in patients with a complete cleft (44 %) as compared to patients with incomplete cleft palate (9.8 %). A higher percentage for additional surgery was noted after the Bardach procedure (50 %) as opposed to the lower revision rate after Veau-Wardill-Kilner (22.8 %) and Furlow (17.6 %). After the von Langenbeck procedure, the need for revision eventuated only in 5.5 % of cases. It is important to mention that there were no significant differences in the incidence of secondary surgery between the patients with cleft palate with or without the presence of Pierre Robin sequence. Neither there was observed a significant difference in the incidence of additional surgery between male and female patients. However, a higher need for pharyngeal flap was noted in the female group (Tab. 8, Ref. 38). Keywords: complications after palatoplasty, cleft repair techniques, Pierre Robin sequence, pharyngeal flap.

Carpal Tunnel Syndrome: Symptoms, Causes and Treatment Options. Literature Reviev.

Carpal Tunnel Syndrome (CTS) is the most common form of entrapment neuropathy. Several authors have investigated the anatomical and pathophysiological features of CTS and have identified several parameters that, in combination, play a significant role in its pathophysiology. Advancement in biological research on CTS has enabled the advent of efficient diagnostic techniques such as provocative tests and nerve conduction studies. Sophisticated technologies, such as magnetic resonance imaging (MRI) and ultrasonography (US), have facilitated the diagnosis of CTS. This review article aims at consolidating the relevant medical literature pertaining to the symptoms, pathophysiology, clinical diagnosis and treatment strategies of CTS. It also compares the various methods of diagnosis and discusses their benefits and disadvantages. Finally, it sheds light on the conservative vs. surgical approach to treatment and compares them. While the surgical approach has proved to be more efficient relative to the conservative methods of steroid injections and splinting, many studies have demonstrated both advantages and adverse effects of the surgical methods. Surgical options and complications are discussed in detail. This article comprehensively summarizes all medical aspects of CTS to update medical professionals' knowledge regarding the disease.