Mothers of children with cleft palate undergoing speech intervention change communicative interaction.

INTRODUCTION: Natural learning must include language learning relationships that provide natural support for communication and language learning. OBJECTIVE: To find out if including the mother as an active participant during speech therapy sessions would improve the communicative style and mode of the interaction of the mothers with their cleft palate children. MATERIALS AND METHODS: Fifty-nine children with cleft palate and their mothers were included in the study group. The patients were divided into two groups randomly. Patients received the same treatment. Twenty-eight of the children were included in the control group. They participated in small working groups comprising the speech pathologist and two children. Thirty-one of the children were included in the experimental group. In this case, the mothers of the children were also included as active participants. The mothers of the patients from the two groups were assessed at the beginning and end of the speech therapy period to find out their style and mode of interaction. Pre- and post-data of the mothers from both groups were compared. RESULTS: Eighty-nine per cent of the mothers of the experimental group modified their patterns of interaction. In contrast, only 19% of the mothers of the control group modified their style and mode of interaction. A Fisher exact test demonstrated that the frequency of mothers from the experimental group that modified their style and mode of interaction was significantly greater as compared to the number of mothers from the control group that were able to modify their style and mode of interaction. CONCLUSIONS: Mothers of children with cleft palate and accompanying language delay modify their communicative style and mode of interaction through active participation in speech therapy.

Restoration of facial contour in Romberg's disease and hemifacial microsomia: experience with 118 cases.

The experience with free flaps and conventional reconstructive procedures for 118 patients with Rombergapos;s disease and hemifacial microsomia over a 10-year period is presented. The groin free flap was used most frequently for patients with Rombergapos;s disease, whereas the scapular free flap was used for patients with hemifacial microsomia. The rectus abdominis or the latissimus dorsi free flap was chosen only when additional volume was required. To achieve better contour, secondary procedures, such as defatting the flap, pedicled temporal fascial flaps, cartilage and bone grafts, orthognathic surgery, and bone distraction were performed in severe cases. For patients with Rombergapos;s disease, excellent results were achieved in 35% (n = 28) of mild cases, in 72% (n = 27) out of 38 moderately and in 41% (n = 5) out of 12 severely affected patients. In hemifacial microsomia group (n = 40) excellent results were obtained in 66% of cases.

Free flaps for head and neck reconstruction in non-oncological patients: experience of 200 cases.

Two hundred free flaps for reconstructing the head and neck regions in 192 patients with non-oncological pathology were studied. Pathological entities included Romberg's disease, hemifacial microsomia, acquired facial palsy, trauma, and burn sequelae. Indications for selecting a specific free flap for reconstructing each case, details of anastomoses, reexploration, flap success, operative time, length of hospitalization, and complications were studied. The long-term results of cosmetic and function were also obtained. Patient age ranged from 6 to 40 years. The most common diagnosis was Romberg's disease 39% (n = 75), followed by hemifacial microsomia 20% (n = 40). The free flap most frequently used was the scapular 32% (n = 64), followed by the groin free flap 21% (n = 42). A total of 190 flaps (95%) were successful, whereas only 10 (5%) were lost. The mean operative time was 5:30 h and the average hospital stay was only 6 days. There were no major complications and no deaths in the study group. The patients were followed for at least 1 year in all cases. It is concluded that free flaps are safe and reliable procedures for reconstructing complex head and neck non-oncological defects.

Frontotemporal fasciocutaneous island flap for facial aesthetic subunit reconstruction.

The frontotemporal fasciocutaneous island flap is a useful source of tissue for correcting aesthetic units of the face. The quality of the tissue may be enhanced, and a successful color and texture match may be achieved. This flap is based on the temporal vessel system and its own fascia. Its provides excellent venous drainage and its pedicle length and arc of rotation may be increased. The donor scar is hidden under the hair-bearing area. The frontotemporal fasciocutaneous island flap was used in patients with inferior eyelid defects, for cheek reconstruction, for providing coverage of superior and inferior lip defects, for restoring the normal anatomy of columellar defects, and for reestablishing the contour of menton defects. The frontotemporal fasciocutaneous island flap was employed successfully in 9 patients at the Hospital Gea Gonzalez. The wide treatment possibilities for the reconstruction of aesthetic units in the face with the frontotemporal fasciocutaneous island flap are illustrated.