Indian Journal of Public Health Research & Development

Abstract

Purpose: To study a series of cases where vascularised fibula flap was used in mandibular defect.

Patients and Method: The investigators designed a retrospective study composed of patients with any pathology or defect who underwent reconstruction of mandible with vascularised fibula free flap from 2014 to 2018. All patients were evaluated for age, gender, location and type of defect, incorporation of adjoining skin paddle and muscle, number of fibula osteotomies, ischaemia time, anticoagulant regimen, length of hospital stay, flap failure rate, dental implant rehabilitation. All patients with a minimum follow-up of 6 months post-operatively, were included in this study.

Results: The study sample composed of 8 patients with average age of 40 years. Immediate reconstruction done in all patients. In two patients, the fibula was double barrelled. Skin island was included with the fibula in all patients. Two patients underwent dental rehabilitation using implantswith double barrel reconstructions. Hematoma at the recipient site was the commonest post-operative complication, although itsfrequency was low. A low donor site morbidity was seen. Average stay in hospital was about 10 days. Post-operatively all patients ambulated normally and none used assisted devices. A reconstruction plate was used to achieve the ideal contour of the jaw in most cases. Aesthetic results were usually good, especially in young patients. The overall success rate was good. Conclusion: The fibula has many assets which make it the ideal choice for bony reconstruction of mandible skeleton and adjoining soft tissue with predictable results.

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Abstract

Introduction: A correction of cleft lip/palate associated rhinoplasty using abbe flap is performed in this study. The outcome and perception of the abbe flap for cleft rhinoplasty at patient, surgeons, and patients caregiver evaluation questionnaire.

Materials and Method: A retrospective analysis of preoperative satisfaction and prospective analysis of postoperative satisfaction of patients who underwent cleft rhinoplasty were carried out using questionnaire.

Results: Six case of bilateral cleft lip and palate who had earlier undergone cleft rhinoplasty and lip revision with abbe’s flap formed the study group. The mean age of 6 subjects was 23.00+/-3.8 years. there were 2 males and 4 female forming the study group.the mean presurgical questionnaire score was 22.8+/-10.6 while the postsurgical score was 83.5+/-26.2. This difference was statistically significant (p = 0.001). the difference in score between the time period was 60.7%.

Discussion: From the questionnaire and other qualitative parameters, it is possible to demonstrate the impact of abbe flap of cleft rhinoplasty and its impact on the quality of life of patient. most of the patient and caregivers believed that this approach achieved agood or excellent postoperative results

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Context: le fort 1 maxillary osteotomy in operated patients of cleft lip and palate (CLCP). AIMS: to study stability of le fort 1 maxillary osteotomy in operated patients of CLCP by two-imensional evaluation using cephalometric analysis.

Setting and Design: Prospective study conducted at Sree Balaji dental collage and Hospital from 2016-2018.

Materials and Method: Subjects included 3 consecutively operated patients of CLCP with maxillary hypoplasia. Maxillary advancement be le fort 1 maxillary step osteotomy was performed. There was two males and one females with an age of range of 18 to 20 years and follow up range was 6 to 24 months. presurgical and postsurgical changes were compared usingcephalometricsfor orthognathic surgery (cogs) system to determine stability of maxillary movements and quantify relapse at 21 days and 18 months.

Statistical Analysis: Student t-test.

Result: Mean linear horizontal advancement achieved along nasion (N) to anterior nasal spine (ANS) with reference to true vertical plane at 21 days and 18 months was 4.17 and 2.91mm,respectively. The mean relapse in anteroposterior dimension was 20.63%. the mean vertical displacement observed along nasion and ANS with reference to true horizontal plane at 21 days and 18 months was 4.21mm and 2.3, respectively with a resultant relapse of 38.54%.

Conclusion: Based on clinical and COGS analysis, it is evident that le fort 1 advancement in operated cases of CLCP has inherent potential for relapse.

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Introduction: Widening of alar base width is often required in the lip/palate rehabilitation.the aims of this study is to evaluate such a procedure.

Materials and Method: This is a retrospective study. All cleft case requiring alar base widening were analysed, and the outcome presented at end of 4^th and 8^th month. This study was typical superomedially placed nasolabial full thickness flap to correct the alar base width simultaneously replaced the nasal lining.

Result: A total of three cleft patient underwent the procedure. Qualitative observation of the outcomes and postoperative changes with the resultant nasal alar base width are presented.

Discussion: The efficacy of this type of nasolabial flap for the alar basal widening and of nasal lining reconstruction is presented. The essential, functional and anatomical consideration in such a flap design is presented in this study.

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