Comparative Evaluation of Palatal Length, Speech Outcome, and Surgical Complications With Use of Von Langenbeck and Bardach 2 Flap Technique for the Repair of Cleft Palate: A Prospective Randomized Study

FACE ◽  
2021 ◽  
pp. 273250162110618
Author(s):  
Yash A. Oswal ◽  
Srivalli Natarajan ◽  
Gaurav S. Despande ◽  
Neha S. Patil
Keyword(s):  
Cleft Palate ◽  
Soft Palate ◽  
Surgical Complications ◽  
Cleft Lip ◽  
Randomized Study ◽  
Significant Difference ◽  
Group A ◽  
Group B ◽  
Intravelar Veloplasty

Purpose: Successful closure of cleft palate is no more the sole criteria for determining the success of palatoplasty. Approximating soft palate musculature plays an equally important role. A continuous palate with muscular sling, speech and unhampered maxillary growth are 3 important goals of palatoplasty. The current study compared 2 popular palatoplasty techniques and also focused on other vital secondary parameters which would alter the final outcome of palatoplasty. Methods: Thirty-two primary cleft palate patients with repaired cleft lip ranging from 4 to 30 years were randomly and equally divided into 2 groups. Group A underwent Langenbeck and Group B underwent Bardach palatoplasty. Sommerlad’s Intra-Velar Veloplasty was performed in all patients. The patients were evaluated for certain palatal and cleft measurements, speech, and surgical complications. The study also compared impact of cleft severity on speech and complications. Results: All the patients showed improvement in palatal length and speech. Significant palatal lengthening was achieved by Bardach as compared to Langenbeck palatoplasty ( P = .002). Amongst the various speech parameters so compared Bardach group showed better speech articulation post-operatively ( P = .020). No significant difference was found between the 2 groups in relation to other speech parameters. Total 4 complications were encountered 2 belonging to each group. Conclusion: Hard palate cleft repair technique plays little role as far as speech outcomes are concerned. It was Intravelar Veloplasty which reestablished the velopharyngeal sphincter and improved the quality of speech. Hence restoring the muscular sling of soft palate using radical dissection should be stressed upon by the surgeons besides the closure of cleft. The current study found few confounding factors such as age, cleft width, and Veau’s class which altered the speech outcomes and/or complications of palatoplasty.

scholarly journals COMPARISON BETWEEN THERAPEUTIC ULTRASOUND AND SCAR MOBILIZATION OVER PERSISTENT POSTNATAL DYSPAREUNIA

2017 ◽  
Vol 10 (9) ◽  
pp. 48
Author(s):  
Mariyam Farzana Sf ◽  
Ponmathi P ◽  
Sivakumar Pvr
Keyword(s):  
Quality Of Life ◽  
Analogue Scale ◽  
Therapeutic Ultrasound ◽  
Ultrasound Therapy ◽  
Age Group ◽  
Functional Index ◽  
Significant Difference ◽  
Group A ◽  
Group B

  Objective: Dyspareunia is known as the painful sexual intercourse. This study was conducted to compare the effectiveness between therapeutic ultrasound and scar mobilization in persistent postnatal dyspareunia.Methods: This is an experimental study. 30 subjects with superficial dyspareunia, age group between 25 and 35 years are taken in this study and 15 subjects in Group A were treated with ultrasound therapy, 15 subjects in Group B were treated with scar mobilization. Female sexual functional index questionnaire (FSFI) and visual analogue scale (VAS) were used as the outcome measure.Results: Results showed a significant difference in FSFI and VAS measurements in both the groups, but clinically Group A showed better improvement in pain and quality of life than Group B.Conclusion: There is no significant difference between ultrasound therapy and scar mobilization over the pain and quality of life in patients with persistent postnatal dyspareunia.

scholarly journals The Effect on Performance Time and Quality of the Knots after Mono or Bimanual Training of Laparoscopic Intracorporeal Knot Tying according to the Gladiator Rule Technique

2018 ◽  
Vol 40 (05) ◽  
pp. 266-274
Author(s):  
Fernanda Asencio ◽  
Helizabet Ribeiro ◽  
Armando Romeo ◽  
Arnauld Wattiez ◽  
Paulo Ribeiro
Keyword(s):  
Dominant Hand ◽  
Resident Students ◽  
Performance Time ◽  
Laparoscopic Suture ◽  
Significant Difference ◽  
Bimanual Training ◽  
Group A ◽  
Group B ◽  
Intracorporeal Knot Tying

Objective To assess whether the monomanual or bimanual training of laparoscopic suture following the same technique may interfere with the knots' performance time and/or quality. Methods A prospective observational study involving 41 resident students of gynecology/obstetrics and general surgery who attended a laparoscopic suture training for 2 days. The participants were divided into two groups. Group A performed the training using exclusively their dominant hand, and group B performed the training using both hands to tie the intracorporeal knot. All participants followed the same technique, called Romeo Gladiator Rule. At the end of the course, the participants were asked to perform three exercises to assess the time it took them to tie the knots, as well as the quality of the knots. Results A comparative analysis of the groups showed that there was no statistically significant difference (p = 0.334) between them regarding the length of time to tie one knot. However, when the time to tie 10 consecutive knots was compared, group A was faster than group B (p = 0.020). A comparison of the knot loosening average, in millimeters, revealed that the knots made by group B loosened less than those made by group A, but there was no statistically significant difference regarding the number of knots that became untied. Conclusion This study demonstrated that the knots from group B showed better quality than those from group A, with lower loosening measures and more strength necessary to untie the knots. The study also demonstrated that group A was faster than B when the time to tie ten consecutive knots was compared.

scholarly journals Closed versus open lateral internal anal sphincterotomy in a chronic anal fissure

2017 ◽  
Vol 4 (3) ◽  
pp. 1055 ◽  
Author(s):  
Anandaravi B. N. ◽  
Ramaswami B.
Keyword(s):  
Anal Fissure ◽  
Recurrence Rate ◽  
Chronic Anal Fissure ◽  
Randomized Study ◽  
Lateral Internal Sphincterotomy ◽  
Internal Sphincterotomy ◽  
Closed Technique ◽  
Significant Difference ◽  
Group A ◽  
Group B

Background: Anal fissure is a common proctological problem, which presents with pain in the anal region during and after defecation. The aim of the study was to determine the best technique for surgical treatment of chronic anal fissure patients.Methods: The study was designed as a prospective randomized study. The study was conducted in surgical unit, K.R. Hospital, MMCRI, Mysore, India from January 2015 to June 2016. A total of 100 patients undergoing surgery were divided into two groups. In group A there were 50 patients who were treated by closed lateral internal anal sphincterotomy, and in group B there were 50 patients who were managed by open lateral internal anal sphincterotomy method. Patients were followed up for 6 months following surgery to observe for pain, bleeding, infection, incontinence, and recurrence. The exclusion criteria were patients who had in addition haemorrhoids or any other anorectal diseases.Results: There was acceptable difference in postoperative acute complications between the two methods of internal anal sphincterotomy. However, in group A, three patients (6%) versus 10 (20%) were complicated with incontinence postoperatively, whereas the recurrence rate was 4 versus 4% in group A versus group B, respectively (P = 0.015).Conclusions: There was significant difference between closed and open methods of lateral internal sphincterotomy in recurrence rate, healing rate, and other complications. Closed lateral internal sphincterotomy is treatment of choice for chronic anal fissure and can be done effectively and safely with acceptable rate of complications. Our recommendations are that closed technique should be adopted by experienced surgeons and Trainee should be initially trained by open technique then be shifted to closed technique.

scholarly journals CLEFT LIP AND PALATE

2016 ◽  
Vol 23 (05) ◽  
pp. 516-521
Author(s):  
Tajammal Abbas Shah
Keyword(s):  
Family History ◽  
Soft Palate ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Study Results ◽  
History Of ◽  
Group A ◽  
Group B ◽  
Surgical Unit ◽  
Palatal Defect

A prospective study was conducted to look for prevalence of cleft lip and palate ina population presenting to a surgical unit in a teaching hospital. Objectives: To see prevalenceof cleft lip and palate alone, lip and palate combined, right or left sided, male to femaledistribution, and possible factors responsible for clefting. Study Design: A prospective study.Setting: Surgical Unit II at Allied Hospital Faisalabad. Period: March 2009 to March 2010 forone year. Materials and Methods: Total 55 patients were treated in year 2009 out of total17900 (0.3 %) patients admitted in all surgical wards and 6508 patients admitted in surgicalunit II (0.8%). Patients were divided into three groups, cleft lip alone (group A), cleft palatealone (group B) and combined cleft lip and palate (group C). Children up to the age of 5 yearswith congenital abnormality were included in study. Results: Out of 6508 patients admitted insurgical unit II 55 patients (0.8%) had cleft lip and palate defect. 55 patients were divided inthree groups. In group A, 32 patients presented with cleft lip alone ( 58.1 % ), 16 ( 29 % ) weremales and 16 ( 29 % ) were females, 21 patients have left sided ( 38 % ), 4 right sided (7.27% )and 7 patients have bilateral ( 12.72 % ) defects. 2 patients (3.63 %) had family history of cleft lipand both were males. In group B, 12 patients ( 21.8 %) had cleft palate alone, 7 patients ( 12.72% ) were males and 5 patients ( 9 % ) were females, 10 patients ( 1.18 % ) had soft palate onlywhile 2 patients ( 3.63 % ) had compete ( hard and soft ) palatal defect. In group C, 11 patients,had cleft lip and palate combined ( 20 % ), 6 patients were males ( 10.9 % ) and 5 patients ( 9% ) were females, 8 patients ( 14.54 % ) had only soft palate defect while 3 patients ( 5.45 % )had complete palatal defect associated with 8 patients ( 14.54 % ) left sided unilateral lip defectand 3 patients ( 5.45% ) had bilateral cleft lip. All patients were operated without any mortality.Ages of mothers at earliest were 16 and 18 years, 3 cousin marriages, ( 5.45 % ) all fathers weresmokers, belonged to poor socio economic families and no history of mother’s exposure toradiation, drug abuse during gestational life. Conclusion: As it is obvious from this study thatall patients belongs to poor socio economics group, and all fathers were smokers, 3 patientsborn in parents who had cousin marriages ( 5.45 % ) 2 patients ( 3.63 % ) with family history,cleft lip and palate are multifactorial congenital abnormalities, runs in families and is influencedby various environmental factors.

scholarly journals Dispositivos interespinosos en discectomías lumbares primarias. ¿Favorecen la recurrencia de la hernia de discos? [Interspinous device in primary lumbar discectomy. Does it favor the recurrence of disc herniation?]

2019 ◽  
Vol 84 (2) ◽  
pp. 105-111
Author(s):  
Joint Halley Guimbard Pérez ◽  
Mariano Pomba ◽  
Gustavo Alejandro González ◽  
Nicolás Ortiz
Keyword(s):  
Disc Herniation ◽  
Randomized Study ◽  
Herniated Disc ◽  
Recurrence Rates ◽  
Significant Difference ◽  
Group A ◽  
Interspinous Spacers ◽  
Group B ◽  
Lumbar Spinal ◽  
Lost To Follow Up

Objetivo: Evaluar si la colocación de los dispositivos interespinosos siliconados tipo DIAM favorecen una tasa más alta de recidiva de la hernia discal homolateral clínica y por imágenes comparada con la discectomía pura.Materiales y Métodos: Se realizó un estudio prospectivo, observacional, aleatorizado desde mayo de 2009 hasta mayo de 2013, en nuestro Centro. Se evaluó a 123 pacientes, 3 se perdieron en el seguimiento; l muestra incluyó 120 sujetos. Todos fueron operados por el mismo equipo quirúrgico. Se formaron dos grupos: grupo A: discectomía más colocación de dispositivo interespinoso siliconado, 30 pacientes (16 mujeres y 14 hombres), con mayor frecuencia L4-L5 (27 pacientes, 90%) y grupo B: discectomías puras, 90 pacientes (53 mujeres y 37 hombres) con más frecuencia L4 y L5 (72 pacientes, 80%).Resultados: Seis de los pacientes del grupo A (20%) tuvieron una recidiva clínica y por imágenes, y 3 (10%) fueron operados nuevamente; en el grupo B, hubo 4 recidivas discales (4,4%), uno fue operado nuevamente (1,1%). Se hallaron diferencias significativas en las tasas de recidiva y reintervención entre los grupos (p = 0,0073 y p = 0,0188, respectivamente).Conclusiones: Los beneficios de los dispositivos interespinosos para tratar el canal estrecho lumbar secundario a hernia de disco son controvertidos, pero en nuestro estudio, se halló una diferencia significativa según el grupo. Al mantener el movimiento del segmento y cambiar ligeramente las cargas fisiológicas aumentarían la tasa de recidiva discal; no obstante, son necesarios estudios con mayor evidencia científica para corroborar estas tendencias. AbstractObjective: The objective of this study was to evaluate if discectomy with placement of an interspinous silicon DIAM spacer is associated with a different rate of clinical and radiographic ipsilateral disc herniation recurrence than discectomy alone.Methods: A prospective, observational,randomized study was performed from May 2009 to May 2013 at XXXXX. Of the 123 patients included in the study, 3 were lost to follow-up, leaving 120 patients for data analysis. All patients were operated on by the same surgical team. Patients received one of two types of treatment. Group A consisted of 30 patients (16 women and 14 ment) who underwent discectomy with placement of an interspinous silicone DIAM spacer. Group B was composed of 90 patients (53 women and 37 men) who received discectomy alone.Results: Discectomy at L4-L5 was the most common level, occurring in 90% (27) Group A patients and 80% (72) Group B patients. Group A demonstrated clinical and radiographic disc herniation recurrence in 6/30 (20%) of patients. Disc herniation recurrence developed in 4/90 (4.4%) Group B patients. One patient underwent reoperation (1.1%). Both recurrence and reoperation was significantly higher in Group A (p = 0.007 and p = 0.019, respectively).Conclusions: The benefits of interespinosos devices for the treatment of the lumbar spinal stenosis secondary to herniated disc while they are controversial in the present study showed significant difference according to the Group. In this study, patients that underwent discectomy and interspinous spaceer placement had higher reoperation and recurrence rates than discectomy patients that did not receive an interspinous spacer. Interspinous spacers may increase the rate of disc herniation by maintaining movement at the level of prior disc herniation and changing the physiologic load. More studies are needed to corroborate and evaluate these trends.

Septoplasty Improves Life Quality Related to Allergy in Patients with Septal Deviation and Allergic Rhinitis

2011 ◽  
Vol 145 (6) ◽  
pp. 910-914 ◽  
Author(s):  
Young Hyo Kim ◽  
Beom Joon Kim ◽  
Kang Hyun Bang ◽  
Yoonseok Hwang ◽  
Tae Young Jang
Keyword(s):  
Quality Of Life ◽  
Allergic Rhinitis ◽  
Clinical Course ◽  
Septal Deviation ◽  
Vas Score ◽  
Medication Score ◽  
Significant Difference ◽  
Group A ◽  
Group B

Objective. Evaluate the effect of septoplasty on the clinical course of allergic rhinitis by comparing (1) symptom change using the Visual Analogue Scale (VAS), (2) change of the medication score, and (3) improvement of the quality of life using a questionnaire. Study Design. Prospective pilot. Setting. Academic tertiary rhinological practice. Subjects and Methods. Sixty-two patients who had undergone septoplasty and turbinoplasty for septal deviation and allergic rhinitis were enrolled in group A. Twenty-six patients who had undergone only turbinoplasty for allergic rhinitis were enrolled in group B. The VAS score, the Average Rescue Medication Score (ARMS), and the Rhinasthma Questionnaire for the quality of life were all obtained from each patient. These parameters were compared before and after the surgery and between the groups. Results. Both groups showed significant improvement of the VAS score ( P < .001). When the change of VAS was compared between groups, there was a significant difference in group A only for nasal obstruction ( P = .047). Comparison of the ARMS between groups showed significant improvement in both groups after the surgery ( P < .01). However, there were no differences between the groups. The Rhinasthma score of group A was significantly lowered after the surgery (56.4 ± 13.2 to 34.1 ± 12.3, P < .001). The Rhinasthma score of group A was significantly lower than that of group B after the surgery ( P = .004). Conclusions. This is the first research about the potential effect of septoplasty on the clinical course of allergic rhinitis. Further studies are needed to elucidate the mechanisms underlying these effects.

Simple Decompression versus Anterior Submuscular Transposition of the Ulnar Nerve in Severe Cubital Tunnel Syndrome: A Prospective Randomized Study

Neurosurgery ◽  
2005 ◽  
Vol 56 (1) ◽  
pp. 108-117 ◽  
Author(s):  
Olga Gervasio ◽  
Giuseppe Gambardella ◽  
Claudio Zaccone ◽  
Damiano Branca
Keyword(s):  
Ulnar Nerve ◽  
Randomized Study ◽  
Cubital Tunnel Syndrome ◽  
Cubital Tunnel ◽  
Prospective Randomized Study ◽  
Significant Difference ◽  
Group A ◽  
Tunnel Syndrome ◽  
Group B ◽  
Simple Decompression

Abstract OBJECTIVE: The authors report the results of a clinical series of selected patients with severe cubital tunnel syndrome. The degree of ulnar nerve compression was evaluated by use of a grading system that includes measurements of motor and sensitive function. The submuscular transposition with flexor-pronator mass Z lengthening was compared with simple decompression through a prospective randomized study. METHODS: From February 1998 to June 2003, 70 patients with severe cubital tunnel syndrome were included in this study: 35 patients were submitted to simple decompression (Group A), and 35 patients were treated by anterior deep submuscular transposition (Group B). The preoperative status was determined by use of Dellon's classification. The selected patients had Dellon's Grade 3 (severe syndrome). The mean follow-up period after surgery was 47 months for Group A and 46.94 months for Group B. RESULTS: Postoperative clinical and electrophysiological outcomes were assessed 6 months after surgery in all 70 patients. According to the Bishop scoring system, 19 patients (54.3%) of Group A were clinically graded as excellent, 9 (25.7%) were graded as good, and 7 (20%) were graded as fair; in Group B, 18 patients (51.43%) were graded as excellent, 11 (31.43%) as good, and 6 (17.14%) as fair. Neither severe complications nor recurrences were observed in the two groups. CONCLUSION: No statistically significant difference was found between the two groups with regard to the clinical or the electrophysiological outcome. The surgical treatment gains in Group A and B were 80% and 82.86%, respectively (good to excellent results).

scholarly journals Comparison by Objective Parameters in Patients with Chronic Rhinosinusitis Managed Medically and Surgically (with and without Powered Instruments)

2016 ◽  
Vol 7 (3) ◽  
pp. ar.2016.7.0169
Author(s):  
Samarendra Behera ◽  
Satyawati Mohindra ◽  
Sourabha K. Patro ◽  
Ashok K. Gupta
Keyword(s):  
Chronic Rhinosinusitis ◽  
Test Scores ◽  
Mucociliary Clearance ◽  
Sinus Surgery ◽  
Clearance Time ◽  
Significant Difference ◽  
Group A ◽  
Group B ◽  
Treatment Surgery

Objective To compare mucociliary clearance time and quality of life in patients who underwent sinus surgery using conventional and powered instruments, and in patients who were treated nonsurgically. Methods A total of 151 patients with chronic rhinosinusitis were included. Fifty-four patients were treated conservatively, 48 patients were managed surgically by using conventional instruments and 49 patients were managed by using a microdebrider. Kupferberg nasal endoscopy grades, 20-item Sino-Nasal Outcome Test scores, Lund-Mackay scores, and mucociliary clearance time were analyzed. Results On comparison among the groups, it was found that there was a significant difference between group A (nonsurgically treated) compared with group B (surgery by conventional means) or group C (surgery with microdebrider) in nasal endoscopic grades, Lund-Mackay scores, 20-item Sino-Nasal Outcome Test scores, and mucociliary clearance time. However, in comparison between groups B and C, there was no statistically significant difference. Conclusion Mucociliary clearance time tended to recover after starting treatment for chronic rhinosinusitis both after conservative treatment and after surgical treatment. Surgery provided better improvement in different objective scores in chronic rhinosinusitis. There exists no statistical difference in parameters independent of the instrument used for surgery.

Does the Sweating Severity of Primary Hyperhidrosis Sites Affect Post-Sympathotomy Results?

2020 ◽  
Author(s):  
Hüseyín Ulaş Çınar ◽  
Burçin Çelik
Keyword(s):  
Patient Satisfaction ◽  
Clinical Improvement ◽  
Severity Score ◽  
Postoperative Results ◽  
Satisfaction Rate ◽  
Significant Difference ◽  
Group A ◽  
Primary Hyperhidrosis ◽  
Group B

Abstract Background Improvement in quality of life (QOL) and patient satisfaction after endoscopic thoracic sympathotomy (ETS) in patients with primary hyperhidrosis may be affected by various factors. We examined whether the preoperative sweating severity of primary hyperhidrosis sites affects postoperative results. Methods The records of 112 patients who underwent bilateral ETS were reviewed retrospectively. The patients were divided into three groups according to the sweating severity score obtained from all primary hyperhidrosis sites (primary hyperhidrosis severity score [PHSS]) and analyzed comparatively. Group A (PHSS = 1–4) included 22 patients, Group B (PHSS = 5–8) 36 patients, and Group C (PHSS ≥ 9) 54 patients. Outcome measures included QOL prior to surgery, improvement in QOL after surgery, degree of clinical improvement, presence, severity, localization, and site number of reflex sweating (RS) and general patient satisfaction after 6 months of surgery. Results The preoperative QOL of patients with higher PHSS (groups B, C) was worse than other patients (group A). More than 91% of all patients had any level improvement in QOL, and over 96% had slight or great clinical improvement. RS developed in 80% of the patients, mostly in the back, very severe in 8%, and in median two different body areas. The overall patient satisfaction rate was more than 95%. There was no significant difference between the three groups in terms of all postoperative results. Conclusion Preoperative sweating severity of primary hyperhidrosis sites does not affect post-sympathotomy results. Surgeons should not be worried when deciding upon surgery, even in patients with high sweating severity.

scholarly journals Prospective Randomized Study between Open Vs Closed Lateral Anal Internal Sphincterotomy in Patients with Chronic Fissure in Ano

2020 ◽  
Vol 3 (1) ◽  
pp. 167-171
Author(s):  
Anand Shanmugaiah ◽  
Saravanan Pandian
Keyword(s):  
Anal Fissure ◽  
Chronic Anal Fissure ◽  
Randomized Study ◽  
Fissure In Ano ◽  
Internal Sphincterotomy ◽  
Post Surgery ◽  
Significant Difference ◽  
Group A ◽  
Group B

Background: One of the the most common cause of pain during defecationin young patientsis chronic fissure in ano. Surgical treatment of choice for chronic fissure in ano is internal sphincterotomy. This procedure can be performed by open or closed method. The aim of the study was to compare the closed and open anal internal sphincterotomy in patients admitted in our hospital with chronic anal fissure. Subjects and Methods: 105 patients admitted in department of general surgery with chronic fissure in ano were divided into two groups. 50 patients (Group A) who were treated by closed method and 55 patients (Group B) who were managed by open lateralanal sphincterotomy method. A 3 months follow up done in both post-surgery to observe for pain, bleeding, infection, incontinence, and recurrence. Results: Significant difference was observed in postoperative acute complications between the two methods of internal anal sphincterotomy. Conclusion: Lateral anal sphincterotomy is the treatment of choice for chronic anal fissure, either open or closed method. However, the closed method was observed to have lesserpost operative complication compared to the open method.

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