Lipofilling in patients with a cleft lip (and palate) - a pilot study assessing functional outcomes and patients' satisfaction with appearance.
唇裂 (和腭裂) 患者的脂肪填充-评估功能结局和患者外观满意度的初步研究。
- 作者列表："Alighieri C","Bettens K","Roche N","Bruneel L","Van Lierde K
INTRODUCTION:Lipofilling of the upper lip as secondary treatment in patients with a cleft lip (and palate) (CL ± P) has been proposed to improve projection and volume especially in profile view. The purpose of the present study was to document differences in functional (i.e. logopaedic) and self-reported aesthetic outcomes by comparing pre- and postoperative results after lipofilling of the upper lip in patients with CL ± P. METHODS:Eight Dutch-speaking youngsters and young adults (three women, five men) with CL ± P were included. The median age was 19 years (range: 14-24 years). Logopaedic outcomes (i.e. assessment of orofacial myofunctional behavior, articulation and lip strength) and self-reported aesthetic outcome (i.e. patients' satisfaction using the Cleft Evaluation Profile) were determined. RESULTS:Neither for lip strength and orofacial myofunctional behavior nor for articulation statistically significant differences were found when comparing measurements before and after lipofilling. Regarding patients' satisfaction, a statistically significant increased self-evaluation of appearance in profile was found after lipofilling. CONCLUSION:Regarding functionality, the present study did not find any differences when comparing outcomes before and after lipofilling. Nevertheless, patients were more satisfied with appearance in profile after performance of this technique. As this is a small sample study, further research and long-term follow-up studies are necessary.
引言: 上唇脂肪填充术作为唇裂 (和腭裂) 患者的二次治疗 (cl ± p) 已被提出用于改善投影和体积，特别是在侧面观方面。本研究的目的是记录功能上的差异 (Logopaedic) 和自我报告的美学结果，通过比较cl ± p患者上唇脂肪填充后的术前和术后结果。 方法: 纳入 8 例讲荷兰语的青少年和年轻成人 (3 例女性，5 例男性) 的cl ± p。中位年龄为 19 岁 (范围: 14-24 岁)。Logopaedic结果 (i.e.评估口面部肌肉功能行为、清晰度和唇部力量) 和自我报告的美学结果 (即使用裂隙评估概况) 确定患者的满意度。 结果: 在比较脂填充前后的测量值时，无论是唇部力量和口面部肌肉功能行为还是关节清晰度都没有发现统计学显著差异。关于患者的满意度，在填充脂肪后发现具有统计学意义的外观自我评价增加。 结论: 关于功能性，本研究在比较脂肪填充前后的结局时没有发现任何差异。尽管如此，患者在实施该技术后对外形更满意。由于这是一个小样本的研究，进一步的研究和长期的随访研究是必要的。
METHODS::Impairments in social cognition have been frequently described in 22q11.2 deletion syndrome (22q11.2DS) and are thought to be a hallmark of difficulties in social interactions. The present study addresses aspects that are critical for everyday social cognitive functioning but have received little attention so far. Sixteen children with 22q11.2DS and 22 controls completed 1 task of facial expression recognition, 1 task of attribution of facial expressions to faceless characters involved in visually presented social interactions, and 1 task of attribution of facial expressions to characters involved in aurally presented dialogues. All three tasks have in common to involve processing of emotions. All participants also completed two tasks of attention and two tasks of visual spatial perception, and their parents completed some scales regarding behavioural problems of their children. Patients performed worse than controls in all three tasks of emotion processing, and even worse in the second and third tasks. However, they performed above chance level in all three tasks, and the results were independent of IQ, age and gender. The analysis of error patterns suggests that patients tend to coarsely categorize situations as either attractive or repulsive and also that they have difficulties in differentiating emotions that are associated with threats. An isolated association between the tasks of emotion and behaviour was found, showing that the more frequently patients with 22q11.2DS perceive happiness where there is not, the less they exhibit aggressive behaviour.
METHODS:BACKGROUND:We describe the first radiographic clinic in the literature for DDH and how this novel clinic can significantly improve the efficiency and cost-effectiveness of service in a tertiary referral centre. AIMS:A radiographic clinic for the management of developmental dysplasia of the hip was introduced in 2017 in our institution. We performed a detailed cost analysis to assess the economic savings made with the introduction of this new clinic. We assessed the efficiency of the service by identifying how many unnecessary outpatient visits were prevented. We also assessed the difference in times from referral to review between the two clinics. METHODS:Analysis of the clinic activity in 2017 was possible as all data was collected prospectively by the DDH CNS and stored in our database. Cost analysis was performed, and the savings made per patient along with the financial benefit to our institution was recorded. RESULTS:The new radiographic clinic reduced the cost of reviewing one patient by €162.51 per patient. There was a 73% discharge rate from the clinic which prevented 251 unnecessary patient visits to the outpatient department over the course of the year. There was a significant 11-day reduction in waiting times between referral and review when comparing the radiographic to the conventional clinic (p < 0.05). CONCLUSIONS:A radiographic clinic for the management of developmental dysplasia of the hip has a significant effect on the efficiency and overall cost-effectiveness of service provision in a tertiary referral centre.
METHODS:INTRODUCTION:Triple pelvic osteotomy (TPO) involves periacetabular osteotomies of the ilium, ischium, and pubis to reorient the acetabulum. This operation is indicated in certain situations for the treatment of developmental dysplasia of the hip, dysplastic neuromuscular hips, and for containment of the femoral head in cases of Legg-Calvé-Perthes disease. METHODS:This retrospective cohort study compares radiographic outcomes of patients who underwent TPO using two different techniques and describes a novel single-incision direct lateral approach. TPO was performed on 22 patients by the senior author. The first 10 patients underwent TPO through a single-incision anterolateral approach. The last 12 patients underwent TPO using the direct lateral approach. Preoperative and postoperative pelvic radiographs were reviewed for each patient, and the migration index and center-edge angle were recorded. RESULTS:The migration index and center-edge angle were evaluated and were not found to be significantly different between the anterolateral and direct lateral groups. The direct lateral approach is described. CONCLUSION:The direct lateral approach for TPO is equivalent to the anterolateral approach on radiographic evaluation. Advantages of the direct lateral approach include direct visualization of the ischial osteotomy, effective mobilization of the acetabulum, and safety of the sciatic nerve.