Gentle Plastic Surgery To Restore The Pharyngeal Ring In Patients With Congenital Cleft Palate
VOLUME 23, 2026
The Role of Targeted Infra-popliteal Endovascular Angioplasty to Treat Diabetic Foot Ulcers Using the Angiosome Model: A Systematic Review
VOLUME 6, 2023
Abdulhak M. Mahkamov, Rustam A. Amanullayev, Laziz Y. Soyibnazarov, Mokhir E. Mahkamov
Abstract
Relevance. Congenital cleft palate is one of the most severe forms of malformations of the maxillofacial region. Despite the variety of surgical methods, the results of treatment of children with congenital cleft palate are often unsatisfactory. After surgery, patients may experience postoperative defects that require additional surgical interventions. The purpose of our study was to study and modernize the technique of urano-, velo- and pharyngoplasty with simultaneous restoration of the palatopharyngeal ring.
Materials and methods. This work was carried out at the Republican Children's Multidisciplinary Hospital in the city of Nukus (Karakalpak Republic), Uzbekistan. 280 patients with congenital cleft lip and palate (CCLP) were examined, comparing the results of previous operations. Among the studied patients, 120 children and 68 patients with congenital cleft palate, 34 with CCLP, and 18 with bilateral CCLP were identified. The first group included 35 patients, the second group consisted of 85 patients (42 patients who had undergone cheiloplasty and 43 primary isolated cleft palates IIa – 16, IIb - 17). The examination of patients was carried out jointly with otorhinolaryngologic (ENT) specialists to assess changes in the nasopharyngeal space.
Results. By studying the anamnesis of the selected patients, the types of postoperative complications were determined. To achieve a narrowing of the pharyngeal ring, we suggest using a muscular-mucous flap on the pedicle located in the side wall. This flap will mechanically contribute to the contraction and elevation of the soft palate, closing the nasopharyngeal space.
Conclusion. When performing early veloplasty before cheiloplasty, the strength of the muscles and scars leads to an expansion of the cleft lip. Early performed cheilo-veloplasty leads to a decrease in pathological changes in the tissues of the nasopharyngeal space. The results of the study showed that the proposed technique can improve the results of speech therapy sound correction and speed up the rehabilitation process.
Keywords :
congenital cleft palate, palatopharyngeal insufficiency, eustachian tube..
Erin Saricilar
Lecture in accounting. University of Basrah, College of Administration and Economics, Department of Accounting.
Lecture in accounting. University of Basrah, College of Administration and Economics, Department of Accounting.
Abstract
Atherosclerotic disease significantly impacts patients with type 2 diabetes, who often present with recalcitrant peripheral ulcers. The angiosome model of the foot presents an opportunity to perform direct angiosome-targeted endovascular interventions to maximise both wound healing and limb salvage. A systematic review was performed, with 17 studies included in the final review. Below-the-knee endovascular interventions present significant technical challenges, with technical success depending on the length of lesion being treated and the number of angiosomes that require treatment. Wound healing was significantly improved with direct angiosome-targeted angioplasty, as was limb salvage, with a significant increase in survival without major amputation. Indirect angioplasty, where the intervention is applied to collateral vessels to the angiosomes, yielded similar results to direct angiosome-targeted angioplasty. Applying the angiosome model of the foot in direct angiosome-targeted angioplasty improves outcomes for patients with recalcitrant diabetic foot ulcers in terms of primary wound healing, mean time for complete wound healing and major amputation-free survival.
Keywords :
Diabetic foot ulcer, angiosome, angioplasty