Structure

Card Set Information

Author:
melihuff
ID:
13091
Filename:
Structure
Updated:
2010-04-04 20:58:52
Tags:
Cleft Palate
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Description:
Mod 10 Surgeries
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  1. Palatal Surgery
    AKA ?
    • Primary palatoplasty
    • initial palatoplasty
  2. Primary Goal in Palatal Surgery
    intact division between oral and nasal cavities

    functional VP closure mechanism for speech
  3. Palatal surgery goal hope that it will?
    • Facilitate feeding
    • reduce URI's
    • Normalize/improve otologic health
    • Provide structural integrity for early speech learning (artic placements, oral direction of airflow, adequate resonance)
  4. Primary Veloplasty aka?
    delayed hard palate closure
  5. Primary veloplasty is NOT another term for ?
    initial palatoplasty
  6. Primary Veloplasty involves?
    • early closure of the soft palate/velum and
    • later closure of the hard palate

    Ages vary across centers and studies
  7. Initial Palatoplasty (long standing popular procedures?
    (4)
    • Von Langenbeck (1861) -straight line repair
    • V-Y pushback (1937)
    • Bardach 2-flap procedure
    • Furlow Z-plasty (1976) aka double opposing Z-plasty
  8. Bardach 2-flap procedure
    modifies ?
    Less denuding of ?
    No ?
    Includes ?
    M: the V-Y

    L: bone

    pushback

    levator reconstruction
  9. ___ Procedure produces greater palatal length
    sacrifices width
    incorporated levator reconstruction
    • Furlow procedure
    • "double opposing Z-plasty"
  10. How to handle the alveolar cleft in complete cleft lip and palate?
    Options (4)
    The argument continues...
    • 1) leave the alveolar cleft unoperated
    • 2) close it by a primary gingivoperiostomy at the time of lip repair
    • 3) close it by primary bone grafting (in deciduous dentition, using autogenous bone)
    • 4) Close it by secondary bone grafting
  11. Secondary bone grafting to the alveolar cleft is done __?
    • before eruption of the permanent canine (cuspid) teeth
    • about 9-11 years
    • teeth will erupt only into bone
  12. ____ tx precedes the graft to align the two segments;
    canine or lateral incisor will be guided to erupt into the grafted site?
    Orthodontic tx
  13. A bone graft can also serve as?
    the housing for dental (endosseous) implants
  14. Fistulas asr not just a "hole" in the palate they have ?
    a 3-dimentional configuration
  15. Oronasal fistulas (fistulae) and surgical management

    ___:?from alveolus or labial sulcus into nasal cavity/nose
    Nasolabial
  16. Oronasal fistulas (fistulae) and surgical management

    ____: sometimes intentional after surgical closure of palate?
    Anterior hard palate into nose
  17. Oronasal fistulas (fistulae) and surgical management

    ___: ?

    ___: ?
    juncture of hard and soft palate

    soft palate proper
  18. Fistulas can be physically "closed" either through ?
    • surgical management or
    • maxillary obturator appliance
  19. SMCP is not always easily seen on ? and there may not be a ?

    So clinician may assume there is no cleft to account for the "cleft type speech"
    intraoral exam

    palpable notch
  20. There may be visible physical signs of SMCP evident on intraoral exam but no?
    associated speech disorder
  21. Surgical tx for SMCP is warranted only when there is ?
    an associated speech problem, not on the basis of physical signs
  22. Persons with repaired clefts may require surgical advancement of the midface to ?
    "normalize" or improve the maxilla-to-madible relationship
  23. A key question of maxillary advancement is the affect of this orthognathic surgery on?
    speech
  24. In general surgery in individuals with repaired clefts
    May improve:
    May increase:
    May cause:
    May have:
    *articulation errors related to malocclusion

    *or have no effect on VP speech function/speech resonance

    * a "return" of VP inadequacy

    * no significant effect on articulation or resonance
  25. Facial Advancement surgery
    ___:?
    Advancement of maxilla only
    Transverse cut made just above roots of teeth
    to improve facial and occlusion
    Le Fort I Osteotomy
  26. Facial Advancement surgery

    ___:?

    Mid-face moved forward (nasal bones and maxilla)
    Improve aesthetics and occlusion
    May improve nasal airway
    Le Fort II Osteotomy
  27. Facial Advancement surgery

    ___:?
    Major advancement of facial bones
    From superior orbital rims down through maxilla
    Improves occlusion and aesthetics, nasal airway
    Le Fort III Osteotomy
  28. ____:
    Generic term for several different techniques used for moving facial bones, mandible or maxilla
    Distraction osteogenesis
  29. Places internal or external metal device that is used to gradually push the divided bone segments apart in a slow, very controlled manner over a few weeks?
    Distraction Osteogenesis
  30. A crew in the device is turned to gradually incease the gap created by surgery

    Resulting gap is filled in by natural formation of new bone

    Creates a mandible or maxilla that is longer in vertical plane, the horizontal plane or both depending on the presenting problem and desired result.
    Distraction osteogenesis

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