Global cleft care in low-resource settings / / Jordan W. Swanson, editor ; David W. Low, illustrator

• Record Nr.: UNINA9910483672803321
• Pubbl/distr/stampa: Cham, Switzerland : , : Springer, , [2021]; ©2021
• ISBN: 3-030-59105-0
• Descrizione fisica: 1 online resource (xxx, 585 pages) : illustrations
• Disciplina: 617.522
• Soggetti: Cleft lip - Surgery; Cleft palate - Surgery; Fissura labial; Cirurgia maxil·lofacial; Persones desfavorides; Llibres electrònics
• Lingua di pubblicazione: Inglese
• Formato: Materiale a stampa
• Livello bibliografico: Monografia
• Nota di bibliografia: Includes bibliographical references and index.
• Nota di contenuto: Intro -- Foreword -- Foreword -- Preface -- Acknowledgments -- Contents -- Case Studies in Cleft Surgery -- About the Editors -- Editor -- Illustrator -- Section Editors -- Contributors -- Part I: Introduction to Global Cleft Care -- 1: Introduction: A Paradigm Shift in Global Cleft Care -- Five Forces Shaping Global Cleft Care -- Surgery as Public Health -- Locally Delivered Cleft Care -- Focus on Achieving Great Patient Outcomes -- Innovation Borne of Low-Resource Settings -- The Conundrum of Evidence-Based Medicine -- References -- 2: Burden of Cleft Disease and Opportunity for Impact -- Introduction -- Defining Cleft Conditions -- The Burden of Cleft Disease -- Epidemiology -- Outcomes for Cleft Patients -- Economics of Cleft Care -- Approaches to Cleft Care -- Defining Adequate Cleft Care -- Methods of Reaching Untreated or Undertreated Patients -- The Potential Impact of Cleft Care -- References -- 3: Patient Barriers to Care -- Introduction -- Availability of Care (Supply) -- Workforce -- Infrastructure -- Affordability and Acceptability of Surgical Care (Demand) -- Affordability -- Acceptability -- Conclusion -- References ; -- 4: Innovations in Reaching Patients -- Introduction -- Design Thinking -- Examples from the Field -- Cleft Lip and Palate -- Patient Accompaniment: Partners in Health and Operation Smile Honduras -- Problem Statement -- Program Overview -- Why It Works -- Enhancing the Patient Experience: Operation Smile, Madagascar -- Problem Statement -- Program Overview -- Why It Works -- Primary Care -- Nuka System of Care: Southcentral Foundation, Alaska, United States -- Problem Statement -- Program Overview -- Why It Works -- Community Health Workers: Last Mile Health, Liberia -- Problem Statement -- Program Overview -- Why it Works -- Infectious Disease.; Community-Based Surveillance System: CORE Group Polio Project, South Sudan -- Problem Statement -- Program Overview -- Why It Works -- Conclusion &amp -- Key Takeaways -- References -- Part II: Patient and Cleft Assessment -- 5: Patterns, Anatomy, and Classification of Clefts -- Introduction -- Epidemiology -- Patterns of Cleft Lip and Palate -- Syndromic Clefts -- Racial and Ethnic Epidemiologic Variations -- Embryology -- The Gene-Environment Interplay -- Facial Development -- Clefts as Failure of Fusion Events -- Cleft-Related Anatomy -- Nose: Tip, Alae, Columella, Nasal Sill, Paranasal Muscles -- Palate -- Classification -- Severity Classification -- Patterns -- Unilateral Cleft Lip and Palate (UCLPA): Main Features -- Bilateral Cleft Lip and Palate (BCLPA): Main Features -- Cleft Palate: Main Features -- References -- 6: Early Nutrition, Feeding and Management of Infants with an Oral Cleft -- Introduction -- Feeding Guidance for Patients with Cleft Lip/Palate -- Normal Feeding -- Feeding Duration and Amounts -- Initial Feeding Assessment -- Specific Feeding Problems of Infants with CL+/− P -- Cleft Lip -- Cleft Palate with or Without Cleft Lip -- Assisted Breast/Bottle Feeding and Devices -- Breastfeeding -- Modified Bottles -- Oral Plates/Obturators -- Nasogastric (NG) Feeding -- Oral Hygiene -- Positioning and Winding/Burping -- Sources of Milk and Milk Alternatives -- Weaning -- Nutrition and Growth Assessment -- Growth Measurement -- Weight Measure -- Length Measure -- Head Circumference Measure -- Mid-Upper Arm Circumference (MUAC) Measure -- Malnourishment: Diagnosis and Management -- Perioperative Feeding Considerations -- Preoperative Nutritional Assessment -- Postoperative Feeding -- References -- 7: Surgical Evaluation, Diagnosis, and Treatment Planning -- Introduction -- Surgical Diagnosis and Cleft Care Plan -- Cleft Diagnosis.; Surgical Treatment Pathway -- Surgical Patient Screening and Specific Treatment Plan -- Prioritizing Patients -- Structuring Safe Surgery in the Mission/Outreach Setting -- Surgical Schedule -- Avoiding Complications -- Postoperative Care Planning -- References -- 8: Pediatric and Anesthesiologic Evaluation -- Introduction -- Overall Health and Nutrition -- Ruling Out Syndromic Conditions and/or Associated Congenital Anomalies -- Cleft Palate and Pierre Robin Sequence -- Preoperative Assessment of the CLP Patient -- Review of Systems: Medical History -- Review of Systems: Physical Examination -- Further Workup: Laboratory and Imaging Studies -- CLP Surgery, Anesthesia, and Comorbidities -- Ruling Out Concurrent Infections -- Otitis Media -- Respiratory Tract Infections (RTIs) -- RTIs and the CLP Surgical Patient -- Other Respiratory Comorbidities -- Asthma -- Obstructive Sleep Disorders (OSDs) -- Surgical Timing and Surgical Readiness -- References -- Part III: Complete Surgical Treatment -- 9: Anesthesia for Patients with Cleft Lip and Palate -- Introduction -- Anesthesia Challenges -- Epidemiological Public Health Issues -- Timing of Surgery and Anesthesia Implications -- Preoperative Assessment -- Upper Respiratory Tract Infection (URI) -- Nutrition ; and Hydration -- Associated Conditions and Anesthesia Implications -- Airway Management: Relevant Facts for Surgeons -- Antibiotic Prophylaxis -- Anesthesia Technique -- Intraoperative and Postoperative Pain Management -- General Consideration -- Regional Anesthesia in Cleft Surgery -- Infraorbital Nerve Block -- Palatal Nerve Blocks -- Bilateral Maxillary Nerve Block by Suprazygomatic Approach -- Particular Considerations -- CL Repair -- Primary CP repair -- Secondary CP Repair -- Alveolar Bone Graft Surgery -- Secondary Correction of Nasal Deformities in CLP Patients: Open Rhinoplasty.; Orthognathic Surgery -- Conclusion -- Bibliography -- 10: Principles of Cleft Lip Repair -- Introduction -- Aesthetics and Functional Considerations -- Timing of Repair, Nasoalveolar Molding, and Lip Adhesion -- Cleft Lip Adhesion -- Timing of Definitive Repair -- Technical Considerations -- Anatomic Subunits of the Nose and Lip -- Cleft Severity and Tension of Repair -- Nasal Floor Repair -- Rhinoplasty at Primary Lip Repair -- Revisions -- Conclusions -- References -- 11: Unilateral Cleft Lip repair: Rotation-Advancement Technique -- Introduction -- Patient Selection and Clinical Planning -- Timing of Surgery -- Operative Planning -- Relevant Surface Anatomy -- Key Equipment -- Anesthesia -- Procedural Technique -- Incisions on the Non-cleft Side -- Mohler's Incision (Fig. 11.2) -- Simple Rotation Incision (Fig. 11.3) -- Adequate Rotation -- Muscle Dissection on the Rotation Flap -- C-Flap and Footplate of Medial Crura -- Nasal Septal Dissection -- Incisions on the Cleft Side -- L-Mucosal Flap -- Inferior Turbinate Flap -- Incision and Dissection -- Removal of Fat Pad Under the Vestibulum -- Elevation of Orbicularis Marginalis Flap -- Nasal Floor Reconstruction and Alar Base Repositioning -- Lip Repair with Anterior Palate Repair -- Lip Repair Without Anterior Palate Repair -- Sequence of Operation When an Anterior Palate Repair Is Combined with Lip Repair -- Closure of the Base of Columella -- Muscle Reconstruction -- Insertion of the WSR Flap -- Incisions for Triangular Vermillion Flap -- Closure of the Free Border of the Lip -- Closure of the Nasal Floor and the Lip Skin -- Semi-open Rhinoplasty -- Incision -- Release of Fibrofatty Tissue from LLCs -- Repositioning of LLCs -- Trimming the Excessive Skin -- Primary Septal Cartilage Graft -- Alar Base Position -- Creation of the Alar-Facial Groove -- Postoperative Care -- Wound Care.; Stitch Removal -- Aftercare -- Follow-Up and Complication Management -- References -- 12: Unilateral Cleft Lip Repair: Modified Mohler Technique -- Introduction -- Anatomy -- Preoperative Planning -- Surgical Management -- Surgical Approach -- Positioning -- Markings -- Surgical Technique -- Postoperative Care -- Outcomes -- Complications -- References -- 13: Unilateral Cleft Lip Repair: Anatomic Subunit Approximation Technique -- Introduction -- Principles -- Technique -- Plan -- Lip Points -- Nose Points -- Medial Markings: Connect the Dots -- Lateral Lip Vermilion Flap -- Determining Base Width of Lateral Lip Inferior Triangle Flap -- Fitting the Lateral Lip Markings to the Available Lateral Lip Height -- Connecting the Two Sides -- Surgical Release and Re-measure -- Component Reconstruction -- Final Closure -- Case Examples -- References -- 14: Bilateral Cleft Lip Repair -- Introduction -- Goals of Surgery -- Timing and Indications for Surgery -- Our Technique for Bilateral Complete Cleft Lip Repair -- Patient Preparation and Setup -- Markings (Fig. 14.1) -- We Start by Making the Markings on the Prolabium -- Markings on the Lateral Lip Elements -- Surgery: the Execution of Your Plan -- Creation of the Philtral Tie and Posterior Wall of the Upper Buccal Sulcus -- Incision of the Lateral Lip Markings ; -- Release of the Lateral Lip Elements and Alar Bases -- Muscle Release -- Evaluation of Alar Base Position with Muscle Closure -- Closure of the Lip Mucosa -- Muscle Repair -- Anterior Closure of the Lip Skin and Vermillion -- Primary Nasal Correction -- Postoperative Care -- References -- 15: Secondary Cleft Lip Repair -- Introduction -- Patient Selection and Clinical Planning -- Timing of Surgery -- Planning Surgery -- Relevant Anatomy -- Key Equipment -- Anesthesia -- Procedural Technique -- Unilateral Cleft Lip Deformities.; Clinical Examples of Unilateral Cleft Lip Deformities.