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cleft lip and palate
This is a mind map about cleft lip and palate. The main contents include: cleft palate, surgery, cleft lip, and development. The introduction is detailed and the description is comprehensive. I hope it will be helpful to those who are interested!
Edited at 2024-11-27 16:34:19- Rumi 10 spiritual high-dimensional awakenings
Rumi: 10 dimensions of spiritual awakening. When you stop looking for yourself, you will find the entire universe because what you are looking for is also looking for you. Anything you do persevere every day can open a door to the depths of your spirit. In silence, I slipped into the secret realm, and I enjoyed everything to observe the magic around me, and didn't make any noise. Why do you like to crawl when you are born with wings? The soul has its own ears and can hear things that the mind cannot understand. Seek inward for the answer to everything, everything in the universe is in you. Lovers do not end up meeting somewhere, and there is no parting in this world. A wound is where light enters your heart.
- Pathophysiology - Heart failure
Chronic heart failure is not just a problem of the speed of heart rate! It is caused by the decrease in myocardial contraction and diastolic function, which leads to insufficient cardiac output, which in turn causes congestion in the pulmonary circulation and congestion in the systemic circulation. From causes, inducement to compensation mechanisms, the pathophysiological processes of heart failure are complex and diverse. By controlling edema, reducing the heart's front and afterload, improving cardiac comfort function, and preventing and treating basic causes, we can effectively respond to this challenge. Only by understanding the mechanisms and clinical manifestations of heart failure and mastering prevention and treatment strategies can we better protect heart health.
- Pathophysiology - ischemia - reperfusion injury
Ischemia-reperfusion injury is a phenomenon that cellular function and metabolic disorders and structural damage will worsen after organs or tissues restore blood supply. Its main mechanisms include increased free radical generation, calcium overload, and the role of microvascular and leukocytes. The heart and brain are common damaged organs, manifested as changes in myocardial metabolism and ultrastructural changes, decreased cardiac function, etc. Prevention and control measures include removing free radicals, reducing calcium overload, improving metabolism and controlling reperfusion conditions, such as low sodium, low temperature, low pressure, etc. Understanding these mechanisms can help develop effective treatment options and alleviate ischemic injury.
cleft lip and palate
- Rumi 10 spiritual high-dimensional awakenings
Rumi: 10 dimensions of spiritual awakening. When you stop looking for yourself, you will find the entire universe because what you are looking for is also looking for you. Anything you do persevere every day can open a door to the depths of your spirit. In silence, I slipped into the secret realm, and I enjoyed everything to observe the magic around me, and didn't make any noise. Why do you like to crawl when you are born with wings? The soul has its own ears and can hear things that the mind cannot understand. Seek inward for the answer to everything, everything in the universe is in you. Lovers do not end up meeting somewhere, and there is no parting in this world. A wound is where light enters your heart.
- Pathophysiology - Heart failure
Chronic heart failure is not just a problem of the speed of heart rate! It is caused by the decrease in myocardial contraction and diastolic function, which leads to insufficient cardiac output, which in turn causes congestion in the pulmonary circulation and congestion in the systemic circulation. From causes, inducement to compensation mechanisms, the pathophysiological processes of heart failure are complex and diverse. By controlling edema, reducing the heart's front and afterload, improving cardiac comfort function, and preventing and treating basic causes, we can effectively respond to this challenge. Only by understanding the mechanisms and clinical manifestations of heart failure and mastering prevention and treatment strategies can we better protect heart health.
- Pathophysiology - ischemia - reperfusion injury
Ischemia-reperfusion injury is a phenomenon that cellular function and metabolic disorders and structural damage will worsen after organs or tissues restore blood supply. Its main mechanisms include increased free radical generation, calcium overload, and the role of microvascular and leukocytes. The heart and brain are common damaged organs, manifested as changes in myocardial metabolism and ultrastructural changes, decreased cardiac function, etc. Prevention and control measures include removing free radicals, reducing calcium overload, improving metabolism and controlling reperfusion conditions, such as low sodium, low temperature, low pressure, etc. Understanding these mechanisms can help develop effective treatment options and alleviate ischemic injury.
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- Outline
cleft lip and palate
development
2w proliferation period 3-8w differentiation, embryonic stage 9w fetal period
If affected in the first 12 weeks, various deformities will occur 6 to 7 weeks of union, prone to deformity 9~12w cleft palate
cleft lip
1:1000, prevalence rate 1,624:1000, male to female ratio 1,5:1, more males than females
Unilateral cleft lip
Unilateral complete cleft lip
Complete split from upper lip to bottom of nose
Unilateral incomplete cleft lip
The fissure does not reach the bottom of the nose
Bilateral cleft lip
international classification
Incomplete bilaterally
Complete bilaterally
Mixed sides
Domestic classification
one time
lipstick only
Second time
The upper lip is partially split, but the bottom of the nose is still intact
three degrees
The entire upper lip to the bottom of the nose is cracked
micro cleft lip
There are no cracks in the skin and mucous membranes, the underlying muscle layers fail to join or are misplaced, there is a shallow groove-like depression on the side of the cleft lip, and the lip peaks are separated.
cleft palate
Classification
Cleft soft palate
Cleft in the soft palate only, sometimes only in the palatal lobe
Incomplete cleft palate
Partial cleft palate, complete cleft of the soft palate and partial cleft of the hard palate
Unilateral complete cleft palate
There is a complete cleft from the palate vertically to the incisal foramen, diagonally outward until reaching the alveolar process, and the alveolar cleft is often accompanied by a cleft lip on the same side.
Bilateral complete cleft palate
Often occurs simultaneously with bilateral cleft lip and free nasal septum
clinical manifestations
Voice: Cleft palate voice for 8 years, heavy nasal sound
Abnormal palate morphology
sucking function
Changes in the self-cleaning effect of the oral and nasal cavities
prone to aspiration and infection
Dentition disorder
Hearing function impairment
Abnormal attachment of the tensor veli palatini and levator veli palatini muscles leads to decreased activity and changes in the opening ability of the middle ear Eustachian tube, affecting the middle ear and easily leading to otitis media.
Velopharyngeal insufficiency makes food easily reflux, leading to otitis media
Jaw development disorder
Operation
cleft lip
Unilateral: 3 to 6 months Bilateral: 6 to 12 months Weight: 5~6kg or more
cleft palate
time
12 to 18 months, 1 year of postoperative observation After the operation, training will begin one month later, and you will not be admitted to the hospital until you are four years old. Orthodontic treatment for deciduous teeth and replacement teeth Bone grafting is performed at the age of 9 to 11 years (when the canine root is 1/2 to 2/3 formed)
Second phase restoration
preschool
11-year-old with nasal deformity (wearing a nasal tube when he was six months old)
Velopharyngeal insufficiency is corrected one year after cleft palate surgery (preschool age)
Orthodontics is usually done by age 16
Preoperative preparation
The day before the operation, local skin treatment was performed. Wash the upper and lower lips and nose with soapy water, cut off nose hair, clean the mouth with normal saline, clean teeth, remove lesions, and rinse the mouth with gargle. Infants and young children should be given 10% glucose orally or 100-150ml of sugar water 4 hours before surgery. The surgery should be done in the morning as much as possible. Prophylactic antibiotics 0.5h to 1h before surgery Inject atropine at 0.1mg/3~4kg body weight 30 minutes before surgery, 3~4mg/kg for adults.
Postoperative care
Before the child wakes up from anesthesia after surgery, he should lie down with his head to one side to avoid aspiration. Children under general anesthesia can be given a small amount of fluid or breast milk 4 hours after they wake up. Liquid food for 2 to 3 weeks, semi-liquid food for one week, and regular food after two weeks Cover the cleft lip wound with a dressing on the same day and absorb the secretions. After exposure therapy, you can apply antibiotics and keep it moist. If the tension is high, use No. 18 steel wire to bend it into a labial arch and reduce the tension to fix it. Give antibiotics within 24 hours Normal wound sutures can be removed in 5 to 7 days, and intraoral sutures can be removed later or until they fall off on their own.
Postoperative palatal fistula (junction of soft and hard palate and palatal lobe)
Main reason: insufficient separation of mucoperiosteal flaps on both sides
Second-stage surgery 6 to 12 months