Help
Options
Didn't know it?
click below
click below
Knew it?
click below
click below
Don't Know
Remaining cards (0)
Know
retry
shuffle
restart
0:00
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.
Normal Size Small Size show me how
Normal Size Small Size show me how
Surgery
Cleft Palate Exam 2
| Term | Definition |
|---|---|
| When does primary lip surgery take place? | 8 - 10 wks |
| What is the rule of 10s? | Hemoglobin 10 g/dl, weight 10 lbs., and 10 wks for surgery on babies cleft lip |
| Goals of first cleft surgery | Accurate membrane union, symmetrical nasal floor, minimal scar, normal philtrum, no alar collapse |
| Which muscle is divided during 1st cleft surgery? | Obicularis orisis |
| Types of lip repair | Straight line, triangular repair, rotational advancement |
| Straight line repair | Works for small cleft unilaterally, suture together in a straight line |
| Trianular repar | Lengthens the philtrum, cut is farther down and suture into triangle, 2nd most common |
| Rotational Advancement | Most widely used, 80% of surgeries. high up, pull each side together |
| How do they ensure skin comes together? | Taping prior to surgery for better outcomes on lip |
| NAM or PNAM | Shapes and improves the position of the nose symmetry before surgery, given during 1st week of life, wear 24 hrs./day, dental visits weekly, new 3-6 months |
| What affects candidacy for PNAM or NAM? | Personal, affordability, access to follow-up, sleep apnea/med concerns |
| Latham appliance | Rotate alveolar segment, bring it all together before surgery, minimize skin stretching and reduce possibility of bone graft later |
| What is more simple than Latham but does the same thing? | Lip taping |
| Goals of palate repair | Closure for normal growth, remove elevator from hard palate to create sling, bulk to velum, improve middle ear function |
| When does palate repair take place? | 9-18 months |
| What is the early vs late issue? | Some argue that boney anatomy can affect other structures so should do palate repair later |
| Why is early repair better? | Less pervasive faulty arctic. |
| If there is no syndromes affecting... | Should do surgery before 1 year if possible |
| 3 main types of palate repair | Von Langenbeck, V-Y, Furlow paltoplasty |
| Von Langenbeck | Elevate mucoperisium, least common |
| V-Y Pushbak | Retroposition and fill-in gap with material to grow |
| Furlow Palatoplasty | Lengthen velum, most common, cut in z suture which causes velum to stretch, best if the palate is short |
| Why is secondary palate repair done? | Close palatal fistula, correction of maxillary/mandibular issue, correct velopharyngeal dysfunction |
| What is more important for SLP, primary or secondary surgery? | Secondary, VP closure, often this is for speech, prior to 12 months they aren't talking |
| Palatal/Oronasal Fistula | Opening b/t oral and nasal cavities leading to nasal emissions or hypernasality, compensatory arctic., nasal regurgitation |
| What happens if palatal fistula is large? | Hypernasality |
| What happens if palatal fistula is small/medium? | Nasal emissions, whistle sound |
| Types of secondary palate repair | Pharyngeal flap, Sphincterpharyngoplasty |
| Pharyngeal flap | Midline flap with lateral post for breathing, inserted into PPW |
| When is the pharyngeal flap best recommended? | Weak velum and strong lateral pharyngeal walls (lateral walls need to move to close, velum often hypotonic) |
| What is an age where good speech sample with nasal endoscope is possible to assess velum function for recommendation for secondary surgeries? | 3-5ys |
| Complications associated with pharyngeal flap | Obstructive sleep apnea (most common), snoring, anesthesia complications |
| Sphincterpharyngoplasty | Pharyngeal flaps for more narrow sphincter |
| What secondary surgery is better for small VP gap? | Sphincterpharyngoplasty |
| What secondary surgery is better for large VP gap? | Pharygenal Flap |
| When is the sphincterpharyngoplasty best recommended? | Poor pharyngeal wall movement but good velar movement, essential this surgery makes sphincter smaller by creating bulk on sides of lateral pharyngeal walls |
| <4 mm | Sphincterpharyngeoplasty |
Created by:
morganmc3
Popular Speech Therapy sets