1.Outcomes of Primary Unilateral Cheiloplasty in Same-Day Surgical Settings.
Mansoor KHAN ; Hidayat ULLAH ; Asif AZIZ ; Muhammad TAHIR
Archives of Plastic Surgery 2016;43(3):248-253
BACKGROUND: Financial, clinical, and psychological considerations have made same-day surgery an attractive option for a variety of procedures. This article aimed to analyse the postoperative results of same-day primary unilateral cleft nasolabial repair. METHODS: This study was performed from 2011 to 2014. Unilateral cleft lip patients fulfilling the inclusion criteria were preoperatively classified as mild, moderate, and severe. All patients underwent same-day surgery and were discharged after satisfying the appropriate clinical criteria, receiving thorough counselling, and the establishment of a means of communication by phone. Postoperative outcomes were assessed and stratified according to preoperative severity and the type of repair. RESULTS: A total of 423 primary unilateral cleft lip patients were included. Fisher's anatomical subunit approximation technique was the most common procedure, followed by Noordhoff's technique. The postoperative outcome was good in 89.8% of cases, fair in 9.9% of cases, and poor in 0.2% of cases. The complication rate was 1.18% (n=5), and no instances of mortality were observed. The average hospital stay was 7.5 hours, leading to a cost reduction of 19% in comparison with patients who stayed overnight for observation. CONCLUSIONS: Mild unilateral cleft lip was the most common deformity for which Fisher's anatomical subunit approximation technique was performed in most of the cases, with satisfactory postoperative outcomes. Refinements in the cleft rhinoplasty techniques over the course of the study improved the results regarding cleft nasal symmetry. Single-day primary unilateral cleft cheiloplasty was found to be a cost-effective procedure that did not pose an additional risk of complications.
Cleft Lip
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Congenital Abnormalities
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Day Care, Medical
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Humans
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Length of Stay
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Mortality
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Rhinoplasty
2.Sinonasal mucosal melanoma: An enigma
Hidayat Ullah ; Mirza Qaisar Baig
Philippine Journal of Otolaryngology Head and Neck Surgery 2011;26(1):34-38
Objective:
To report two cases of mucosal melanoma of the sinonasal cavity from India and review the literature emphasizing current important clinical and biologic aspects of this tumor.
Methods:
Design: Case Report
Setting: Tertiary Public Referral Hospital
Patients: Two
Results:
Two patients presenting with progressive unilateral nasal obstruction over three to six months, respectively, were diagnosed to have sinonasal mucosal melanoma. The mass involved the nasal cavity and maxillary antrum in both patients. The first patient deferred radiotherapy for four months until pulmonary metastasis became evident, necessitating palliative chemotherapy; the second patient underwent surgical excision and radiotherapy.
Conclusion
In spite of aggressive therapy, the prognosis for people with mucosal melanoma is extremely poor. Surgery remains the mainstay of treatment, although adjuvant radiation therapy has recently had an increasing role in the treatment of mucosal melanoma. A clear understanding of the pathophysiology of this disease may yield more specific immunotherapy and chemotherapy techniques. A multicenter prospective study is required to objectively assess the optimal treatment regimen.