Background: Cleft palate results from incomplete fusion of the palatine shelves during embryonic development and varies in severity. It affects speech, hearing, and feeding, often leading to complications such as nasal regurgitation and recurrent infections. The condition is common worldwide and frequently coexists with cleft lip. Surgery remains the primary treatment, aiming to restore both palatal length and function. In this study, Furlow’s double Z-plasty and von Langenbeck palatoplasty have been compared for their effectiveness in minimizing complications and improving outcomes. Methods: This study included 22 children aged 6 to 18 months with non-syndromic complete cleft palates, randomly assigned into two groups. Group A underwent von Langenbeck’s palatoplasty with intravelar veloplasty, while Group B underwent Furlow’s double opposing Z-plasty. Results: Preoperative palatal measurements were comparable between the two groups. Cleft width did not significantly affect surgical outcomes, and both techniques effectively achieved tension-free closure. Von Langenbeck’s repair with intravelar veloplasty was as effective as Furlow’s palatoplasty in achieving palatal lengthening, while offering the additional advantage of being an anatomically based repair associated with lower fistula rates. Conclusion Von Langenbeck’s repair with intravelar veloplasty is as effective as Furlow’s palatoplasty in achieving palatal lengthening and provides the advantage of an anatomically sound repair with a reduced fistula rate.

Direct carotid-cavernous fistula (CCF) refers to direct communication between the cavernous portion of the internal carotid artery (ICA) and the cavernous sinus due to rent in the ICA, most commonly secondary to trauma. These are generally high-flow fistula and rarely resolve spontaneously. We report a case of a young male who developed features of direct CCF after trauma, was denied any treatment for 4 years, and then presented with spontaneous thrombosis of the fistula and a residual large pseudoaneurysm of the cavernous segment of the right ICA, which was subsequently managed with parent vessel occlusion.

BACKGROUND: The present study examines a hypothesis that short allergen-derived peptides may shift an Aspergillus fumigatus (Afu-) specific TH2 response towards a protective TH1. Five overlapping peptides (P1-P5) derived from Asp f1, a major allergen/antigen of Afu, were evaluated for prophylactic or therapeutic efficacy in BALB/c mice. METHODS: To evaluate the prophylactic efficacy, peptides were intranasally administered to naive mice and challenged with Afu-allergens/antigens. For evaluation of therapeutic efficacy, the mice were sensitized with Afu-allergens/antigens followed by intranasal administration of peptides. The groups were compared for the levels of Afu-specific antibodies in sera and splenic cytokines evaluated by ELISA. Eosinophil peroxidase activity was examined in the lung cell suspensions and lung inflammation was assessed by histopathogy. RESULTS: Peptides P1-, P2- and P3 decreased Afu-specific IgE (84.5~98.9%) and IgG antibodies (45.7~71.6%) in comparison with Afu-sensitized mice prophylactically. P1- and P2-treated ABPA mice showed decline in Afu-specific IgE (76.4~88%) and IgG antibodies (15~54%). Increased IgG2a/IgG1 and IFN-gamma/IL-4 ratios were observed. P1-P3 prophylactically and P1 therapeutically decreased IL-5 levels and eosinophil peroxidase activity. P1 decreased inflammatory cells' infiltration in lung tissue comparable to non-challenged control. CONCLUSION: Asp f1-derived peptide P1, prophylactically and therapeutically administered to Balb/c mice, is effective in regulating allergic response to allergens/antigens of Afu, and may be explored for immunotherapy of allergic aspergillosis in humans.
Administration, Intranasal ; Animals ; Antibodies ; Aspergillosis ; Aspergillosis, Allergic Bronchopulmonary ; Aspergillus fumigatus ; Cytokines ; Enzyme-Linked Immunosorbent Assay ; Eosinophil Peroxidase ; Eosinophils ; Epitopes ; Humans ; Immunoglobulin E ; Immunoglobulin G ; Immunotherapy ; Interleukin-5 ; Lung ; Mice ; Peptides ; Pneumonia ; Suspensions ; Viperidae