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Intraoperative vascular anatomy, arterial blood flow velocity, and microcirculation in unilateral and bilateral cleft lip repair
JournalArticle (Originalarbeit in einer wissenschaftlichen Zeitschrift)
 
ID 2832888
Author(s) Mueller, Andreas A.; Schumann, Dieter; Reddy, Rajgopal R.; Schwenzer-Zimmerer, Katja; Mueller-Gerbl, Magdalena; Zeilhofer, Hans Florian; Sailer, Hermann F.; Reddy, Srinivas Gosla
Author(s) at UniBasel Müller-Gerbl, Magdalena
Müller, Andreas A.
Year 2012
Title Intraoperative vascular anatomy, arterial blood flow velocity, and microcirculation in unilateral and bilateral cleft lip repair
Journal Plastic and Reconstructive Surgery
Volume 130
Number 5
Pages / Article-Number 1120-30
Keywords Blood Flow Velocity; Cleft Lip/blood/ physiopathology/ surgery; Cleft Palate/blood/physiopathology; Hemoglobins/analysis; Humans; Intraoperative Period; Lip/ blood supply/ physiology; Microcirculation/physiology; Nose/ blood supply/ physiology
Mesh terms Blood Flow Velocity; Cleft Lip, surgery; Cleft Palate, physiopathology; Hemoglobins, analysis; Humans; Intraoperative Period; Lip, physiology; Microcirculation, physiology; Nose, physiology
Abstract Background: Cleft lip repair aims to normalize the disturbed anatomy and function. The authors determined whether normalization of blood circulation is achieved. Methods: The authors measured the microcirculatory flow, oxygen saturation, and hemoglobin level in the lip and nose of controls (n = 22) and in patients with unilateral and bilateral cleft lip-cleft palate. The authors measured these parameters before lip repair (n = 29 and n = 11, respectively), at the end of lip repair (n = 27 and 10, respectively), and in the late postoperative period (n = 33 and n = 20, respectively). The arterial flow velocity was measured in unilateral groups at the same time points (n=13, n=11, and n=12, respectively). Statistical differences were determined using analysis of variance. Results: Before surgery, the arterial flow velocities and microcirculation values were similar on each side of the face and between groups. The microcirculatory flow was significantly higher in the prolabium of bilateral patients than in the philtrum of controls. All circulation values in unilateral and bilateral patients in the late postoperative period were within the range of controls and of those before surgery. Intraoperatively, the authors consistently found a perforating artery on the superficial side of the transverse nasalis muscle. Conclusions: There appears to be no intrinsic circulatory deficit in unilateral and bilateral cleft lip-cleft palate patients. The increased flow in the prolabium indicates a strong hemodynamic need in this territory, compelling its vascular preservation. Whether surgical preservation of the nasalis perforator artery is of long-term benefit should be addressed in future studies.
Publisher Lippincott, Williams & Wilkins
ISSN/ISBN 0032-1052 ; 1529-4242
edoc-URL http://edoc.unibas.ch/dok/A6338256
Full Text on edoc No
Digital Object Identifier DOI 10.1097/PRS.0b013e318267d4fb
PubMed ID http://www.ncbi.nlm.nih.gov/pubmed/23096613
ISI-Number WOS:000310572100061
Document type (ISI) Journal Article
 
   

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