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Management of the ear in cleft lip and palate

The management of patients with cleft lip and palate includes a focus on effective speech and language function. Poor eustachian tube function and middle ear dysfunction mean over 90% of children suffer from otitis media with effusion. This article provides...

Cosmesis of the nose in cleft lip and palate

The cleft nose is one of the most challenging pathologies for rhinologists and facial plastic surgeons to address. The combination of architectural deformity (related to the extent of lip deformity) and scarring from previous surgery combine to cause the surgical...

Rhinoplasty for the cleft lip and palate patient

The cleft nose is one of the most challenging pathologies for rhinologists and facial plastic surgeons to address. The combination of architectural deformity (related to the extent of lip deformity) and scarring from previous surgery combine to cause the surgical...

Is it necessary to put ventilation tubes at the time of surgery in children with cleft palate?

It is commonly understood that existence of a palatal cleft is associated with abnormal action of tensor veli palatini muscle. Frequent middle ear effusions therefore occur because this muscle obstructs rather than opens the Eustachian tube on yawning and swallowing,...

Stepwise approach to manage palatal myoclonus successfully

Palatal myoclonic tinnitus (PMT) is a rare condition caused by rhythmic voluntary or involuntary movements of the soft palate, mainly the tensor veli palatini and levator veli palatine muscles. Patients usually present with a ‘clicky’ noise in the ear. Oral...

Is it possible to fix condylar neck fractures with one plate?

Fractures of the condylar neck are fairly common and account for over 25% of all mandible fractures. Over the years a number of modalities have been used to fix these fractures. Direct reduction is complicated by the overlying proximity of...

Effectiveness of oral pressure therapy in obstructive sleep apnoea: a systematic analysis

Oral pressure therapy (OPT) is a relatively new form of therapy for obstructive sleep apnoea (OSA). Paradoxically it seems to work even though it creates a vacuum in the oral cavity as opposed to the gold standard of continuous positive...

Rhinoplasty for cleft nose deformity

Modern cleft lip and palate repairs produce excellent functional and aesthetic results at an early age. Tony Holmes, a craniofacial surgeon with over 40 years’ experience, shares his wisdom on the best timing and techniques for addressing the associated complex...

Increasing tongue strength to reduce dysphagia: what is the potential benefit of a device driven exercise?

Weakness in tongue muscle strength and laryngeal elevation is known to have an adverse impact on swallowing function. Various swallowing exercises are often recommended to improve function of these important structures with the goal of preventing aspiration and improving swallow...

A rare superior tongue tie

The authors present a very rare case of ankyloglossia superior syndrome: first described in 1911 but with only 14 case reports in English literature it was of sufficient interest to discuss the aetiology, classification and management. As the palatal shelves...

Locked or unlocked?

This systematic review and meta-analysis from the Netherlands evaluates postoperative complications of mandibular fractures using locking and non-locking systems. It is suggested that postoperative complications of surgical treatment of mandibular fractures occur in 20-26% of patients, and it is thought...

‘Pen’doscope - writing in a reduction in healthcare delivery costs

Optimal management of cleft lip and palate requires a multidisciplinary team approach to treatment, with the goal being maintenance of facial growth and improvement in speech and hearing, in addition to closure of the cleft. This can be especially challenging...