Harvesting the Buccal Fat Pad Does Not Result in Aesthetic Deformity in Cleft Patients
| Autor: | Christian J. Vercler, Katelyn G. Bennett, Steven R. Buchman, Todd E. Thurston, Steven J. Kasten |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
medicine.medical_specialty
Cleft Lip Dentistry Surgical Flaps 03 medical and health sciences 0302 clinical medicine stomatognathic system Deformity medicine Retrospective analysis Humans Retrospective Studies Mouth Buccal fat pad business.industry Infant Retrospective cohort study 030206 dentistry Pedicled Flap Buccal administration Surgery Cleft Palate stomatognathic diseases Cheek Adipose Tissue Facial Asymmetry Child Preschool 030220 oncology & carcinogenesis Tissue and Organ Harvesting medicine.symptom business Cleft palate surgery |
| Zdroj: | Plastic and Reconstructive Surgery. 140:362-368 |
| ISSN: | 0032-1052 |
| DOI: | 10.1097/prs.0000000000003521 |
| Popis: | Buccal fat is often used as a pedicled flap in cleft palate repairs to minimize scarring and fortify tenuous closures. Although many surgeons have adopted this technique, others have remained circumspect because of the concern for subsequent facial asymmetry.Patients who underwent cleft palate repair using buccal fat pad flaps for closure between 2007 and 2015 were reviewed. Only patients with unilateral buccal fat pad flaps and three-dimensional photography were included. Volumetric analysis was performed on each patient to measure cheek volumes of both the flap and nonflap sides. A subgroup analysis on cleft palate and bilateral cleft lip and palate patients was performed to eliminate the confounding asymmetries of unilateral cleft lip and palate patients. Paired t tests were used to determine differences in cheek volumes. In addition, three reviewers examined photographs of patients and were asked to determine the side of fat pad harvest.Twenty-four patients met inclusion criteria. Mean follow-up was 55 months. The volume difference between the flap and nonflap sides was not significant (p = 0.81). Subgroup analysis on cleft palate and bilateral cleft lip and palate patients did not reveal a volume difference between the flap and nonflap sides (p = 0.98). When asked to determine which side buccal fat pads were harvested from based on patient photographs, the average percentage correct for three independent reviewers was 57 percent and the Cohen's kappa was -0.084, indicating poor agreement.Although the buccal fat pad is thought to play a role in facial aesthetics, the authors found no difference in volume between harvest and nonharvest sides, nor was there a clinically detectable difference.Therapeutic, IV. |
| Databáze: | OpenAIRE |
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