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2012, Número 2

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Cir Plast 2012; 22 (2)


Prevención de las malformaciones postquirúrgicas en pacientes con labio y paladar hendidos. Fundamentos y protocolo

Velázquez JM, Berlanga F, Estrada H, Álvarez J, Flores M

Idioma: Español
Referencias bibliográficas: 43
Paginas: 57-66
Archivo PDF: 1148.05 Kb.


RESUMEN

El objetivo de este trabajo es describir un protocolo de tratamiento para obtener un crecimiento y desarrollo maxilofacial adecuados a largo plazo, evitando o minimizando las secuelas postquirúrgicas en pacientes con labio y paladar hendidos. Los objetivos son obtener un desarrollo óseo adecuado con lenguaje funcional, resultados estéticos óptimos e integración psicosocial del paciente a su medio. El método está basado en el conocimiento de las interacciones entre los efectos negativos que las intervenciones quirúrgicas producen en el desarrollo y crecimiento, inherentes de los tejidos y cómo tratarlos de manera lógica y anatomofuncional. Además, se toma en cuenta la facultad de moldear, estimular o direccionar el crecimiento vómer-palatino mediante ortopedia maxilar pre y postquirúrgica. Las observaciones expuestas comprenden pacientes tratados en otros centros hospitalarios con el protocolo tradicional de operar labio y paladar hendidos a edad temprana, comparados con pacientes tratados con nuestro protocolo de ortopedia prequirúrgica y cirugía conservadora y escalonada. Resulta significativa la diferencia entre ambos grupos. Los resultados en lenguaje también fueron mejores que los pacientes operados a edad temprana sin seguimiento adecuado. En la discusión se resaltan los beneficios obtenidos con esta rutina para normar criterios quirúrgicos y de tratamiento en pacientes con labio y paladar hendidos para minimizar las secuelas de crecimiento maxilofacial, y lograr un lenguaje adecuado al mismo tiempo. Estos principios expuestos se pueden adaptar incluso en las llamadas campañas quirúrgicas tan comunes en nuestro medio.


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