- Email: [email protected]
Psychological adjustment in Norwegian adults who had undergone standardised treatment of complete cleft lip and palate
Brirish Journal of Oral and MaxilloJacial Surgery (1997) 35, 70 % 1997 The Bntish Association of Oral and Maxdlofacial Surgeons
Book review that attempt to convey a sense of operative reality. Unfortunately, this is rarely achieved. Intraoperative photographs would have been much more helpful in this respect. Most of the commonly used extra-oral and intraoral approaches to the facial skeleton are described. The authors comment that the approaches described allow complete access to the craniofacial skeleton for any skeletal procedure that is being performed. This is perhaps, a little optimistic. Some commonly used approaches, such as the WeberFergusson approach to the anterior maxilla, are omitted for no obvious reason. The book confines itself to the details of soft tissue dissection and makes no reference to osteomising the facial skeleton for surgical access. I would also expect a comprehensive text on surgical approaches to include guidance on the design of extended incisions for access to the skull base. Despite these criticisms, this is a useful book for those starting higher training in maxillofacial surgery. There is one catch, however, the book retails at &170. If it was redesigned as a small paperback pocket atlas, it would surely be cheaper and therefore more accessible to the market at which it is presumably aimed. C. Penfold North Wales, UK
Surgical approaches to the facial skeleton. By E. Ellis III, M. F. Zider. 1995. Williams ISBN: o-683-02794-8.
&Wilkins.
pp. 223. Price 6172.
This is a good practical atlas outlining basic surgical approaches to the facial skeleton. A brief outline of general principles is followed by 13 chapters, each describing a specific surgical approach. The chapters have been arranged into sections based predominantly on the region of the face being exposed: periorbital approaches, coronal approach, transoral approaches, transfacial approaches to the mandible, approaches to the temporomandibular joint, and surgical approaches to the nasal skeleton. In most surgical texts, surgical approaches are described in the context of specific surgical procedures, such as fracture repair and the approach itself is often described in less than adequate detail. This book is different because it focuses on the surgical approaches, and the question of why the facial skeleton is being exposed is largely avoided. The text is precise and the anatomical descriptions are detailed and refreshingly clear. The colour drawings are excellent and effectively complemented by the text. They are accompanied by photographs of cadaver dissections
Journal abstracts Anthropometric profile evaluation of the midface in patients with cleft lip and palate. N. Chaisrisookumporn. J. P. Stella, B. N. Epker. Oral Surg Oral Med Oral Path01 Oral Radio1 Endod 1995; 80: 127-136.
adult cleft lip and palate exist in the nose and secondarily in other components of the midface. W. P. Smith Northampton/Kettering, UK
This study was done to determine those profile anthropometric measurements that are abnormal in the midface profile in patients with cleft lip and palate. The sample population consisted of 30 randomly selected skeletally mature white patients with a cleft lip and palate who had been treated by the same team, who were accredited by the American Cleft Palate-Craniofacial Association. Twenty patients had unilateral and 10 had bilateral complete clefts. None of these patients had previously undergone orthognathic surgery or definitive rhinoplasty surgery. Fifteen facial anthropometric features were measured on each person’s pace. The result from this study showed that in patients with cleft lip and palate right versus left side differences did not exist and only four statistically significant differences existed between the unilateral and bilateral cases. However, in all patients, four of these esthetic facial features were consistently and significantly abnormal: obtuse nasofrontal angle: obtuse nasomental angle; a posteriorly positioned infraorbitale relative to globe; and an obtuse general facial angle. Several other features were abnormal in a high percentage of persons in the study. These were lack of supratip break, flat to concave paranasal contour, increased subnasale-alargroove: subnasale-pronasale ratio, decreased nasal protrusion: nasal length ratio, decreased nasolabial angle ratio, decreased maxillary length ratio, increased nasal bridge projection: nasal protrusion ratio, and deficient cheek contour. This data indicates that the major deformity in persons with
Psychological adjustment in Norwegian adults who had undergone standardised treatment of complete cleft lip and palate. T. Ramstad, E. Ottem, W. C. Saw. Stand J Plast Reconstr Hand Surg 1995; 29: 329-336. Aspects of social and psychological adjustment were investigated in a sample of 233 Norwegian adults 20-35 years old with repaired complete cleft lip and palate; in 126 the cleft was on the left, in 45 on the right, and in 62 it was bilateral. All subjects received a standardised regime from the Oslo cleft palate team. Adults with complete clefts were compared with a large control sample of the same age. The purpose of this paper is to describe the occurrence of common psychological problems amongst subjects with CLP. Anxiety, depression and palpitations were reported about twice as often by subjects with CLP compoared with controls, and these psychological problems were strongly associated with concerns about appearance, dentition, speech, and desire for further treatment. More than a third of patients expressed a wish for further treatment, mainly surgery, despite the fact that all patients had been discharged with treatment completed. These findings suggest that there is an impaired level of psychological wellbeing among subgroups of subjects with clefts. W. P. Smith Northampton/Kettering, UK
70
Book review that attempt to convey a sense of operative reality. Unfortunately, this is rarely achieved. Intraoperative photographs would have been much more helpful in this respect. Most of the commonly used extra-oral and intraoral approaches to the facial skeleton are described. The authors comment that the approaches described allow complete access to the craniofacial skeleton for any skeletal procedure that is being performed. This is perhaps, a little optimistic. Some commonly used approaches, such as the WeberFergusson approach to the anterior maxilla, are omitted for no obvious reason. The book confines itself to the details of soft tissue dissection and makes no reference to osteomising the facial skeleton for surgical access. I would also expect a comprehensive text on surgical approaches to include guidance on the design of extended incisions for access to the skull base. Despite these criticisms, this is a useful book for those starting higher training in maxillofacial surgery. There is one catch, however, the book retails at &170. If it was redesigned as a small paperback pocket atlas, it would surely be cheaper and therefore more accessible to the market at which it is presumably aimed. C. Penfold North Wales, UK
Surgical approaches to the facial skeleton. By E. Ellis III, M. F. Zider. 1995. Williams ISBN: o-683-02794-8.
&Wilkins.
pp. 223. Price 6172.
This is a good practical atlas outlining basic surgical approaches to the facial skeleton. A brief outline of general principles is followed by 13 chapters, each describing a specific surgical approach. The chapters have been arranged into sections based predominantly on the region of the face being exposed: periorbital approaches, coronal approach, transoral approaches, transfacial approaches to the mandible, approaches to the temporomandibular joint, and surgical approaches to the nasal skeleton. In most surgical texts, surgical approaches are described in the context of specific surgical procedures, such as fracture repair and the approach itself is often described in less than adequate detail. This book is different because it focuses on the surgical approaches, and the question of why the facial skeleton is being exposed is largely avoided. The text is precise and the anatomical descriptions are detailed and refreshingly clear. The colour drawings are excellent and effectively complemented by the text. They are accompanied by photographs of cadaver dissections
Journal abstracts Anthropometric profile evaluation of the midface in patients with cleft lip and palate. N. Chaisrisookumporn. J. P. Stella, B. N. Epker. Oral Surg Oral Med Oral Path01 Oral Radio1 Endod 1995; 80: 127-136.
adult cleft lip and palate exist in the nose and secondarily in other components of the midface. W. P. Smith Northampton/Kettering, UK
This study was done to determine those profile anthropometric measurements that are abnormal in the midface profile in patients with cleft lip and palate. The sample population consisted of 30 randomly selected skeletally mature white patients with a cleft lip and palate who had been treated by the same team, who were accredited by the American Cleft Palate-Craniofacial Association. Twenty patients had unilateral and 10 had bilateral complete clefts. None of these patients had previously undergone orthognathic surgery or definitive rhinoplasty surgery. Fifteen facial anthropometric features were measured on each person’s pace. The result from this study showed that in patients with cleft lip and palate right versus left side differences did not exist and only four statistically significant differences existed between the unilateral and bilateral cases. However, in all patients, four of these esthetic facial features were consistently and significantly abnormal: obtuse nasofrontal angle: obtuse nasomental angle; a posteriorly positioned infraorbitale relative to globe; and an obtuse general facial angle. Several other features were abnormal in a high percentage of persons in the study. These were lack of supratip break, flat to concave paranasal contour, increased subnasale-alargroove: subnasale-pronasale ratio, decreased nasal protrusion: nasal length ratio, decreased nasolabial angle ratio, decreased maxillary length ratio, increased nasal bridge projection: nasal protrusion ratio, and deficient cheek contour. This data indicates that the major deformity in persons with
Psychological adjustment in Norwegian adults who had undergone standardised treatment of complete cleft lip and palate. T. Ramstad, E. Ottem, W. C. Saw. Stand J Plast Reconstr Hand Surg 1995; 29: 329-336. Aspects of social and psychological adjustment were investigated in a sample of 233 Norwegian adults 20-35 years old with repaired complete cleft lip and palate; in 126 the cleft was on the left, in 45 on the right, and in 62 it was bilateral. All subjects received a standardised regime from the Oslo cleft palate team. Adults with complete clefts were compared with a large control sample of the same age. The purpose of this paper is to describe the occurrence of common psychological problems amongst subjects with CLP. Anxiety, depression and palpitations were reported about twice as often by subjects with CLP compoared with controls, and these psychological problems were strongly associated with concerns about appearance, dentition, speech, and desire for further treatment. More than a third of patients expressed a wish for further treatment, mainly surgery, despite the fact that all patients had been discharged with treatment completed. These findings suggest that there is an impaired level of psychological wellbeing among subgroups of subjects with clefts. W. P. Smith Northampton/Kettering, UK
70