Five surgical maneuvers on nasal mucosa movement in cleft palate repair – a cadaver study
Abstract Introduction This biomechanical study aims to characterize the nasal mucosa during palatoplasty, describing the soft tissue attachments at different zones and quantifying movement following their release. Methods Palatal nasal mucosa was exposed and divided in the midline in 10 adult cadave...
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| Veröffentlicht in: | Journal of plastic, reconstructive & aesthetic surgery reconstructive & aesthetic surgery, 2016-06, Vol.69 (6), p.789-795 |
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| creator | Nguyen, Dennis C., MD Patel, Kamlesh B., MD Parikh, Rajiv P., MD Skolnick, Gary B., BS Woo, Albert S., MD |
| description | Abstract Introduction This biomechanical study aims to characterize the nasal mucosa during palatoplasty, describing the soft tissue attachments at different zones and quantifying movement following their release. Methods Palatal nasal mucosa was exposed and divided in the midline in 10 adult cadaver heads. Five consecutive maneuvers were performed: (1) elevation of nasal mucosal off the maxilla; (2) dissection of nasal mucosa from soft palate musculature; (3) separation of nasal mucosa from palatine aponeurosis; (4) release of mucosa at the pterygopalatine junction; (5) mobilization of vomer flaps. The mucosal movements across the midline at the midpalate and posterior nasal spine following each maneuver were measured. Results At the midpalate, maneuvers 1-4 cumulatively provided 3.8 mm (36.9%), 4.9 mm (47.6%), 6.1 mm (59.2%), and 10.3 mm, respectively. Vomer flap (10.5 mm) elevation led to mobility equivalent to that of maneuvers 1-4 (p=0.72). At the posterior nasal spine, cumulative measurements after maneuvers 1-4 were 1.3 mm (10%), 2.4 mm (18.6%), 5.7 mm (44.2%), and 12.9 mm. Here, vomer flaps (6.5 mm) provided less movement (p |
| doi_str_mv | 10.1016/j.bjps.2016.03.012 |
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| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_5091938</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>1_s2_0_S174868151630002X</els_id><sourcerecordid>1795881639</sourcerecordid><originalsourceid>FETCH-LOGICAL-c510t-27ce364f66ee7106b61f033bb2d121f0629e4a903db1b7c39dec8b7612012d253</originalsourceid><addsrcrecordid>eNp9Us2K1jAULaI44-gLuJAs3bTmp0lbkAEZZlQYcKGC4OKSprdjapvUpC18O9_BN_RJTPnGQV24yiU55-Tce26WPWW0YJSpF0PRDnMseKoLKgrK-L3slNVVnVMpmvuprso6VzWTJ9mjGAdKS8FK-TA74RWjUpbqNPt8ZTckcQ031uiRTNrhumGIxDvidNyvVuOjJpPfcEK3EOuIGbFfyKxHvSAJOGsbyM_vP4gmRnc60Ulc1u7wOHvQ6zHik9vzLPt4dfnh4k1-_e7124tX17mRjC45rwwKVfZKISZfqlWsp0K0Le8YT6XiDZa6oaJrWVsZ0XRo6rZSLDXOOy7FWXZ-1J3XdsLOJJdBjzAHO-lwAK8t_P3i7Be48RtI2rBG1Eng-a1A8N9WjAtMNhocxzQNv0ZgVSPrminRJCg_Qk3wMQbs775hFPZUYIA9FdhTASogeUykZ38avKP8jiEBXh4BmMa0WQwQjUVnsLMBzQKdt__XP_-Hbkbr9kC_4gHj4NfgUgDAIHKg8H7fi30tUkeUUv5J_AIwgbUY</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1795881639</pqid></control><display><type>article</type><title>Five surgical maneuvers on nasal mucosa movement in cleft palate repair – a cadaver study</title><source>MEDLINE</source><source>Elsevier ScienceDirect Journals</source><creator>Nguyen, Dennis C., MD ; Patel, Kamlesh B., MD ; Parikh, Rajiv P., MD ; Skolnick, Gary B., BS ; Woo, Albert S., MD</creator><creatorcontrib>Nguyen, Dennis C., MD ; Patel, Kamlesh B., MD ; Parikh, Rajiv P., MD ; Skolnick, Gary B., BS ; Woo, Albert S., MD</creatorcontrib><description>Abstract Introduction This biomechanical study aims to characterize the nasal mucosa during palatoplasty, describing the soft tissue attachments at different zones and quantifying movement following their release. Methods Palatal nasal mucosa was exposed and divided in the midline in 10 adult cadaver heads. Five consecutive maneuvers were performed: (1) elevation of nasal mucosal off the maxilla; (2) dissection of nasal mucosa from soft palate musculature; (3) separation of nasal mucosa from palatine aponeurosis; (4) release of mucosa at the pterygopalatine junction; (5) mobilization of vomer flaps. The mucosal movements across the midline at the midpalate and posterior nasal spine following each maneuver were measured. Results At the midpalate, maneuvers 1-4 cumulatively provided 3.8 mm (36.9%), 4.9 mm (47.6%), 6.1 mm (59.2%), and 10.3 mm, respectively. Vomer flap (10.5 mm) elevation led to mobility equivalent to that of maneuvers 1-4 (p=0.72). At the posterior nasal spine, cumulative measurements after maneuvers 1-4 were 1.3 mm (10%), 2.4 mm (18.6%), 5.7 mm (44.2%), and 12.9 mm. Here, vomer flaps (6.5 mm) provided less movement (p<0.001). Maneuver 4 yielded the greatest amount of movement of the lateral nasal mucosa at both the midpalate (4.2 mm, 40.8%) and posterior nasal spine (7.2 mm, 55.8%). Conclusion At the midpalate, complete release of the lateral nasal mucosa achieves as much movement as the vomer flap. At the hard-soft palate junction, the maneuvers progressively add to the movement of the lateral nasal mucosa. The most powerful step is release of attachments along the posterior aspect of the medial pterygoid.</description><identifier>ISSN: 1748-6815</identifier><identifier>EISSN: 1878-0539</identifier><identifier>DOI: 10.1016/j.bjps.2016.03.012</identifier><identifier>PMID: 27105546</identifier><language>eng</language><publisher>Netherlands: Elsevier Ltd</publisher><subject>Aged ; Aged, 80 and over ; Biomechanical ; Cadaver ; Cadaver study ; Cleft Palate - surgery ; Female ; Humans ; Male ; Models, Anatomic ; Nasal mucosa ; Nasal Mucosa - pathology ; Nasal Mucosa - transplantation ; Palate - pathology ; Palate - surgery ; Palate dissection ; Plastic Surgery ; Reconstructive Surgical Procedures - methods ; Surgical Flaps ; Vomer - pathology ; Vomer - surgery</subject><ispartof>Journal of plastic, reconstructive & aesthetic surgery, 2016-06, Vol.69 (6), p.789-795</ispartof><rights>2016</rights><rights>Published by Elsevier Ltd.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c510t-27ce364f66ee7106b61f033bb2d121f0629e4a903db1b7c39dec8b7612012d253</citedby><cites>FETCH-LOGICAL-c510t-27ce364f66ee7106b61f033bb2d121f0629e4a903db1b7c39dec8b7612012d253</cites><orcidid>0000-0001-7441-2102</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S174868151630002X$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>230,314,776,780,881,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27105546$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Nguyen, Dennis C., MD</creatorcontrib><creatorcontrib>Patel, Kamlesh B., MD</creatorcontrib><creatorcontrib>Parikh, Rajiv P., MD</creatorcontrib><creatorcontrib>Skolnick, Gary B., BS</creatorcontrib><creatorcontrib>Woo, Albert S., MD</creatorcontrib><title>Five surgical maneuvers on nasal mucosa movement in cleft palate repair – a cadaver study</title><title>Journal of plastic, reconstructive & aesthetic surgery</title><addtitle>J Plast Reconstr Aesthet Surg</addtitle><description>Abstract Introduction This biomechanical study aims to characterize the nasal mucosa during palatoplasty, describing the soft tissue attachments at different zones and quantifying movement following their release. Methods Palatal nasal mucosa was exposed and divided in the midline in 10 adult cadaver heads. Five consecutive maneuvers were performed: (1) elevation of nasal mucosal off the maxilla; (2) dissection of nasal mucosa from soft palate musculature; (3) separation of nasal mucosa from palatine aponeurosis; (4) release of mucosa at the pterygopalatine junction; (5) mobilization of vomer flaps. The mucosal movements across the midline at the midpalate and posterior nasal spine following each maneuver were measured. Results At the midpalate, maneuvers 1-4 cumulatively provided 3.8 mm (36.9%), 4.9 mm (47.6%), 6.1 mm (59.2%), and 10.3 mm, respectively. Vomer flap (10.5 mm) elevation led to mobility equivalent to that of maneuvers 1-4 (p=0.72). At the posterior nasal spine, cumulative measurements after maneuvers 1-4 were 1.3 mm (10%), 2.4 mm (18.6%), 5.7 mm (44.2%), and 12.9 mm. Here, vomer flaps (6.5 mm) provided less movement (p<0.001). Maneuver 4 yielded the greatest amount of movement of the lateral nasal mucosa at both the midpalate (4.2 mm, 40.8%) and posterior nasal spine (7.2 mm, 55.8%). Conclusion At the midpalate, complete release of the lateral nasal mucosa achieves as much movement as the vomer flap. At the hard-soft palate junction, the maneuvers progressively add to the movement of the lateral nasal mucosa. The most powerful step is release of attachments along the posterior aspect of the medial pterygoid.</description><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Biomechanical</subject><subject>Cadaver</subject><subject>Cadaver study</subject><subject>Cleft Palate - surgery</subject><subject>Female</subject><subject>Humans</subject><subject>Male</subject><subject>Models, Anatomic</subject><subject>Nasal mucosa</subject><subject>Nasal Mucosa - pathology</subject><subject>Nasal Mucosa - transplantation</subject><subject>Palate - pathology</subject><subject>Palate - surgery</subject><subject>Palate dissection</subject><subject>Plastic Surgery</subject><subject>Reconstructive Surgical Procedures - methods</subject><subject>Surgical Flaps</subject><subject>Vomer - pathology</subject><subject>Vomer - surgery</subject><issn>1748-6815</issn><issn>1878-0539</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9Us2K1jAULaI44-gLuJAs3bTmp0lbkAEZZlQYcKGC4OKSprdjapvUpC18O9_BN_RJTPnGQV24yiU55-Tce26WPWW0YJSpF0PRDnMseKoLKgrK-L3slNVVnVMpmvuprso6VzWTJ9mjGAdKS8FK-TA74RWjUpbqNPt8ZTckcQ031uiRTNrhumGIxDvidNyvVuOjJpPfcEK3EOuIGbFfyKxHvSAJOGsbyM_vP4gmRnc60Ulc1u7wOHvQ6zHik9vzLPt4dfnh4k1-_e7124tX17mRjC45rwwKVfZKISZfqlWsp0K0Le8YT6XiDZa6oaJrWVsZ0XRo6rZSLDXOOy7FWXZ-1J3XdsLOJJdBjzAHO-lwAK8t_P3i7Be48RtI2rBG1Eng-a1A8N9WjAtMNhocxzQNv0ZgVSPrminRJCg_Qk3wMQbs775hFPZUYIA9FdhTASogeUykZ38avKP8jiEBXh4BmMa0WQwQjUVnsLMBzQKdt__XP_-Hbkbr9kC_4gHj4NfgUgDAIHKg8H7fi30tUkeUUv5J_AIwgbUY</recordid><startdate>20160601</startdate><enddate>20160601</enddate><creator>Nguyen, Dennis C., MD</creator><creator>Patel, Kamlesh B., MD</creator><creator>Parikh, Rajiv P., MD</creator><creator>Skolnick, Gary B., BS</creator><creator>Woo, Albert S., MD</creator><general>Elsevier Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0001-7441-2102</orcidid></search><sort><creationdate>20160601</creationdate><title>Five surgical maneuvers on nasal mucosa movement in cleft palate repair – a cadaver study</title><author>Nguyen, Dennis C., MD ; Patel, Kamlesh B., MD ; Parikh, Rajiv P., MD ; Skolnick, Gary B., BS ; Woo, Albert S., MD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c510t-27ce364f66ee7106b61f033bb2d121f0629e4a903db1b7c39dec8b7612012d253</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Biomechanical</topic><topic>Cadaver</topic><topic>Cadaver study</topic><topic>Cleft Palate - surgery</topic><topic>Female</topic><topic>Humans</topic><topic>Male</topic><topic>Models, Anatomic</topic><topic>Nasal mucosa</topic><topic>Nasal Mucosa - pathology</topic><topic>Nasal Mucosa - transplantation</topic><topic>Palate - pathology</topic><topic>Palate - surgery</topic><topic>Palate dissection</topic><topic>Plastic Surgery</topic><topic>Reconstructive Surgical Procedures - methods</topic><topic>Surgical Flaps</topic><topic>Vomer - pathology</topic><topic>Vomer - surgery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Nguyen, Dennis C., MD</creatorcontrib><creatorcontrib>Patel, Kamlesh B., MD</creatorcontrib><creatorcontrib>Parikh, Rajiv P., MD</creatorcontrib><creatorcontrib>Skolnick, Gary B., BS</creatorcontrib><creatorcontrib>Woo, Albert S., MD</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Journal of plastic, reconstructive & aesthetic surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Nguyen, Dennis C., MD</au><au>Patel, Kamlesh B., MD</au><au>Parikh, Rajiv P., MD</au><au>Skolnick, Gary B., BS</au><au>Woo, Albert S., MD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Five surgical maneuvers on nasal mucosa movement in cleft palate repair – a cadaver study</atitle><jtitle>Journal of plastic, reconstructive & aesthetic surgery</jtitle><addtitle>J Plast Reconstr Aesthet Surg</addtitle><date>2016-06-01</date><risdate>2016</risdate><volume>69</volume><issue>6</issue><spage>789</spage><epage>795</epage><pages>789-795</pages><issn>1748-6815</issn><eissn>1878-0539</eissn><abstract>Abstract Introduction This biomechanical study aims to characterize the nasal mucosa during palatoplasty, describing the soft tissue attachments at different zones and quantifying movement following their release. Methods Palatal nasal mucosa was exposed and divided in the midline in 10 adult cadaver heads. Five consecutive maneuvers were performed: (1) elevation of nasal mucosal off the maxilla; (2) dissection of nasal mucosa from soft palate musculature; (3) separation of nasal mucosa from palatine aponeurosis; (4) release of mucosa at the pterygopalatine junction; (5) mobilization of vomer flaps. The mucosal movements across the midline at the midpalate and posterior nasal spine following each maneuver were measured. Results At the midpalate, maneuvers 1-4 cumulatively provided 3.8 mm (36.9%), 4.9 mm (47.6%), 6.1 mm (59.2%), and 10.3 mm, respectively. Vomer flap (10.5 mm) elevation led to mobility equivalent to that of maneuvers 1-4 (p=0.72). At the posterior nasal spine, cumulative measurements after maneuvers 1-4 were 1.3 mm (10%), 2.4 mm (18.6%), 5.7 mm (44.2%), and 12.9 mm. Here, vomer flaps (6.5 mm) provided less movement (p<0.001). Maneuver 4 yielded the greatest amount of movement of the lateral nasal mucosa at both the midpalate (4.2 mm, 40.8%) and posterior nasal spine (7.2 mm, 55.8%). Conclusion At the midpalate, complete release of the lateral nasal mucosa achieves as much movement as the vomer flap. At the hard-soft palate junction, the maneuvers progressively add to the movement of the lateral nasal mucosa. The most powerful step is release of attachments along the posterior aspect of the medial pterygoid.</abstract><cop>Netherlands</cop><pub>Elsevier Ltd</pub><pmid>27105546</pmid><doi>10.1016/j.bjps.2016.03.012</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0001-7441-2102</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Aged Aged, 80 and over Biomechanical Cadaver Cadaver study Cleft Palate - surgery Female Humans Male Models, Anatomic Nasal mucosa Nasal Mucosa - pathology Nasal Mucosa - transplantation Palate - pathology Palate - surgery Palate dissection Plastic Surgery Reconstructive Surgical Procedures - methods Surgical Flaps Vomer - pathology Vomer - surgery |
| title | Five surgical maneuvers on nasal mucosa movement in cleft palate repair – a cadaver study |
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