Which strategy is least favourable for dealing with velopharyngeal incompetence?
Posterior pharyngeal wall augmentation. This is the least favourable strategy. Hynes from Sheffield UK delivered his Hunterian Oration on his sphincter pharyngoplasty technique in 1953. This involved use of the salpingopharyngeus muscle, but it was developed to later include a greater amount of musculature including palatopharyngeus. Orticochea from Bogota in Colombia, described an inferiorly-based pharyngeal flap in conjunction with sphincter pharyngoplasty. Intravelar veloplasty has been popularised by Sommerlad. These, along with Furlow’s double-opposing Zplasty soft palate repair, are useful strategies for velopharyngeal incompetence. Veau’s push-back repair lengthens the soft palate and has theoretical advantages, but has fallen out of favour as it causes unacceptable midfacial hypoplasia. Augmentation of the posterior pharyngeal wall with fillers ranging from Teflon® to autologous fat have not, as yet, been successful to the extent that they have been widely adopted.
The overall incidence of bifid uvula in the population is:
Between 1:100 and 1:70.
Which French surgeon was the first to use the buried skin strip to repair hypospadias?
Duplay. The Frenchman, Simon Duplay, was the first to use a buried skin strip in 1874. Instead of sewing it into a tunnel he allowed it to tube itself to form the new urethra and covered it with lateral flaps. The method was popularised in England by Denis Browne at Great Ormond Street Hospital.
Which method used to repair hypospadias is the odd one out?
Horton-Devine. Horton and Devine devised a single-stage correction; all the others are two-stage or multi-stage.
Who was the first to advocate including the palatal periosteum in flaps used to repair cleft palate?
von Langenbeck. Dieffenbach was the first to repair the defect in the bone of the hard palate in 1826 by performing an osteotomy on the palatal bones and shifting a composite flap of bone and mucosa medially but von Langenbeck saw the potential of including just periosteum with mucosal flaps and designed a special elevator to achieve this end. He presented his modification of Dieffenbach’s method in 1861 in Berlin.
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