Primary Palatoplasty for Unilateral Cleft Lip and Palate Using Mucosal Grafts and Flaps.

The mucosal graft and flaps method (MG method) is a palatoplasty technique that was developed for the purpose of improving maxillary growth in patients with cleft palate. In the MG method, full-thickness buccal mucosa is grafted onto the raw surface created by pushback palatoplasty. The method is unlikely to result in severe scarring and has a favorable effect on maxillary growth. In addition, it is unlikely to result in oronasal fistula and provides good speech results. Overall, postive long-term treatment results have been obtained. Although the MG method is technically difficult and requires a lengthy surgery, the technique is considered to be effective for palate closure in terms of speech and maxillary growth.

Computer-aided diagnosis for screening of lower extremity lymphedema in pelvic computed tomography images using deep learning.

Lower extremity lymphedema (LEL) is a common complication after gynecological cancer treatment, which significantly reduces the quality of life. While early diagnosis and intervention can prevent severe complications, there is currently no consensus on the optimal screening strategy for postoperative LEL. In this study, we developed a computer-aided diagnosis (CAD) software for LEL screening in pelvic computed tomography (CT) images using deep learning. A total of 431 pelvic CT scans from 154 gynecological cancer patients were used for this study. We employed ResNet-18, ResNet-34, and ResNet-50 models as the convolutional neural network (CNN) architecture. The input image for the CNN model used a single CT image at the greater trochanter level. Fat-enhanced images were created and used as input to improve classification performance. Receiver operating characteristic analysis was used to evaluate our method. The ResNet-34 model with fat-enhanced images achieved the highest area under the curve of 0.967 and an accuracy of 92.9%. Our CAD software enables LEL diagnosis from a single CT image, demonstrating the feasibility of LEL screening only on CT images after gynecologic cancer treatment. To increase the usefulness of our CAD software, we plan to validate it using external datasets.

Primary alveolar bone grafting and gingivoperiosteoplasty or gingivomucoperiosteal flap at the time of 1-stage repair of unilateral cleft lip and palate.

It takes quite a long time to finish treating patients with cleft lip and palate. Usually, lip closure, palate repair, secondary alveolar bone grafting, and secondary repair of lip/nose have been given to patients at appropriate time according to their growth. However, these series of surgical interventions impose a considerable burden on the patients and their families. As for palate repair, it is considered that the earlier the better for the sake of speech, but it should be delayed to approximately 1(1/2) years of age for maxillary growth. However, we have developed a palate repair technique that will hardly result in marked maxillary growth impairment by modifying the Furlow method, so we have become able to perform palate repair between 3 and 10 months after birth. Accordingly, we can perform lip and palate repair simultaneously, which have been performed separately. As we have developed a 1-stage repair of cleft lip and palate including primary alveolar bone grafting from nasal concha and/or hard plate and gingivoperiosteoplasty or gingivomucoperiosteal flap, we report on our technique and treatment outcome.