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Modified surgical reconstruction technique for a rare isolated congenital sternal cleft: In a six -year-old child.

ABSTRACT:

SUBMITTER: Chaudhry IUH

PROVIDER: S-EPMC8082199 | biostudies-literature | 2021 May

REPOSITORIES: biostudies-literature

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Modified surgical reconstruction technique for a rare isolated congenital sternal cleft: In a six -year-old child.

Chaudhry Ikram Ul Haq IUH Cheema Ahsan A Aqeel Chaudhry C Al Shaer Ahmed A Alradei Fahad G FG Alquraish Fatima F Tawfeeq Mansour M

Annals of medicine and surgery (2012) 20210414

We report the modified surgical reconstruction technique for correction for a large isolated congenital sternal cleft in 6 years old girl using a methyl methacrylate marlex mesh sandwich plate (MMS). The patient was referred to our tertiary care institution with a sizeable anterior chest wall bony defect. There was a large bulging under the skin due to protrusion of mediastinal viscera and visible cardiac pulsations with breathing. A chest x-ray and computed tomographic scan (CT) of the thorax w ...[more]

PMID: 33981421

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Project description:ObjectivesTo describe the prevalence and significance of first branchial cleft anomalies in children with congenital aural atresia.MethodsRetrospective cohort study and case series. Patients were included if they had ICD-10 code Q16.0, Q16.1, Q16.9, Q17.2, or Q17.9 in their medical record and were seen at UCSF Benioff Children's Hospital from 2012 to 2020 for aural atresia. Children were categorized as having aural atresia and first branchial cleft anomalies if the presence of a first branchial cleft anomaly was noted in otolaryngology provider notes; otherwise, they were categorized as aural atresia alone. Patients with aural atresia and first branchial cleft anomalies were included in the case series.ResultsAmong 125 children with congenital aural atresia, 5 (4%) were identified with first branchial cleft anomalies. In all cases, an epithelialized tract was noted to originate from the inferior aspect of the middle ear cleft, exiting the temporal bone in an inferomedial position adjacent to the stylomastoid foramen, with a cutaneous exit point inferior to the expected location of the native ear canal. There was no association with sex, microtia grade, or laterality of atresia; however, children with aural atresia and first branchial cleft anomalies were significantly more likely to have syndromes such as Goldenhar and Treacher Collins (p = .04) than those with aural atresia alone.3/5 (60%) children with aural atresia and first branchial cleft anomalies presented with cholesteatoma compared with 1/120 (0.8%) children with aural atresia alone, a significant difference (p < .001). All four children over the age of two have undergone surgical management. In two of these, excision of the branchial cleft anomaly could be combined with atresiaplasty, with normal hearing results in both cases.ConclusionsAural atresia can be associated with comorbid anomalies of the head and neck. First branchial cleft anomalies can be suspected based on characteristic clinical appearance and confirmed with computed tomography showing a typical course through the temporal bone. When present in the context of congenital aural atresia, first branchial cleft anomalies are associated with a significantly increased risk for cholesteatoma, often necessitating surgical management with favorable hearing outcomes.Level of evidence4.

Dataset Information

Modified surgical reconstruction technique for a rare isolated congenital sternal cleft: In a six -year-old child.

Publications

Modified surgical reconstruction technique for a rare isolated congenital sternal cleft: In a six -year-old child.

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