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Importance of Stem Cell Transplantation in Cleft Lip and Palate Surgical Treatment Protocol.

Abstract

Cleft lip and palate is a congenital malformation that requires a multidisciplinary treatment that evolves pediatrician, obstetrics, fetal medicine, genetics, plastic surgery, orthodontics, speech therapist, nursery, and psychology. Actually, the authors believe that it could be possible to ad protocols to use stem cells.The intrauterine diagnosis leads to preborn parental orientation and better parental collaboration to accept a precocious multidisciplinary treatment. After birth the authors' protocol is: orthodontic devices, phonoaudiology, and surgical procedures.The authors' cleft lip and palate reconstructive surgery protocol demands several steps and begins at 4 to 6-month old with rhinocheiloplasty and soft palate closure at the same moment. The treatment sequence involves the hard palate surgery (8-18 months after the first surgical step), alveoloplasty (after 10 years old), and secondary rhinoplasty (after 14 years old).New ideas to use stem cells and blood from the umbilical cord and also blood from placenta are discussed to improve final surgical results. Maternal stem cells are easy to collect, there are no damage to the patient and mother, it is autologous and it could be very useful in the authors' protocol.Nine patients with clef lip and palate were operated and had stem cells from umbilical cord blood and placenta blood injected into the bone and soft tissue during the primary procedure (rhinocheiloplasty).The stem cells activity into soft tissue and bone were evaluated. Preliminary results have shown no adverse results and improvement at the inflammatory response. A treatment protocol with stem cells was developed. It had a long time follow-up of 10 years.

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  • Publisher Full Text
  • Authors+Show Affiliations

    ,

    Brazilian Plastic Surgery Society, Brazilian Cleft Lip and Palate Society, Plastic Surgery Division at Darcy Vargas Children Hospital.

    ,

    Brazilian Plastic Surgery Society, Brazilian Craniofacial Surgery Society, Plastic Surgery at São Paulo University.

    ,

    Brazilian Plastic Surgery Society, Plastic Surgery Division at Darcy Vargas Children Hospital.

    ,

    Brazilian Cryogenic Center (BCC).

    ,

    Umbilical Cord Blood Laboratory of Brazilian Cryogenic Center (BCC).

    Facial Defects Studies and Research Center, São Paulo, Brazil.

    Source

    The Journal of craniofacial surgery 29:6 2018 Sep pg 1445-1451

    MeSH

    Adolescent
    Alveoloplasty
    Child
    Cleft Lip
    Cleft Palate
    Clinical Protocols
    Cord Blood Stem Cell Transplantation
    Female
    Follow-Up Studies
    Humans
    Infant
    Male
    Outcome Assessment (Health Care)
    Palate, Hard
    Palate, Soft
    Reconstructive Surgical Procedures
    Rhinoplasty
    Time-to-Treatment

    Pub Type(s)

    Journal Article

    Language

    eng

    PubMed ID

    30067525

    Citation

    Mazzetti, Marcelo Paulo Vaccari, et al. "Importance of Stem Cell Transplantation in Cleft Lip and Palate Surgical Treatment Protocol." The Journal of Craniofacial Surgery, vol. 29, no. 6, 2018, pp. 1445-1451.
    Mazzetti MPV, Alonso N, Brock RS, et al. Importance of Stem Cell Transplantation in Cleft Lip and Palate Surgical Treatment Protocol. J Craniofac Surg. 2018;29(6):1445-1451.
    Mazzetti, M. P. V., Alonso, N., Brock, R. S., Ayoub, A., Massumoto, S. M., & Eça, L. P. (2018). Importance of Stem Cell Transplantation in Cleft Lip and Palate Surgical Treatment Protocol. The Journal of Craniofacial Surgery, 29(6), pp. 1445-1451. doi:10.1097/SCS.0000000000004766.
    Mazzetti MPV, et al. Importance of Stem Cell Transplantation in Cleft Lip and Palate Surgical Treatment Protocol. J Craniofac Surg. 2018;29(6):1445-1451. PubMed PMID: 30067525.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Importance of Stem Cell Transplantation in Cleft Lip and Palate Surgical Treatment Protocol. AU - Mazzetti,Marcelo Paulo Vaccari, AU - Alonso,Nivaldo, AU - Brock,Ryane Schmidt, AU - Ayoub,Alexandre, AU - Massumoto,Sally Mizukami, AU - Eça,Lilian Piñero, PY - 2018/8/2/pubmed PY - 2018/12/27/medline PY - 2018/8/2/entrez SP - 1445 EP - 1451 JF - The Journal of craniofacial surgery JO - J Craniofac Surg VL - 29 IS - 6 N2 - Cleft lip and palate is a congenital malformation that requires a multidisciplinary treatment that evolves pediatrician, obstetrics, fetal medicine, genetics, plastic surgery, orthodontics, speech therapist, nursery, and psychology. Actually, the authors believe that it could be possible to ad protocols to use stem cells.The intrauterine diagnosis leads to preborn parental orientation and better parental collaboration to accept a precocious multidisciplinary treatment. After birth the authors' protocol is: orthodontic devices, phonoaudiology, and surgical procedures.The authors' cleft lip and palate reconstructive surgery protocol demands several steps and begins at 4 to 6-month old with rhinocheiloplasty and soft palate closure at the same moment. The treatment sequence involves the hard palate surgery (8-18 months after the first surgical step), alveoloplasty (after 10 years old), and secondary rhinoplasty (after 14 years old).New ideas to use stem cells and blood from the umbilical cord and also blood from placenta are discussed to improve final surgical results. Maternal stem cells are easy to collect, there are no damage to the patient and mother, it is autologous and it could be very useful in the authors' protocol.Nine patients with clef lip and palate were operated and had stem cells from umbilical cord blood and placenta blood injected into the bone and soft tissue during the primary procedure (rhinocheiloplasty).The stem cells activity into soft tissue and bone were evaluated. Preliminary results have shown no adverse results and improvement at the inflammatory response. A treatment protocol with stem cells was developed. It had a long time follow-up of 10 years. SN - 1536-3732 UR - https://www.unboundmedicine.com/medline/citation/30067525/Importance_of_Stem_Cell_Transplantation_in_Cleft_Lip_and_Palate_Surgical_Treatment_Protocol L2 - http://Insights.ovid.com/pubmed?pmid=30067525 DB - PRIME DP - Unbound Medicine ER -