Matthew J. Fell

Matthew J. Fell
Spires Cleft Centre

Bachelor of Medicine

About

55
Publications
7,370
Reads
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361
Citations
Education
September 2004 - September 2011
The University of Manchester
Field of study
  • Medicine and Surgery

Publications

Publications (55)
Article
Full-text available
The incomplete unilateral cleft lip shares many of the same phenotypic characteristics as a complete unilateral cleft lip, but key differences include an intact nasal sill, a relative excess of skin in the lateral lip element, and favorable skeletal support. Surgical techniques for incomplete unilateral cleft lips should be tailored to the specific...
Article
Objective To consider the clinical anatomy, safety and effectiveness of the suprazygomatic maxillary nerve block in cleft palate surgery. Design Observational case series. Setting Single cleft centre in the United Kingdom Participants Patients born with a cleft palate (with or without a cleft lip) undergoing palatal surgery between the ages of 9...
Article
Background Traditional surgical approaches excluded septoplasty at primary cleft lip reconstruction due to concerns about restricted nasal and midfacial growth. Modern opinion in the treatment of cleft lip has increasingly employed primary septoplasty; this scoping review and historical perspective aims to chronicle the evolution of septoplasty in...
Article
Objective To investigate the association between the sidedness of orofacial clefts and additional congenital malformations. Design Linkage of a national registry of cleft births to national administrative data of hospital admissions Setting National Health Service, England Participants 2007 children born with cleft lip ± alveolus (CL ± A) and 27...
Article
The Timing of Primary Surgery (TOPS) trial was published August 2023 in the New England Journal of Medicine and is a milestone achievement for a study focused on cleft palate. Due to the complexity of outcome reporting in cleft and the rarity of such comparative trials, TOPS presents a useful opportunity to critically review the design, analysis an...
Article
Full-text available
Cleft care services in the UK have been nationally funded since centralisation 25 years ago and during this time have been able to demonstrate improved clinical outcomes. Integrated care systems have been introduced into legislature as part of the Health Care Act of 2022 and will be responsible for the paradigm shift of allocating funds on a region...
Preprint
Full-text available
Objective: To investigate the association between the sidedness of orofacial clefts and additional congenital malformations. Design: Linkage of a national registry of cleft births to national administrative data of hospital admissions Setting: National Health Service, England Participants: 2,007 children born with cleft lip +- alveolus (CL+-A) and...
Article
Full-text available
Objective To determine whether facial growth at five years is different for children with a left versus right sided cleft lip and palate. Design Retrospective cohort study. Setting Seven UK regional cleft centres. Patients Patients born between 2000-2014 with a complete unilateral cleft lip and palate (UCLP). Main Outcomes Measure 5-Year-Old's...
Article
Objective An overview of the literature relating to the sidedness of unilateral cleft lip with or without cleft palate to map current knowledge on the cause and impact of directional asymmetry. Design Scoping review with a systematic search of Medline and Embase from inception to May 2023. Patients, Participants Humans born with a left or right u...
Preprint
Full-text available
Objective To determine whether facial growth at five years is different for children with a right versus left sided cleft lip and palate. Design Retrospective cohort study Setting Nine UK cleft centres Patients Patients born between 2000-2014 with a complete unilateral cleft lip and palate (UCLP) Main outcomes measure 5-Year-Old’s Index scores...
Preprint
Full-text available
Objectives: An overview of the literature relating to the sidedness of unilateral cleft lip with or without cleft palate to map current knowledge on the cause and impact of directional asymmetry in the unilateral cleft lip phenotype. Data Sources: Medline and Embase from inception to May 2023 Study selection: Studies including left and right unilat...
Article
Objective: Identification of patient factors influencing velopharyngeal function for speech following initial cleft palate repair. Design: A literature search of relevant databases from inception until 2018 was performed using medical subject headings and keywords related to cleft palate, palatoplasty and speech assessment. Following three stage...
Article
Full-text available
Objective: To explore the impact of directional laterality in complete Unilateral Cleft Lip (UCL) amongst the global cleft surgeon community. Design: Cross-sectional survey study. Setting: Global distribution of online survey distributed in English and Spanish. Participants: Cleft surgeons from around the world. Main outcome measures: Surv...
Article
Background: There is a disparity in access, quality, and sustainability of cleft care in low and middle income countries, where burden of disease is greatest. CLEFT-Bridging the Gap (registered charity number: 1194581) is a UK-based charity that aims is to solve this through teaching, empowerment and development of sustainable cleft services. A St...
Chapter
The one-flap palatoplasty is a single mono-pedicled muco-periosteal flap used to reconstruct the hard palate in patients with unilateral cleft lip and palate. There are fewer surgical incisions on the hard palate compared to the two-flap palatoplasty and this may have benefits for better mucoperiosteal flap vascularization. The key aspect when perf...
Article
Objective This study describes primary surgical reconstructions performed for children born with a cleft lip and/or palate (CL ± P) in the United Kingdom (UK). Design Data forms completed at the time of surgery included details on timing, technique, and adjuncts used during the operative period. Demographic data on participants were validated via...
Article
Full-text available
Neurodevelopmental delays can interfere with children’s engagement with the world and further development, and may have negative consequences into adulthood. Mercury is highly toxic and may negatively influence neurodevelopment because it can freely cross the placenta and accumulate in the fetal brain. We searched four publication databases (Embase...
Article
Full-text available
A consortium of global cleft professionals, predominantly from low- and middle-income countries, identified adaptations to cleft care protocols during and after COVID-19 as a priority learning area of need. A multidisciplinary international working group met on a videoconferencing platform in a multi-staged process to make consensus recommendation...
Article
Full-text available
Purpose The purpose of this study was to examine parent/caregiver perspectives and experiences of speech-language pathology provision during the COVID-19 pandemic for children born with cleft palate. Method An online questionnaire to parents of children born with cleft palate asked about delays and changes to speech-language pathology provision du...
Article
Full-text available
Background Both active and passive cigarette smoking have previously been associated with orofacial cleft aetiology. We aimed to analyse the impact of declining active smoking prevalence and the implementation of smoke-free legislation on the incidence of children born with a cleft lip and/or palate within the United Kingdom. Methods and findings...
Preprint
Full-text available
Objective: A consortium of global cleft professionals, predominantly from low- and middle-income countries, identified adaptions to cleft care protocols during and after COVID as a priority learning area of need. Design: A multidisciplinary international working group met on a videoconferencing platform in a multi-staged process to make consensus r...
Preprint
Background This study describes primary surgical reconstructions performed for children born with a cleft lip and/or palate in the United Kingdom. Methods Data were obtained from the Cleft Collective, a national longitudinal cohort study. Data forms completed at the time of surgery included details on timing, technique and adjuncts used during the...
Article
Full-text available
A systematic review and meta-analysis to determine the association between active maternal smoking and cleft lip and palate etiology. Medline, Embase, Web of Science and the Cochrane Library from inception to November, 2020. Observational studies of cigarette smoking habits in pregnant women. Outcomes included cleft lip and/or palate, cleft lip ±...
Article
Full-text available
The intrauterine environment is critical for healthy prenatal growth and affects neonatal survival and later health. Mercury is a toxic metal which can freely cross the placenta and disrupt a wide range of cellular processes. Many observational studies have investigated mercury exposure and prenatal growth, but no prior review has synthesised this...
Preprint
Objectives: To analyse the association between active and passive cigarette smoking and the incidence of children born with a cleft lip and/or palate within the United Kingdom. Design: First, a longitudinal time-series study was conducted with routinely collected smoking prevalence data for females over 16 years of age. Second, an interrupted time-...
Preprint
Objectives: A systematic review and meta-analysis to determine the association between active maternal smoking and cleft lip and palate etiology. Data Sources: Medline, Embase, Web of Science and the Cochrane database from inception to November 2020. Study selection: Observational studies of cigarette smoking habits in pregnant women. Outcomes incl...
Article
UK cleft services are centralised and involve working in a multidisciplinary team, offering patients a high quality of care and surgeons a potentially enormously rewarding career. Trainees wishing to specialise in cleft surgery should endeavour to gain targetted experience in cleft lip and palate from early in their surgical career as this will sta...
Article
Full-text available
The long-term consequences of performing facial surgery on patients living in rural Ethiopia are largely unknown. A review of 36 patients who had been treated on a short-term surgical mission (STSM) in the previous 2 years was conducted to evaluate the outcomes of the surgical interventions performed. There was a significant reduction in social iso...
Article
Objective: This study sought to investigate the association between maxillary growth and speech outcomes for children with a repaired unilateral cleft lip and palate (UCLP) at 5 years of age. Participants: In all, 521 children (180 females and 341 males) with a nonsyndromic complete UCLP, born between 2007 and 2012 in England, Wales, and Norther...
Article
Plastic Surgery is consistently ranked as one of the most competitive for higher surgical training in the United Kingdom. With falling rates of undergraduate Plastic Surgery education there is a danger that potentially excellent candidates will be deterred from applying for training positions. We sought to investigate a cohort of UK medical student...
Article
Clinical governance is the structured approach to maintaining and improving the quality of patient care and is a vital part of global surgery. BFIRST and BSSH closely collaborate with local doctors on a number of overseas projects, seeking to strengthen and develop local knowledge and skills, aiming for an independent local practice in reconstructi...
Article
Full-text available
Background Plastic Surgery Training in the UK continues to evolve towards an outcomes-based rather than time-served curriculum. UK Plastic Surgery Trainees are appointed nationally, and are assessed according to national standards, but training is delivered regionally. This study sought opinion from current UK Plastic Surgery Trainees in order to h...
Article
Full-text available
Background: Long-term follow up after short-term reconstructive missions is challenging, often due to financial constraints, remote geography and lack of post-operative communication with patients. The aim of this study was to conduct long-term follow up of patients who have undergone surgery for complex facial disfigurement in Ethiopia. Methods:...
Article
Full-text available
The aim of effective healing is to restore comparable structure and function to tissues. In some circumstances, this is not achieved, resulting in fibrotic scar tissue formation. Although this may have offered survival advantages in the past, fibrosis leads to functional disruption, organ failure and even death. Fibrosis affects many tissues types,...
Article
Background: A lack of high-level evidence exists on the outcomes of different cleft palate repair techniques. A critical appreciation for the complication rates of common repair techniques is paramount to optimize cleft palate care. Methods: A literature search was conducted for articles on the measurement of fistula and velopharyngeal insuffici...
Article
Full-text available
A case report to describe the occurrence of Dupuytren's disease in the wrist leading to compression of the palmar cutaneous branch of the median nerve. A 60-year-old male presented with a lump on the volar aspect of the left wrist with reduced sensation in the thenar eminence. Intra-operatively this was found to be a nodule integrated within the pa...
Article
Objective scar assessment tools were designed to help identify problematic scars and direct clinical management. Their use has been restricted by their measurement of a single scar property and the bulky size of equipment. The Scarbase Duo(®) was designed to assess both trans-epidermal water loss (TEWL) and colour of a burn scar whilst being compac...
Article
Background Humanitarian organisations commonly provide reconstructive treatment for patients with cleft lip within developing countries, but follow-up is often non-existent, particularly for those living in rural areas. This study aimed to assess whether a single surgical intervention was sufficient to produce an observable change to the life of a...
Article
Hyenas are effective hunters and will consider humans as potential prey if the need and opportunity arise. This study describes the circumstances of hyena attacks, the patterns of injuries sustained, and reconstruction in a resource-poor setting. As part of a charitable surgical mission to Ethiopia in 2012, 45 patients with facial deformities were...
Article
Often termed an “F3,” a year away from the UK training pathway after the second year of foundation training is an increasingly popular option for doctors in training. Matthew Fell and colleagues look at the options available and discuss what aspiring surgeons should consider http://careers.bmj.com/careers/advice/view-article.html?id=20015702
Article
A 24 year old man presented to his GP with swelling and erythema of the scalp⇑. These symptoms developed a day after he had shaved his head and then spent the day in the sun. On examination, he had a fluctuant boggy mass over the scalp but was well with normal vital signs. A course of oral steroids was prescribed and the oedema settled within four...
Article
In April 2013 I had the opportunity to assist with a facial reconstruction project in Ethiopia. Project Harar is a British charity that provides access to treatment for patients with facial deformities living in rural areas of Ethiopia. Patients with a cleft of the lip and/or palate are the most common group encountered. They are treated by a team...
Article
Surgical missions to the developing world have been criticized for their lack of outcome analysis. Reported studies indicate a high rate of postoperative complications. An integrated pathway developed for surgical missions and a report of its performance in action is presented herein. Patients were optimized for surgery by a medical team from the U...

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