Incidence of Residual Oronasal Fistulas: A 20-Year Experience

Eberlinc, Andreja; Koželj, Vesna

doi:10.1597/10-146

Cited by 46 publications

(52 citation statements)

References 22 publications

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“…1). There were five randomized controlled trials 35,37,42,48,55 and 39 nonrandomized studies, [1][2][3]5,9,13,17,[21][22][23][24][25][26][27][28][29][30][31][32][33][34]36,[38][39][40][41][43][44][45][46][47][49][50][51][52][53][54]56,57 of which 10 were comparative studies and 29 were noncomparative. The mean Detsky score for the randomized controlled trials was 14, with two studies considered to be of high quality.…”

Section: Study Selection and Assessment Of Methodologic Qualitymentioning

confidence: 99%

Fistula Incidence after Primary Cleft Palate Repair

Hardwicke

Landini

Richard

2014

Plastic and Reconstructive Surgery

162

132

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Section: Study Selection and Assessment Of Methodologic Qualitymentioning

confidence: 99%

Fistula Incidence after Primary Cleft Palate Repair

Hardwicke

Landini

Richard

2014

Plastic and Reconstructive Surgery

162

132

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“…Defined as a failure to heal or a breakdown in the primary surgical repair of the palate, fistulization occurs in roughly 5 to 10% of palatoplasties, but reports in excess of 20% have been published. 49,50,51,52,53,54 Fistulas are described by their size, anatomical location, and associated symptoms. The Pittsburgh Classification is useful in standardizing their anatomic location.…”

Section: Secondary Surgerymentioning

confidence: 99%

68 Evaluation and Management of Cleft Lip and Palate Disorders

Papel¹,

Frodel²,

Holt³

et al. 2016

Facial Plastic and Reconstructive Surgery

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The palatal shelves are initially separated by the developing tongue. Growth of the mandible is associated with inferior displacement of the tongue, which allows the palatal shelves to migrate superiorly and assume a horizontal orientation. The "shelf elevating force" that causes the upward motion of the shelves is believed to be mediated by a process involving mesenchymal proliferation and growth factor-induced changes in local extracellular matrix, including hydration of hyaluronic acid in the tips of the shelves. 5,6 If fetal development and mandibular growth do not proceed normally, the tongue does not descend and the palatal shelves cannot migrate superiorly and medially, despite the shelf elevating force. The resulting malformation can result in the Pierre Robin sequence (micrognathia, relative macroglossia, and U-shaped cleft palate) (Fig. 68.3). 7 Fig. 68.1 The developing human face at 5.5 weeks of gestational age. The primary palate is formed by fusion of the paired medial nasal prominences (a). The lateral nasal prominence (b) becomes the nasal ala. The maxillary process (c) forms the upper lip segments lateral to the philtrum. The mandibular process (d) becomes the mandible.This document was downloaded for personal use only. Unauthorized distribution is strictly prohibited.

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“…Fistula repair has a high rate of recurrence and is a difficult procedure. 1–3 Although local flaps around a fistula are used in the repair of relatively small fistulas, 4–6 they can be difficult to use in the repair of a large fistula. This is because the palatal tissue surrounding the fistula can be quite scarred and in short supply.…”

mentioning

confidence: 99%

The Folded Buccal Musculomucosal Flap for Large Palatal Fistulae in Cleft Palate

Kobayashi

Fukawa²,

Hirakawa³

et al. 2014

Plastic and Reconstructive Surgery Global Open

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Background:A palatal fistula is a common complication of cleft palate repair. Although a buccal musculomucosal flap (BMMF) is effective for fistula repair, it does have the following problems: a second operation may be required to release the pedicle on the oral side and unilateral BMMF cannot close mucosal defects of both the nasal and oral sides. A novel fistula closure method using the folded BMMF (f-BMMF) invented by the authors is presented.Case:A 8-year-old-boy with bilateral cleft lip and palate with anencephaly. A fistula in the hard palate occurred after palatoplasty by the Furlow method, and an f-BMMF was planned. The mucosal defects of the nasal and oral sides were covered by 2 separate islands of mucosal epithelium. Finally, no reoperation was needed to remove the pedicle of the f-BMMF.Conclusion:The f-BMMF is able to cover both sides without a raw surface and a mucosal graft even in cases of large fistula closure, although BMMF cannot usually cover both oral and nasal sides of a fistula. The advantages of this procedure are that it does not require second surgery to release the pedicle and that its distal island mucosa can be used to monitor engraftment. This proposed method seems to be an appealing alternative.

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Incidence of Residual Oronasal Fistulas: A 20-Year Experience

Abstract: The low incidence of oronasal fistulas is the result of a surgical technique and tensionless suturing, followed by a two-layer closure, two-stage palate repair in BCLP and UCLP patients, and preoperative orthopedics in UCLP cases.

Cited by 46 publications

References 22 publications

Fistula Incidence after Primary Cleft Palate Repair

Fistula Incidence after Primary Cleft Palate Repair

68 Evaluation and Management of Cleft Lip and Palate Disorders

The Folded Buccal Musculomucosal Flap for Large Palatal Fistulae in Cleft Palate

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