Primary Repair of the Alveolar Cleft

Abstract

Nasoalveolar fistula and oropharyngeal fistula of the anterior palatal region are very commonly seen in cases when there are concomitant clefts of the lip and the palate. Absence of adequate tissue in that region complicates the treatment and necessitates new tissue transfers from near or distant tissues. Today, the techniques used for correcting cleft lip cannot successfully solve these 2 problems. In this study, we describe a technique that depends on the principle of using the lip mucosal tissues that remains during the Tennison cleft lip correction technique, with a flap designation, to correct the tissue defect of the cleft between the foramen incisivum and lip and the alveolar region. Twenty-two patients (13 boys and 9 girls), with ages ranging from 3 to 53 months (mean, 24 mo), with unilateral cleft lip and palate underwent surgery with this new technique. In all these patients, clefts in the anterior palatal and alveolar regions were successfully corrected. Fistula was observed in none of these patients in these regions. Through this method, clefts in the anterior palatal and alveolar regions can be corrected during repair of cleft lips.

The Impact of Presurgical Infant Orthopedics on Oronasal Fistula Rates Following Cleft Repair: A Meta-Analysis

“…Twenty-six of these were excluded because the contact details of the corresponding authors were not available (Furlow, 1986; Amaratunga, 1988; Horswell et al, 1993; Senders and Sykes, 1995; Emory et al, 1997; Wilhelmi et al, 2001; Sie and Gruss, 2002; Helling et al, 2006; Ravishanker, 2006; Hassan and Askar, 2007; Andrades et al, 2008; Bindingnavele et al, 2008; Khosla et al, 2008; Steinbacher et al, 2011; Dong et al, 2012; Lam et al, 2012; Tan et al, 2012; Jackson et al, 2013; Mahoney et al, 2013; Nadjmi et al, 2013; Butow et al, 2014; Lithovius et al, 2014; Pan et al, 2014; Yamaguchi et al, 2016; Mann et al, 2017; Murthy et al). An additional 27 articles were excluded because the corresponding authors did not respond to our request to obtain the necessary data (Padwa and Mulliken, 2003; Jackson et al, 2004; LaRossa et al, 2004; Inman et al, 2005; Mak et al, 2006; Ogata et al, 2006; Kobus, 2007; Phua and de Chalain, 2008; Agrawal, 2009; Sullivan et al, 2009; Ezzat et al, 2010; Lu et al, 2010; Paniagua et al, 2010; Isik et al, 2011; Losken et al, 2011; Williams et al, 2011; Eberlinc and Kozelj, 2012; Rauf et al, 2012; Black and Gampper, 2014; de Agostino Biella Passos et al, 2014; Deshpande et al, 2014; Zhang et al, 2014; Hudson and Pickett, 2015; Hosseinabad et al, 2015;…”

Generation of a bioengineered autologous bone substitute for palate repair: anin vivostudy in laboratory animals

“…Clinical and experimental results suggest that interposition of a bone graft may significantly improve the clinical outcome and functional results of patients with cleft palate, especially when an alveolar cleft is present (Torikai et al ., ; Dik et al ., ; Isik et al ., ; Shirani et al ., ; Cho‐Lee et al ., ; Hara et al ., ). However, harvesting autologous bone grafts is painful and is usually associated with side‐effects at the donor area (Laurie et al ., ; Ophof et al ., ; Meara et al ., ; Sharma et al ., ).…”