Superior Results Using the Islandized Hemipalatal Flap in Palatoplasty: Experience with 500 Cases

Abstract

The authors' data suggest that a double-opposing Z-plasty palate repair performed with islandization results in lower postoperative fistula rates when compared with repair performed without islandization.

Fistula Incidence after Primary Cleft Palate Repair

“…This was based on recently reported fistula incidence, from two large cohort studies, of approximately 5 percent. 27,41 Patients with syndromic clefts were excluded because of small numbers and a reported high fistula incidence, 2,18 which could have skewed the overall results. Because up to 50 percent of patients diagnosed with Pierre Robin sequence may have other underlying syndromes, 51 these too were excluded.…”

“…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.…”

The effect of Gauze Dressing use on reduction of Oronasal Fistula Rates following Cleft Palate Repair

“…Different surgical techniques can be applied to cleft palate repair. These techniques, known as primary palatoplasty techniques, include Veau-Wardill-Kilner palatoplasty (Push back), Bardach 2-fl ap palatoplasty, von Langenbeck palatoplasty (simple palatoplasty), and Furlowpalatoplasty [3,10,11]. In our study, V-Y pushback (77.7%), Simple Palatoplasty (13.8%) and Furlow palatoplasty (8.3%) were applied.…”

An effect comparison between Furlow double opposing Z-plasty and two-flap palatoplasty on velopharyngeal closure

“…In the literature, the fistula rate following Furlow palatoplasty ranged from 0.76% to 23.3%. 1,10,[12][13][14][15][16][17][18][19][20] Although the fistula rate for Furlow palatoplasty gradually reduced, its occurrence was higher than that of the von Langenbeck procedures. Brothers et al, 21 reported a fistula rate of 0% in 10 patients with Wardill-Kilner palatoplasties versus 5% in 21 patients with Furlow repairs.…”