The Furlow Z-plasty in two-staged palatal repair modifications and complications

Mommaerts, Maurice Y.; Combes, F; Drake, David

doi:10.1016/j.bjoms.2005.03.019

Cited by 29 publications

(16 citation statements)

References 18 publications

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“…Our systematic review included 4651 patients with 351 fistulas recorded after primary palate surgery. The frequency of oronasal fistula varied in the included studies from 0% (Mommaerts et al, 2006; Dec et al, 2013; Nadjmi et al, 2013; Baek et al, 2015) to 60.9% (Rohrich et al, 1996). Fistula percentage was calculated as the percentage of cases with fistula among all study participants and was 9.94% (95% confidence level, SD: 13.21, skewness = 2.02, kurtosis = 4.31).…”

Section: Resultsmentioning

confidence: 99%

On the Frequency of Oronasal Fistulation After Primary Cleft Palate Repair

Tache

Mommaerts

2019

The Cleft Palate-Craniofacial Journal

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Objective: The aims of the study were to assess the postoperative oronasal fistula rate after 1-stage and 2-stage cleft palate repair and identify risk factors associated with its development. Design: Systematic review. Setting: Various primary cleft and craniofacial centers in the world. Patients, Participants: Syndromic and nonsyndromic cleft lip, alveolus, and palate patients who had undergone primary cleft palate surgery. Intervention: Assessment of oronasal fistula frequency and correlation with staging, timing, and technique of repair, gender, and Veau type. The results obtained in this systematic review were compared with those in previous reports. Outcome: The main outcome is represented by the occurrence of the oronasal fistula after 1-stage versus 2-stage palatoplasty. Results: The mean fistula percentage was 9.94%. In the Veau I, II, III, and IV groups, the respective fistula rates were 2%, 7.3%, 8.3%, and 12.5%. Oronasal fistula locations based on the Pittsburgh Fistula Classification System were soft palate (type II), 16.2%; soft palate–hard palate junction (type III), 29.3%; and hard palate (type IV), 37.3%. There were no statistically significant differences between 1-stage and 2-stage palatoplasty, syndromic and nonsyndromic, or male and female patients. Primary palatoplasty timing was not a significant predictor. Conclusion: Some disparities arose when comparing studies, mainly regarding location and types of clefting prone to oronasal fistulation. Interestingly, the fistula rate does not differ between 1- and 2-stage closure, and timing of the repair does not play a role.

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Section: Resultsmentioning

confidence: 99%

On the Frequency of Oronasal Fistulation After Primary Cleft Palate Repair

Tache

Mommaerts

2019

The Cleft Palate-Craniofacial Journal

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“… 64 Data from both Mommaerts et al . 65 and Richard et al . 66 further support this statement, as these authors found that one-stage and two-stage protocols showed no difference in postoperative maxillary growth because the hard palate was repaired at the same time in both protocols.…”

Section: Treatment Protocol and Maxillofacial Growthmentioning

confidence: 95%

The impact of cleft lip and palate repair on maxillofacial growth

2014

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Surgical correction is central to current team-approached cleft treatment. Cleft surgeons are always concerned about the impact of their surgical maneuver on the growth of the maxilla. Hypoplastic maxilla, concaved mid-face and deformed dental arch have constantly been reported after cleft treatments. It is very hard to completely circumvent these postoperative complications by current surgical protocols. In this paper, we discussed the factors that inhibit the maxillofacial growth on cleft patients. These factors included pre-surgical intervention, the timing of cleft palate and alveolae repair, surgical design and treatment protocol. Also, we made a review about the influence on the maxillary growth in un-operated cleft patients. On the basis of previous researches, we can conclude that most of scholars express identity of views in these aspects: early palatoplasty lead to maxilla growth inhibition in all dimensions; secondary alveolar bone graft had no influence on maxilla sagittal growth; cleft lip repair inhibited maxilla sagittal length in patients with cleft lip and palate; Veau's pushback palatoplasty and Langenbeck's palatoplasty with relaxing incisions were most detrimental to growth; Furlow palatoplasty showed little detrimental effect on maxilla growth; timing of hard palate closure, instead of the sequence of hard or soft palate repair, determined the postoperative growth. Still, scholars hold controversial viewpoints in some issues, for example, un-operated clefts have normal growth potential or not, pre-surgical intervention and pharyngoplasty inhibited maxillofacial growth or not.

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“…This abolishes the possibility of occurrence of oronasal fistula and none of the operated patients developed wound dehiscence or oronasal fistula. Mommaerts et al [8] reported six patients with wound dehiscence and oronasal fistula after correction of 45 patients with cleft palate by Z-plasty. Jeffery and Boorman [9] stated that the incidence of palatal fistulae following primary repair of the cleft palate varies widely, with the figure quoted ranging from 18% to 34%.…”

Section: Discussionmentioning

confidence: 98%