The use of buccal flap in the closure of posterior post-palatoplasty fistula

Abdel‐Aziz, Mosaad

doi:10.1016/j.ijporl.2008.07.020

Cited by 22 publications

(6 citation statements)

References 22 publications

(22 reference statements)

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“…Tongue flap is one of the examples used for many years with many modifications in the literature. Beside the successful results,10,11 there are also some limitations mentioned in the literature such as need of 2 stage surgery, flap detachment due to tongue mobility and gravitation, tongue deformity or changes in articulation and resonance 11–13. The buccinator flap is another option which can be used for the same purpose.…”

Section: Discussionmentioning

confidence: 99%

Free Flap Reconstruction of Recalcitrant Defects in Cleft Palate Patients

Gur

Tiftikçioğlu

2023

Journal of Craniofacial Surgery

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Introduction: Defects of the palate can be as a result of oronasal fistula of cleft patients and the ablative surgery of tumors. There are many studies about reconstruction of the defects of plate in the literature and most of them are related to tumor surgery. Despite the use of free flaps in cleft patients being not a new approach, the articles in the literature are very few. The authors describe the experience of oronasal fistula reconstructions with free flaps with a new modification of tensionless inset of the free flap's pedicle. Patients and Methods: Between 2019 and 2022, 2 males and 1 female, 3 consecutive cleft patients underwent free flap surgery because of recalcitrant palatal defects. One patient had 5 and each of remain had 3 unsuccessful reconstructive attempts previously. The age of patients was ranged from 20 to 23 years old. Radial forearm flap was the option of oral lining reconstruction for all patients. In 2 patients, the flap was modified as a skin tail was linked to the flap for covering the pedicle as tensionless closure.Results: There was a mucosal swelling in first patient who underwent classical pedicle inset as mucosal tunneling. In 1 patient there was a spontaneous bleeding from the anterior side of the flap and it stopped without medical interventions, spontaneously. There was no additional complication. All flaps survived without anastomosis problems. Conclusion: Incision of the mucosa rather than tunneling provides good surgical exposure and bleeding control and modified flap design may be beneficial and reliable for tensionless pedicle inset and covering.

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Section: Discussionmentioning

confidence: 99%

Free Flap Reconstruction of Recalcitrant Defects in Cleft Palate Patients

Gur

Tiftikçioğlu

2023

Journal of Craniofacial Surgery

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“…Tonsillectomy and adenoidectomy are controversial surgical procedures often indicated in patients with cleft palate and mostly performed after primary palatoplasty. 93,94 Some studies have reported that tonsillectomy and partial or total adenoidectomy significantly prevent the formation of obstructive sleep apnea and do not have any deleterious effect on speech development. 93,94 However, other studies report that performing a total adenotonsilectomy might result in velopharyngeal insufficiency (VPI) with the repaired palate unable to create adequate velopharyngeal seal during speech.…”

Section: Discussionmentioning

confidence: 99%

Otological Challenges in Patients With Non-Syndromic Cleft Lip and Palate: A Systematic Review

James

Otoghile

Adamson

et al. 2023

FACE

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Objectives: To identify the various otological challenges associated with non-syndromic orofacial clefts, how these problems affect quality of life of patients with orofacial clefts and find out the perspectives and current trends in the management of otological problems. Design: We conducted systematic searches for retrospective studies, cross-sectional studies, case-control studies, cohorts’ longitudinal studies and prospective controlled trials in Medline and Google scholar databases. Identified studies were retrieved and assessed for eligibility. Results: Thirty-five articles met all inclusion criteria and were selected for qualitative analysis. Twenty-one articles evaluated otological challenges associated with cleft lip and palate, 7 articles evaluated associated quality of life of patients with otological challenges and 9 articles evaluated management of otological challenges. Based on the results from this review, otological challenges including otitis media with effusion, conductive and sensorineural hearing loss are commonly associated with cleft. The result is a reduced quality of life due to their negative effects on intelligibility and eloquence of speech. They can however be managed by various palatoplasty procedures, rapid maxillary expansion, and use of various otological aids performed at an early age. Conclusion: The prevalence otological challenges in the cleft population are high and these issues require early management due to their possible effects on quality of life. Hence, there is need to incorporate ear care in the routine management of cleft lip and palate.

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“…This flap also helps to lengthen the palate for velopharyngeal incompetence correction at the same time. [1112]…”

Section: Discussionmentioning

confidence: 99%

Tongue flap as salvage procedure for recurrent and large palatal fistula after cleft palate repair

Prakash¹,

Singh²,

Solanki³

et al. 2018

Afr J Paediatr Surg

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Background: Recurrent palatal fistula is a common complication of cleft palate repair. The main causes are poor surgical technique or vascular accidents and infection. Local flaps are not adequate for larger and recurrent fistula. The aim of this study is to analyze the utility of tongue flap in recurrent and large palatal fistula repair. Materials and Methods: From January 2008 to July 2016, 18 patients with recurrent palatal fistula were included in the study. All the patients had undergone repair of cleft palate and fistula previously. Tongue flap repair of the recurrent palatal fistula was performed in all 18 patients. The flaps were divided after 3 weeks and final inset was done. Flap viability, fistula closure, residual tongue function, esthetics, and speech impediment were assessed. Results: In all the patients, fistula could be closed primarily by tongue flap. None of the patients developed flap necrosis while flap dehiscence and bleeding were observed in one patient each. No functional deformity of the tongue and donor-site morbidity was seen. Speech was improved in 80% cases. Conclusion: The central position, mobility, excellent vascularity, and versatility of tongue flap make particularly suitable choice for the repair of large fistula in palates scarred by previous surgery. It is very well tolerated by children. We, therefore, recommend tongue flap for large and recurrent palatal fistula in children.

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The use of buccal flap in the closure of posterior post-palatoplasty fistula

Cited by 22 publications

References 22 publications

Free Flap Reconstruction of Recalcitrant Defects in Cleft Palate Patients

Free Flap Reconstruction of Recalcitrant Defects in Cleft Palate Patients

Otological Challenges in Patients With Non-Syndromic Cleft Lip and Palate: A Systematic Review

Tongue flap as salvage procedure for recurrent and large palatal fistula after cleft palate repair

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