Total Palatal Mobilization and Multilamellar Suturing Technique Improves Outcome for Palatal Fistula Repair

2017 ◽  
Vol 79 (6) ◽  
pp. 566-570 ◽  
Author(s):  
Ahmed Elsherbiny ◽  
John H. Grant
Keyword(s):  
Fistula Repair ◽  
Palatal Fistula ◽  
Suturing Technique

Addition to the Toolbox of Surgical Techniques for Palatal Fistula Repair

2021 ◽  
pp. 105566562110037
Author(s):  
Catherine de Blacam ◽  
David Orr
Keyword(s):  
Bone Graft ◽  
Cancellous Bone ◽  
Hard Palate ◽  
Surgical Techniques ◽  
Cancellous Bone Graft ◽  
Fistula Repair ◽  
Palatal Fistula

In response to the article by Rothermel and colleagues, the authors suggest the use of cancellous bone graft for repair of fistulae of the hard palate as an addition to the proposed toolbox.

scholarly journals Palatal Mucoperiosteal Expansion as an Adjunct to Palatal Fistula Repair: Case Report and Review of the Literature

1996 ◽  
Vol 33 (3) ◽  
pp. 255-257 ◽  
Author(s):  
Philip A. Van Damme ◽  
Hans Peter M. Freihofer
Keyword(s):  
Case Report ◽  
Soft Tissue ◽  
Cleft Palate ◽  
Tissue Expander ◽  
Tissue Expansion ◽  
Review Of The Literature ◽  
Fistula Closure ◽  
Fistula Repair ◽  
Palatal Fistula ◽  
Oronasal Fistula

Case report of conventional palatal soft-tissue expansion in an attempt at cleft palate fistula closure with a standard tissue expander. This technique may be an alternative to a tongue flap to promote closure of persistent oronasal fistula.

scholarly journals Role of tongue flap in palatal fistula repair: A series of 41 cases

2014 ◽  
Vol 47 (02) ◽  
pp. 210-215 ◽  
Author(s):  
Ravi Kumar Mahajan ◽  
Rahul Chhajlani ◽  
Harish C. Ghildiyal
Keyword(s):  
Central Position ◽  
Local Flaps ◽  
Fistula Closure ◽  
Fistula Repair ◽  
Tissue Quality ◽  
Palatal Fistula ◽  
Tongue Flap ◽  
Repair Materials

ABSTRACT Introduction: Despite the improved techniques of repair of cleft palate, fistula occurrence is still a possibility either due to an error in the surgical technique or due to the poor tissue quality of the patient. Though commonly the fistula closure is established by use of local flaps but at times the site and the size of the fistula make use of local flaps for its repair a remote possibility. The use of tongue flaps because of the central position in the floor of the mouth, mobility and the diversity of positioning the flaps make it a method of choice for closure of anterior palatal fistulae than any other tissues. The aim of this study was to analyse the utility of tongue flap in anterior palatal fistula repair. Materials and Methods: We had 41 patients admitted to our hospital during the period 2006-2012 for repair of palatal fistula and were enrolled into the study. In the entire 41 cases, fistula was placed anteriorly. The size of the fistulae varied from 2 cm × 1.5 cm to 5.5 cm × 3 cm. The flaps were divided after 3-week and final inset of the flap was done. Observation and Result: None of the patients developed flap necrosis, in one case there was the dehiscence of the flap, which was reinset and in one patient there was bleeding. None of our patients developed functional deformity of the tongue. Speech was improved in 75% cases. Conclusion: Leaving apart its only drawback of two-staged procedure and transient patient discomfort, tongue flap remains the flap of choice for managing very difficult and challenging anterior palatal fistulae.

scholarly journals Incidence of Palatal Fistula at Time of Secondary Alveolar Cleft Reconstruction

2018 ◽  
Vol 55 (7) ◽  
pp. 999-1005 ◽  
Author(s):  
Vikram A. Shankar ◽  
Alison Snyder-Warwick ◽  
Gary B. Skolnick ◽  
Albert S. Woo ◽  
Kamlesh B. Patel
Keyword(s):  
Bone Grafting ◽  
Cleft Lip And Palate ◽  
Alveolar Bone ◽  
Univariate Analysis ◽  
Fistula Formation ◽  
Maxillary Expansion ◽  
Fistula Repair ◽  
Palatal Fistula ◽  
Reporting Practices ◽  
Alveolar Bone Grafting

Objective: We aim to establish consistent time points for evaluating palatal fistula incidence to standardize reporting practices and clarify prospective literature. Design: An institutional retrospective chart review was conducted on 76 patients with unilateral or bilateral complete cleft lip and palate who underwent secondary alveolar bone grafting between 2006 and 2015. Main Outcome Measures: Early fistula incidence rates were reported prior to maxillary expansion, and late fistula rates were reported at the time of alveolar bone grafting. Fistula recurrence rates after primary repair were also measured. Results: We found an early fistula incidence rate of 20% (n = 15) and a late fistula rate of 55% (n = 42) at the time of secondary ABG. Fistulae recurred after initial repair in 43% of cases. Fistulae were classified using the Pittsburgh Classification System as type III (33%), type IV (60%), or type V (7%). The presence of a bilateral cleft ( P = 0.01) and history of early fistula repair ( P < 0.01) were associated with late fistula incidence in a univariate analysis. In a logistic regression model, only early fistula repair was associated with late fistula incidence (OR = 17.17) and overall likelihood of recurrence (OR = 70.89). Conclusions: Early fistulae should be reported prior to orthodontic expansion of the maxillary arch. Late fistulae should be reported at the time of ABG, following palatal expansion. Patients who develop an early fistula after palatoplasty are likely to experience recurrent fistula formation.

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