Is a one stage or two stage cleft palate repair more beneficial in children with complete one sided cleft palate defects with respect to speech development and palatal fistula formation?

2017 ◽  
Author(s):  
Rajgopal Reddy
Keyword(s):  
Cleft Palate ◽  
Speech Development ◽  
Fistula Formation ◽  
Two Stage ◽  
Palatal Fistula ◽  
One Stage ◽  
Cleft Palate Repair ◽  
Palate Repair

scholarly journals Considerations Regarding Age at Surgery and Fistula Incidence Using One- and Two-stage Closure for Cleft Palate

2013 ◽  
Vol 59 (6) ◽  
pp. 302-305 ◽  
Author(s):  
Stoicescu Simona ◽  
Enescu Dm
Keyword(s):  
Cleft Palate ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Surgical Techniques ◽  
Fistula Formation ◽  
Two Stage ◽  
One Stage ◽  
Age At Surgery ◽  
Cleft Palate Repair ◽  
Palate Repair

Abstract Introduction: Although cleft lip and palate (CLP) is one of the most common congenital malformations, occurring in 1 in 700 live births, there is still no generally accepted treatment protocol. Numerous surgical techniques have been described for cleft palate repair; these techniques can be divided into one-stage (one operation) cleft palate repair and two-stage cleft palate closure. The aim of this study is to present our cleft palate team experience in using the two-stage cleft palate closure and the clinical outcomes in terms of oronasal fistula rate. Material and methods: A retrospective analysis was performed on medical records of 80 patients who underwent palate repair over a five-year period, from 2008 to 2012. All cleft palate patients were incorporated. Information on patient’s gender, cleft type, age at repair, one- or two-stage cleft palate repair were collected and analyzed. Results: Fifty-three (66%) and twenty-seven (34%) patients underwent two-stage and one-stage repair, respectively. According to Veau classification, more than 60% of them were Veau III and IV, associating cleft lip to cleft palate. Fistula occurred in 34% of the two-stage repairs versus 7% of one-stage repairs, with an overall incidence of 24%. Conclusions: Our study has shown that a two-stage cleft palate closure has a higher rate of fistula formation when compared with the one-stage repair. Two-stage repair is the protocol of choice in wide complete cleft lip and palate cases, while one-stage procedure is a good option for cleft palate alone, or some specific cleft lip and palate cases (narrow cleft palate, older age at surgery)

scholarly journals Incidence of Palatal Fistula after One-Stage Palatoplasty and Factors Influencing the Fistula Occurrence

1970 ◽  
Vol 2 (4) ◽  
Author(s):  
Nurardhilah Vityadewi ◽  
Kristaninta Bangun
Keyword(s):  
Body Weight ◽  
Cleft Palate ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Fistula Formation ◽  
Bivariate Analysis ◽  
One Stage ◽  
Cleft Palate Repair ◽  
Hypernasal Speech ◽  
Palate Repair

Background: Cleft palate repair may be compromised by a number of complications, most commonly the development of a fistula. Fistulas are related to an increased rate of hypernasal speech, articulation problems, and food or liquid regurgitation from the nose. Fistulas also tend to recur after a secondary repair to address the fistulas. This study reviews the rate of fistula in our craniofacial center after a onestage cleft palate repair; and to determine whether, cleft type, age at repair, type of cleft repair, hemoglobin level presurgery, and patients nutritional state influence the risk of fistula occurence. Patient and Method: A retrospective analysis was performed on medical records of 93 patients who underwent palate repair between January 2012 to October 2013. All consecutive cleft (lip and) palate patients are included. Bivariate analysis was performed to identify the predictors of fistula formation. Result: Ninety-three patients (50 male and 43 female) underwent one-stage palatoplasty. Cleft palate fistulas occured in 19 of 93 patients (20,4%). The age of the patients at the time of repair ranged from 9 to 144 months (mode 18 months). All palate repairs were done in one stage, using either the two flap (N=66), Wardill-Kilner (N=24), Furlow (N=2), and Langenback (N=1) techniques. No significant influence was found related between age at the time of repair (p 0.789), body weight (p 0.725), Hemoglobin value (p 0.295), and type of cleft (p 0.249) to the rate of fistula occurrence. Summary: This study found no association between , body weight, preoperative hemoglobin value, and the type of cleft to the rate of fistula following cleft palate surgery.

scholarly journals Effect of collagen matrix on postoperative palatal fistula in cleft palate repair

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Jeong Hyun Ha ◽  
Yeonwoo Jeong ◽  
Youn Taek Koo ◽  
Sungmi Jeon ◽  
Jeehyeok Chung ◽  
...  
Keyword(s):  
Cleft Palate ◽  
Characteristic Curve ◽  
Collagen Matrix ◽  
Fistula Formation ◽  
Collagen Membrane ◽  
Palatal Fistula ◽  
Postoperative Fistula ◽  
Cleft Palate Repair ◽  
Palate Repair ◽  
Collagen Graft

Abstract Palatal fistula is a challenging complication following cleft palate repair. We investigated the usefulness of collagen matrix in the prevention of postoperative fistula. We performed a retrospective cohort study of patients with cleft palate who underwent primary palatoplasty (Furlow’s double opposing z-plasty) in Seoul National University Children’s Hospital. Collagen Graft and Collagen Membrane (Genoss, Suwon, Republic of Korea) were selectively used in patients who failed complete two-layer closure. The effect of collagen matrix on fistula formation was evaluated according to palatal ratio (cleft width to total palatal width) and cleft width. A total of 244 patients (male, 92 and female, 152; median age, 18 months) were analyzed. The average cleft width was 7.0 mm, and the average palatal ratio was 0.21. The overall fistula rate was 3.6% (9/244). Palatal ratio (p = 0.014) and cleft width (p = 0.004) were independent factors impacting the incidence of postoperative fistula. Receiver operating characteristic curve analysis showed that the cutoff values in terms of screening for developing postoperative fistula were a palatal ratio of 0.285 and a cleft width of 9.25 mm. Among nonsyndromic patients with values above those cutoffs, the rates of fistula development were 0/5, 1/6 (16.7%), and 4/22 (18.2%) for those who received Collagen Graft, Collagen Membrane, and no collagen, respectively. Collagen matrix may serve as an effective tool for the prevention of palatal fistula when complete two-layer closure fails, especially in wide palatal clefts. The benefit was most evident in Collagen Graft with thick and porous structure.

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

2018 ◽  
Vol 15 (2) ◽  
pp. 88
Author(s):  
Advait Prakash ◽  
Sangram Singh ◽  
Shailesh Solanki ◽  
Bhavesh Doshi ◽  
Venkatesh Kolla ◽  
...  
Keyword(s):  
Cleft Palate ◽  
Salvage Procedure ◽  
Palatal Fistula ◽  
Tongue Flap ◽  
Cleft Palate Repair ◽  
Palate Repair

Cleft Palate

2018 ◽  
Author(s):  
Oksana A Jackson ◽  
Alison E Kaye ◽  
David W Low
Keyword(s):  
Cleft Palate ◽  
Normal Function ◽  
Speech Development ◽  
Velopharyngeal Insufficiency ◽  
Surgical Interventions ◽  
Feeding Difficulties ◽  
Oronasal Fistula ◽  
Cleft Palate Repair ◽  
Palate Repair ◽  
Impaired Speech

A cleft of the palate represents one of the most common congenital anomalies of the craniofacial region. Palatal clefting can occur in combination with a cleft of the lip and alveolus or as an isolated finding and can vary significantly in severity. The intact palate is a structure that separates the oral and nasal cavities, and the function of the palate is to close off the nasal cavity during deglutition and to regulate the flow of air between the nose and mouth during speech production. An unrepaired cleft palate can thus result in nasal regurgitation of food and liquid, early feeding difficulties, and impaired speech development. The goals of surgical repair are to restore palatal integrity by closing the cleft defect and repairing the musculature to allow for normal function during speech. The secondary goal of cleft palate repair is to minimize deleterious effects on growth of the palate and face, which can be impacted by standard surgical interventions. This review describes two of the most commonly performed cleft palate repair techniques in use today, as well as highlighting special anatomic considerations, summarizing perioperative care, and reviewing postoperative complications and their management. This review contains 11 figures, 2 videos, 3 tables and 63 references Key words: cleft, cleft team, Furlow, orofacial, oronasal fistula, palatoplasty, speech, submucous cleft, velopharyngeal insufficiency

Effects of phenytoin spray in prevention of fistula formation following cleft palate repair

2019 ◽  
Vol 47 (12) ◽  
pp. 1887-1890
Author(s):  
Shahin Abdollahi Fakhim ◽  
Masoud Nouri-Vaskeh ◽  
Mohamad Amin Fakhriniya
Keyword(s):  
Cleft Palate ◽  
Fistula Formation ◽  
Cleft Palate Repair ◽  
Palate Repair

Effects of Cleft Width and Veau Type on Rates of Palatal Fistula and Velopharyngeal Insufficiency after Cleft Palate Repair

2012 ◽  
Vol 130 ◽  
pp. 23 ◽  
Author(s):  
Nance Yuan ◽  
Amir H. Dorafshar ◽  
Keith E. Follmar ◽  
Courtney Pendleton ◽  
Richard J. Redett
Keyword(s):  
Cleft Palate ◽  
Velopharyngeal Insufficiency ◽  
Palatal Fistula ◽  
Cleft Palate Repair ◽  
Palate Repair
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