scholarly journals Closure of Oronasal Fistulae Post Palatoraphy with Tongue Flap in Bilateral Complete Cleft Lip Palate Patient: A Case Report

2021 ◽  
Vol 16 (Supp. 1) ◽  
pp. 59-65
Author(s):  
Menik Sayekti ◽  
Liska Barus ◽  
Ni Putu Mira Sumarta ◽  
Norifumi Nakamura
Keyword(s):  
Cleft Lip ◽  
Surrounding Tissue ◽  
Common Complication ◽  
Closure Technique ◽  
Alveolar Cleft ◽  
Tongue Flap ◽  
Fibrotic Tissue ◽  
Cleft Lip Palate ◽  
Palate Patient ◽  
Tissue Defects

Oronasal fistulae are common complication following palatoraphy. There are several surgical procedures to repair oronasal fistulae. However, conventional oronasal fistulae closure technique is not always possible, especially when the surrounding tissue is replaced by fibrotic tissue due to previous palatoraphy. Tissue defects in oronasal fistulae should be replaced with tissues providing good vascularisation such as pedicle tongue flap. A case of pedicle tongue flap used to close oronasal fistulae was reported. Eleven-year-old girl, presented with oronasal fistulae and bilateral alveolar cleft after previous palatoraphy. The oronasal fistulae were closed with pedicled tongue flap. The healing was uneventful, and the division of the pedicle tongue flap was done three weeks later and closed primarily. There was no dehiscence of the wound and masticatory functions were recorded. Vascularised flap such as pedicle tongue flap is a preferred technique to close oronasal fistulae after palatoraphy.

scholarly journals Alveolar cleft and maximum cleft width as predictors for difficult laryngoscopy and intubation in patients with unilateral complete cleft lip and palate

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Gamal A. Abdelhameed ◽  
Wael A. Ghanem ◽  
Simon H. Armanios ◽  
Tamer Nabil Abdelrahman
Keyword(s):  
Body Weight ◽  
Odds Ratio ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Difficult Laryngoscopy ◽  
Secondary Outcome ◽  
Pediatric Airway ◽  
Alveolar Cleft ◽  
Cleft Lip Palate ◽  
Width Measurements

Abstract Background Cleft lip and palate is one of the commonest congenital anomalies, which have an impact on feeding, speech, and dental development away from the significant psychosocial sequel. Early surgical repair aims to restore appearance and function, and the modern techniques can leave many defects undetectable. Therefore, the anesthetic challenge facing the pediatric airway with such abnormalities is still of a great impact. The aim of our study among 189 patients enrolled is to correlate alveolar gap and maximum cleft width measurements as predictors of difficult laryngoscopy and intubation in infants with unilateral complete cleft lip/palate aging from 1 to 6 months. As a secondary outcome, their weight is to be correlated too as another parameter. Results The alveolar gap and maximum cleft width are both of equal high predictive power (p value ≤ 0.001) with 100% sensitivity for both and specificity of 76.10% and 82.39% respectively, with a cut off value of ≤ 10 mm and 11 mm for these dimensions respectively, and odds ratio of incidence of difficult intubation is 4.18 and 5.68 respectively, while body weight ≤ 5.75 kg has an odds ratio of 2.32. Conclusion Alveolar cleft and maximum cleft width can be used as predictors for anticipation of difficult laryngoscopy and intubation infant patients with unilateral complete cleft lip and palate, while body weight ≤ 5.75 kg increases the risk more than twice.

Simultaneous Harvesting of Cancellous Iliac Bone for Alveolar Cleft Closure and Dermis for Augmentation of Median Tubercle

2009 ◽  
Vol 46 (3) ◽  
pp. 295-298 ◽  
Author(s):  
Derek M. Steinbacher ◽  
Bonnie L. Padwa ◽  
John B. Mulliken
Keyword(s):  
Cancellous Bone ◽  
Cleft Lip ◽  
Posterior Approach ◽  
Donor Site ◽  
Iliac Region ◽  
Dermal Graft ◽  
Alveolar Cleft ◽  
Cleft Lip Palate ◽  
Cleft Closure ◽  
Secondary Closure

Children with repaired cleft lip/palate require secondary closure of the alveolar cleft and, often, nasolabial revision. We describe a technique performed in 61 patients for harvesting bone for the alveolar defect and dermis for augmentation of the median tubercle, taking both from the posterior iliac region. The advantages of the posterior approach are as follows: (1) the same donor site is used for cancellous bone and dermal graft and (2) the child's appearance is improved along with alveolar cleft grafting.

scholarly journals Does Early Repair of Cleft Lip Helps to Reduce the Cleft Alveolar and Palatal Gap in Unilateral Complete Cleft Lip - Palate Patients?

2014 ◽  
Vol 13 (3) ◽  
pp. 46-49
Author(s):  
Kazi Md Noor-ul Ferdous ◽  
Md Mafuzul Haq ◽  
S M Mashfiqur Rahman ◽  
Sabbir Karim ◽  
Md Mahabubul Alam ◽  
...  
Keyword(s):  
Family History ◽  
Postoperative Complications ◽  
Hard Palate ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Positive Family History ◽  
Fistula Formation ◽  
Cleft Lip Palate ◽  
Cleft Lip Repair ◽  
Palate Patient

Backgroud: Timing of surgery in the patients with cleft lip palate is an important factor of prognosis. Delaying in surgical repair of cleft lip and palate patient may lead to difficulty. It may causes wide, extensive and difficult dissection. There are always chances of wound infection, wound dehiscence, complete wound disruption, fistula formation, even there is also chance of maxillary hypoplasia and failure to articulate lifelong. The purpose of this study to observe the effects of cleft lip repair in early age on cleft alveolar and cleft palatal gap thus helps during cleft hard palate repair in patients with unilateral complete cleft lip and palate (UCLP). Methods: A retrospective study was done from January 2008 to July 2013. Patients with unilateral complete cleft lip and palate included in this study, who under went cleft lip at first admission and then and after 3 months of cleft palate was repaired. Patients with previous cleft lip-palate surgery were excluded. The gaps of cleft alveolus and posterior border of the cleft hard palate were recorded during 1st and 2nd operations. Age, gender, side of the cleft, associated anomalies, family history of cleft, cleft alveolar and cleft palatal gap noted, postoperative complications were also recorded. All the data were Results: A total of 63 patients included in this study. Age ranged from 4 months to 8 years. 38 patients were male and 25 were female. Right side was involved in 20 and 43 patients involved in left side. Eight patients had positive family history. Nine had associated congenital anomalies. Cleft alveolar and palatal gap reduced more in the patients who were below the age of 18 months. Postoperative complications were mild respiratory distress, notching of vermilion border developed oronasal fistula.Conclusion: In unilateral complete cleft lip palate patient, early cleft lip repair results, reduction of gaps of alveolar cleft and that of hard palate remarkably, especially in the patients who came for cleft lip surgery in appropriate time.DOI: http://dx.doi.org/10.3329/cmoshmcj.v13i3.21023

Polyphosphate (PolyP) for alveolar cleft repair, study protocol for a pilot randomized controlled trial.

2021 ◽  
Author(s):  
Salem Alkaabi ◽  
Diandra S Natsir Kalla ◽  
Abul Fauzi ◽  
Andi Tajrin ◽  
WEG Müller ◽  
...  
Keyword(s):  
Bone Formation ◽  
Cleft Lip ◽  
Controlled Trial ◽  
High Energy ◽  
Graft Material ◽  
Radiographic Imaging ◽  
Code Number ◽  
Alveolar Cleft ◽  
Cleft Lip Palate ◽  
Safety Parameters

Abstract Objective: Bone grafting is an important surgical procedure to restore missing bone in patients with alveolar cleft lip/palate, aiming to stabilize either sides of maxillary segments by inducing new bone formation, and in bilateral cleft cases also to stabilize the pre- maxilla. Polyphosphate (PolyP), a physiological polymer composed of orthophosphate units linked together with high-energy phosphate bonds, is a naturally existing compound in platelets which, when complexed with calcium as Ca-polyP microparticles (Ca-polyP MPs), was proven to have osteoinductive properties in preclinical studies. Aim: To evaluate the feasibility, safety and osteoinductivity of Ca-polyP MPs as a bone-inducing graft material in humans. Methods: This prospective non-blinded first-in-man clinical pilot study shall consist of 8 alveolar cleft patients of 13 years or older to evaluate the feasibility and safety of Ca-PolyP MPs as a bone-inducing graft material. Patients will receive Ca-polyP graft material only, or Ca-polyP in combination with biphasic calcium phosphate (BCP) as a bone substitute carrier. During the trial, the participants will be investigated closely for safety parameters using radiographic imaging, regular blood tests, and physical examinations. After 6 months, a hollow drill will be used to prepare the implantation site to obtain a biopsy. The radiographic imaging will be used for clinical evaluation; the biopsy will be processed for histological/histomorphometric evaluation of bone formation. Discussion: This is the first-in-man study evaluating the safety and feasibilty of the polyP as well as the potential regenerative capacity of polyP using an alveolar cleft model.Trial registration {31a} The clinical trial protocol received a written approval by the ethical committee of Faculty of Medicine, Hasanuddin University, Makassar, Indonesia with code number 1063/UN4.6.4.5.31/PP36/2019. On completion of the trial, the results on safety, feasibility and bone formation with polyP as graft material will published.

Closure of a Large Palatal Fistula with Maxillary Segmental Distraction Osteogenesis in a Cleft Palate Patient

2007 ◽  
Vol 44 (1) ◽  
pp. 112-115 ◽  
Author(s):  
Alper Alkan ◽  
Burcu Baş ◽  
Mete Özer ◽  
Mehmet Bayram
Keyword(s):  
Cleft Palate ◽  
Distraction Osteogenesis ◽  
Closure Technique ◽  
Palatal Fistula ◽  
Surgical Closure ◽  
Tongue Flap ◽  
Palate Patient

Various techniques have been proposed for the repair of palatal clefts. The first surgical closure technique that should be kept in mind is the use of adjacent mucosal flaps. When the palatal cleft is too large to close with adjacent mucosal flaps, distant flaps such as from the tongue or nasolabial region may be considered. This report presents a cleft patient who had previously undergone an unsuccessful palatal cleft repair with a tongue flap. The size of the large palatal fistula was reduced by approximating the segments to each other with maxillary anterior segmental distraction osteogenesis to make it more manageable using conventional mucosal flaps.

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