scholarly journals RECURRENT PALATAL FISTULA AND NASAL REGURGITATION;

2013 ◽  
Vol 20 (03) ◽  
pp. 390-398
Author(s):  
IRFAN ISHAQ ◽  
GHULAM QADIR FAYYAZ
Keyword(s):  
Social Stigma ◽  
Donor Site ◽  
Case Series ◽  
Fistula Closure ◽  
Medical Sciences ◽  
Palatal Fistula ◽  
Tongue Flap ◽  
Dorsal Tongue ◽  
Cleft Palate Repair ◽  
Nasal Regurgitation

Background: Post Palatoplasty fistulas are the common complications seen after cleft palate repair. This produce varioussymptoms including regurgitation of fluids into nasal cavity, interference with normal speech and middle ear problems . Although smallfistulas can be successfully treated with local flaps such as palatal or buccal mucosal flaps, large fistulas are difficult to treat. Because ofrich blood supply, tongue is a suitable and convenient source of large flap. The anteriorly based dorsal tongue flap is a safe and effectivemethod for closure of relatively large recurrent palatal fistula without any functional impairment of donor site. Objective: To determine thesuccess rate of Tongue flap in correction of the nasal regurgitation in recurrent palatal fistulas Duration of study: 12 months from 16thJuly 2010 to 15th July 2011. Study design: It was descriptive case series. Settings: This study was carried out in the department ofplastic surgery Services institute of medical sciences, Services Hospital Lahore. Methods: Forty patients who were having recurrentpalatal fistula included in this study. All underwent palatal fistula repair by dorsal tongue flap. Each patient was followed after one month ofoperation for fistula closure and correction of nasal regurgitation. Results: In this study 65 percent of the patients were male, while 35percent of them were female. 21 (52.5%) of the patients belonged to age group 10-15 years, while 14 (35.0%) of the respondents had 16-20 years of age and remaining 5 (12.5%) of them had 21-30 years of age. The 90 percent (out of 40) of the patients had complete fistulaclosure, while only 10.0 percent of them had not complete fistula closure. Nasal regurgitation was corrected in 38 (95 %) of the patientsand remaining 2 ( 5%) patients had un-corrected nasal regurgitation. Conclusions: Tongue flap is a effective and reliable method oftreatment, not only for palatal fistula closure but also treating nasal regurgitation which is a social stigma for patients in recalcitrant palatalfistula.

scholarly journals The Versatility of the Tongue Flap in the Closure of Palatal Fistula

2012 ◽  
Vol 5 (3) ◽  
pp. 145-159 ◽  
Author(s):  
Sathish M.S. Vasishta ◽  
Gopal Krishnan ◽  
Y.S. Rai ◽  
Anil Desai
Keyword(s):  
Donor Site ◽  
Maxillofacial Surgery ◽  
Donor Site Morbidity ◽  
Early Postoperative Period ◽  
Oral And Maxillofacial Surgery ◽  
Fistula Closure ◽  
Palatal Fistula ◽  
Tongue Flap ◽  
Flap Viability ◽  
Clinical Records

Aims Tongue flaps were introduced for intraoral reconstruction by Lexer in 1909. A retrospective study was performed in the Department of Oral and Maxillofacial Surgery, S.D.M. College of Dental Sciences (Dharwad, India), to assess the use of tongue flap in closure of palatal fistula. Material and Methods A total of 40 patients treated for palatal fistulas were included in this study from the period of January 1, 2000, to January 1, 2007; fistulas present in anterior and midpalate were considered. Patients’ preoperative photographs, clinical records, and preoperative speech analysis were recorded. Following completion of fistula closure, patients were assessed over 6 months to check flap viability, fistula closure, residual tongue function, aesthetics, and speech impediment. Results A total of 40 (24 male and 16 female) patients with palatal fistulas were treated with tongue flap in our study. Six patients were 4 to 6 years old, three were 7 to 10 years old, and 22 were 11 to 20 years old, which accounts for 68% of study subjects. There were nine patients 21 to 30 years old. In the early postoperative period, we encountered bleeding in one patient and sloughing in one patient. There are three recurrences, and two flaps were detached; all remaining cases showed satisfactory healing, and donor site morbidity was minimal. No speech deficits were evident. Conclusion Tongue flaps are used in cleft palate surgery because of their excellent vascularity, and the large amount of tissue that they provide has made tongue flaps particularly appropriate for the repair of large fistulas in palates scarred by previous surgery.

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

scholarly journals A retrospective analysis of incidence and management of palatal fistula

2018 ◽  
Vol 51 (03) ◽  
pp. 298-305 ◽  
Author(s):  
Ravi Kumar Mahajan ◽  
Amreen Kaur ◽  
Sardar Mahipal Singh ◽  
Prakash Kumar
Keyword(s):  
Cleft Palate ◽  
Retrospective Analysis ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Local Flaps ◽  
Palatal Fistula ◽  
Tongue Flap ◽  
Radial Forearm ◽  
Cleft Palate Repair ◽  
Palate Repair

ABSTRACTBackground: Cleft palate repair may be compromised by a number of complications, most commonly the development of a fistula. Fistulas may cause hypernasal speech, articulation problems and food or liquid regurgitation from the nose. Objective: The study determines the incidence and management of cleft palatal fistulas in a series of primary cleft palate repair surgeries. It is a retrospective analysis of total 185 palatal fistula cases operated at our hospital from the year 2004 to 2016. Subjects and Methods: Of 185 palatal fistulas, 132 cases had been operated at our institute for primary palatoplasty, and the rest 53 were the outside-operated cases. The patients with bilateral as well as unilateral cleft lip and palate were included. Isolated cleft palate patients were also included in the study. Palatal fistulas were subdivided into three types depending on their size. Anterior palatal fistulas were mostly treated by using tongue flap (65.57%), followed by local flaps (34.43%). Middle and posterior palatal fistulas were mostly treated by von Langenbeck Palatoplasty. One patient (>5 mm fistula) was treated using free radial forearm flap. Results: Anterior palatal fistulas (65.57%) were most commonly reported, followed by middle (24.86%) and posterior (9.18%). Most commonly, the size of the fistulas ranged from 2 mm to 5 mm. The complication rate was reported to be 3.75% in case of tongue flap and 11.9% complications were reported in case of local flaps. Conclusion: Tongue flap remains the flap of choice for managing very difficult and challenging anterior palatal fistulas compared to local flaps.

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.

Pedicle Tongue Flap for Palatal Fistula Closure

2016 ◽  
Vol 27 (8) ◽  
pp. 2146-2148 ◽  
Author(s):  
Guilherme Strujak ◽  
Tuanny Carvalho de Lima do Nascimento ◽  
Cassia Biron ◽  
Maurício Romanowski ◽  
Antonio Adilson Soares de Lima ◽  
...  
Keyword(s):  
Fistula Closure ◽  
Palatal Fistula ◽  
Tongue Flap

scholarly journals Single layer closure of palatal fistula using anteriorly based dorsal tongue flap

2009 ◽  
Vol 8 (2) ◽  
pp. 199-200 ◽  
Author(s):  
H. S. Charan Babu ◽  
A. Bhagvandas Rai ◽  
Manju Ananthakrishnan Nair ◽  
Meenakshi
Keyword(s):  
Single Layer ◽  
Palatal Fistula ◽  
Tongue Flap ◽  
Dorsal Tongue

scholarly journals Descriptive study of management of palatal fistula in one hundred and ninety-four cleft individuals

2011 ◽  
Vol 44 (01) ◽  
pp. 041-046
Author(s):  
Jyotsna Murthy
Keyword(s):  
Cleft Palate ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Descriptive Study ◽  
Surrounding Tissue ◽  
Palatal Fistula ◽  
Tongue Flap ◽  
Bilateral Cleft Lip ◽  
Cleft Palate Repair ◽  
Palate Repair

ABSTRACT Objective: Palatal fistula is a significant complication following cleft palate repair. The guidelines of management of the palatal fistula is dependent on the type of cleft, site of fistula, condition of surrounding tissue and associated problem. We studied the management and outcome of 194 cleft palate fistula in our institute. Design: We present the descriptive hospital-based study of management of palatal fistula in 194 cleft patients. We have excluded all the syndromic children and children whose anterior palate was not operated as per protocol. Settings: Of 194 cleft palate fistula, 37 had palate repair in our hospital and 157 were refereed with fistula following palate repair. The patients were evaluated by interdisciplinary team and plan of management was decided. Result: Various parameters like types of cleft, site of fistula and management of fistula were studied in all the patients. Fifty-two percent were in unilateral CLP and 30% in bilateral CLP because unilateral CLP is the commonest type of cleft. Postalveolar and hard palate region contributing to 67% of all fistulae, followed by junctional in (9%). Seventy-two percent of fistula were amenable for repair by local available tissue, 28% needed tongue flap due to shortage of tissue. Minor numbers have failure of procedure for fistula closure needing further management. Conclusions: This descriptive study present analysis of management of fistula in our institute. It also reinforces that patient with bilateral cleft lip and palate more likely to have shortage of local tissue needing the local flaps like tongue flap compare to other cleft types. The surgical management of fistula can be combined to tackle the associated problems.

Punch Grafting for the Management of Hard-to-Heal Diabetic Foot Ulcers: A Prospective Case Series

2021 ◽  
pp. 153473462110310
Author(s):  
Marta García-Madrid ◽  
Irene Sanz-Corbalán ◽  
Aroa Tardáguila-García ◽  
Raúl J. Molines-Barroso ◽  
Mateo López-Moral ◽  
...  
Keyword(s):  
Wound Healing ◽  
Clinical Outcomes ◽  
Diabetic Foot ◽  
Donor Site ◽  
Case Series ◽  
Foot Ulcers ◽  
Diabetic Foot Ulcers ◽  
Wound Debridement ◽  
Prospective Case Series

Punch grafting is an alternative treatment to enhance wound healing which has been associated with promising clinical outcomes in various leg and foot wound types. We aimed to evaluate the clinical outcomes of punch grafting as a treatment for hard-to-heal diabetic foot ulcers (DFUs). Six patients with chronic neuropathic or neuroischemic DFUs with more than 6 months of evolution not responding to conventional treatment were included in a prospective case series between May 2017 and December 2020. All patients were previously debrided using an ultrasound-assisted wound debridement and then, grafted with 4 to 6 mm punch from the donor site that was in all cases the anterolateral aspect of the thigh. All patients were followed up weekly until wound healing. Four (66.7%) DFUs were located in the heel, 1 (16.7%) in the dorsal aspect of the foot and 1 (16.7%) in the Achilles tendon. The median evolution time was 172 (interquartile range [IQR], 25th-75th; 44-276) weeks with a median area of 5.9 (IQR; 1.87-37.12) cm2 before grafting. Complete epithelization was achieved in 3 (50%) patients at 12 weeks follow-up period with a mean time of 5.67 ± 2.88 weeks. Two of the remaining patients achieved wound healing at 32 and 24 weeks, respectively, and 1 patient showed punch graft unsuccessful in adhering. The median time of wound healing of all patients included in the study was 9.00 (IQR; 4.00-28.00) weeks. The wound area reduction (WAR) at 4 weeks was 38.66% and WAR at 12 weeks was 88.56%. No adverse effects related to the ulcer were registered through the follow-up period. Autologous punch graft is an easy procedure that promotes healing, achieving wound closure in chronic DFUs representing an alternative of treatment for hard-to-heal DFUs in which conservative treatment has been unsuccessful.

scholarly journals Single-layer Closure with Tongue Flap for Palatal Fistula in Cleft Palate Patients

2016 ◽  
Vol 4 (8) ◽  
pp. e852 ◽  
Author(s):  
Abdulla K. Alsalman ◽  
Emran A. Algadiem ◽  
Mufeed Saeed Alwabari ◽  
Fatimah Jawad Almugarrab
Keyword(s):  
Cleft Palate ◽  
Single Layer ◽  
Palatal Fistula ◽  
Tongue Flap

Calcaneal Reconstruction With Free Deep Circumflex Iliac Artery Osseocutaneous Flap Following Aggressive Benign Bone Tumor Resection

2021 ◽  
pp. 107110072110252
Author(s):  
Mohamad Aizat Rosli ◽  
Wan Faisham Wan Ismail ◽  
Wan Azman Wan Sulaiman ◽  
Nor Azman Mat Zin ◽  
Syurahbil Abdul Halim ◽  
...  
Keyword(s):  
Iliac Artery ◽  
Donor Site ◽  
Tumor Resection ◽  
Case Series ◽  
Benign Tumors ◽  
Reconstruction Method ◽  
Short Term ◽  
Deep Circumflex Iliac Artery ◽  
First Case ◽  
Donor Site Pain

Background: Advances in limb-salvage techniques have made total calcanectomy and primary reconstruction possible in managing calcaneal aggressive benign tumors and selected cases of intraosseous malignant tumors. However, there is still no consensus on the operative approach, oncologic margin, and the best reconstruction method to date. These 2 cases describe our experience in calcaneal reconstruction with the free deep circumflex iliac artery (DCIA) osseocutaneous flap in benign aggressive calcaneal tumors. Methods: We reported 2 consecutive male and female patients, with an average age of 25 years (age 19 and 31, respectively), who underwent total calcanectomy and primary calcaneal reconstruction with the free DCIA osseocutaneous flaps for calcaneal chondroblastoma and giant cell tumor. A marginal resection of the entire calcaneus through the subtalar and calcaneocuboid joints (intra-articular approach) was performed in the first case and a wide local resection leaving 1 cm normal calcaneal bone margin anterosuperiorly (intraosseous approach) was performed in the second case. Results: The follow-up period averaged 48 months. Negative oncologic margins were achieved in both cases. The first case was complicated with venous thrombosis; however, the graft remained viable after emergency reexploration. Normal foot function was restored with good solid osseous union and bony hypertrophy observed. Both patients achieved good short-term functional and aesthetic outcomes with no donor site pain or disability. No local recurrence was reported either. Conclusion: Primary calcaneal reconstruction with the free DCIA osseocutaneous flap can lead to good short-term functional and aesthetic outcomes. Level of Evidence: Level IV, case series.

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