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Easy closure of anterior palatal fistula with local flaps.
J Craniofac Surg. 2010 Jan; 21(1):229-32.JC

Abstract

BACKGROUND

Anterior palatal fistula is often observed in the treatment of the cleft palate with a push-back palatoplasty. High rate of incomplete closure is reported. We describe a reliable new technique with reverse local flaps to close an anterior palatal fistula.

MATERIALS AND METHODS

One hundred seventeen cleft patients, treated with push-back palatoplasty, underwent repair of an anterior palatal fistula by our group. Fistulas were located in the anterior hard palate, with a variable size between 0.1 cm to more than 0.5 cm. Two reverse local flaps from the nasal mucosa of the lateral palatal edges are used to close the fistula. A third flap is elevated from the premaxilla in bilateral clefts. The flaps are elevated toward the center of the fistula. The closure is made in 2 layers for unilateral cleft and in 3 layers for bilateral cleft, using absorbable sutures.

RESULTS

Complete closure of the anterior palatal fistula was achieved in 77 patients (65%) after the first surgery, 27 patients (23%) required a second attempt to close the fistula, and 10 patients (8.5%) required a third surgery. Three patients (2.5%) continued to have a fistula after 5 surgeries.

CONCLUSIONS

We believe that our method is reliable and easy to perform, and it has a high success rate. The technique is indicated to correct small- to medium-size defects.

Authors+Show Affiliations

Department of Head and Neck Surgery, Second University of Naples, Naples, Italy.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

20072005

Citation

Freda, Nicola, et al. "Easy Closure of Anterior Palatal Fistula With Local Flaps." The Journal of Craniofacial Surgery, vol. 21, no. 1, 2010, pp. 229-32.
Freda N, Rauso R, Curinga G, et al. Easy closure of anterior palatal fistula with local flaps. J Craniofac Surg. 2010;21(1):229-32.
Freda, N., Rauso, R., Curinga, G., Clemente, M., & Gherardini, G. (2010). Easy closure of anterior palatal fistula with local flaps. The Journal of Craniofacial Surgery, 21(1), 229-32. https://doi.org/10.1097/SCS.0b013e3181c5a179
Freda N, et al. Easy Closure of Anterior Palatal Fistula With Local Flaps. J Craniofac Surg. 2010;21(1):229-32. PubMed PMID: 20072005.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Easy closure of anterior palatal fistula with local flaps. AU - Freda,Nicola, AU - Rauso,Raffaele, AU - Curinga,Giuseppe, AU - Clemente,Marco, AU - Gherardini,Giulio, PY - 2010/1/15/entrez PY - 2010/1/15/pubmed PY - 2010/5/5/medline SP - 229 EP - 32 JF - The Journal of craniofacial surgery JO - J Craniofac Surg VL - 21 IS - 1 N2 - BACKGROUND: Anterior palatal fistula is often observed in the treatment of the cleft palate with a push-back palatoplasty. High rate of incomplete closure is reported. We describe a reliable new technique with reverse local flaps to close an anterior palatal fistula. MATERIALS AND METHODS: One hundred seventeen cleft patients, treated with push-back palatoplasty, underwent repair of an anterior palatal fistula by our group. Fistulas were located in the anterior hard palate, with a variable size between 0.1 cm to more than 0.5 cm. Two reverse local flaps from the nasal mucosa of the lateral palatal edges are used to close the fistula. A third flap is elevated from the premaxilla in bilateral clefts. The flaps are elevated toward the center of the fistula. The closure is made in 2 layers for unilateral cleft and in 3 layers for bilateral cleft, using absorbable sutures. RESULTS: Complete closure of the anterior palatal fistula was achieved in 77 patients (65%) after the first surgery, 27 patients (23%) required a second attempt to close the fistula, and 10 patients (8.5%) required a third surgery. Three patients (2.5%) continued to have a fistula after 5 surgeries. CONCLUSIONS: We believe that our method is reliable and easy to perform, and it has a high success rate. The technique is indicated to correct small- to medium-size defects. SN - 1536-3732 UR - https://www.unboundmedicine.com/medline/citation/20072005/Easy_closure_of_anterior_palatal_fistula_with_local_flaps_ L2 - https://doi.org/10.1097/SCS.0b013e3181c5a179 DB - PRIME DP - Unbound Medicine ER -