Pedicle Tongue Flap for Palatal Fistula Closure

Strujak, Guilherme; Nascimento, Tuanny Carvalho de Lima do; Biron, C R; Romanowski, Maurício; Lima, Antônio Adilson Soares de; Carlini, João Luiz

doi:10.1097/scs.0000000000003042

Cited by 13 publications

(16 citation statements)

References 15 publications

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“…9,10,13–25 Despite the fact that tongue flap has been proven to be a sturdy, reliable, and efficient means for the closure of hard palate fistula especially in the anterior region, there existed unsuccessful cases due to the over mobility of tongue, and sometimes the massive size of fistula. 4,10,26 For the unique case presented in this article, the anterior fistula due to its irregular shape and extended size of 4.5 × 5 cm was by far the largest fistula comparing with the ones reported in literature. In our case, a double anterior pedicle tongue flaps was designed for the patient based on the following reasons and principles: Firstly, tongue was divided into right and left halves by a medial fibrous septum.…”

Section: Discussionmentioning

confidence: 58%

Double Tongue Flaps for Anterior Huge Palatal Fistula Closure

Zhou

2019

Plastic and Reconstructive Surgery - Global Open

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Summary: Even though it is widely accepted that the tongue flap is effective and feasible for repair of huge palatal fistula, there still exist a few failed cases due to the severity or complicated situation. The aim of this paper is to report the validity and feasibility of using double tongue dorsal flaps to repair a huge anterior fistula. A 10-year-old boy diagnosed with Van de Woude syndrome with repaired bilateral cleft lip and palate presented with a huge anterior fistula divided by septum. A double tongue dorsal flap was designed to cover the fistula. The huge unusual anterior palatal fistula was repaired successfully by usage of double pedicle tongue flaps with a follow-up period of 1 month. The double tongue flap is an alternative choice to handle a large residual fistula in anterior part of palate which was divided into 2 fistulas by septum. This technique was indicated in the situation of large residual fistula in anterior part of palate which was divided into 2 fistulas by septum after bilateral cleft palate repair.

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Section: Discussionmentioning

confidence: 58%

Double Tongue Flaps for Anterior Huge Palatal Fistula Closure

Zhou

2019

Plastic and Reconstructive Surgery - Global Open

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“…Surgeons in the present study recommended that tongue flaps only be used if the patient will cooperate and would rarely use them before the age of 5 years. Recent retrospective studies of fistula repair with tongue flaps have suggested fistula recurrence rates of 8% to 10% (Mahajan et al, 2014; Sodhi et al, 2014; Strujak et al, 2016), although Saralaya et al (2019) reported a recurrence rate of 30% (4/13) for more complex fistulae. Despite the robustness of tongue flaps, a recent study comparing FAMM flaps and tongue flaps for anterior palatal fistula closure found that the 2 approaches had similar effectiveness (0% recurrence), but the FAMM flap required less operative time and had fewer postoperative speech and feeding issues (Sohail et al, 2016).…”

Section: Discussionmentioning

confidence: 99%

A Toolbox of Surgical Techniques for Palatal Fistula Repair

Rothermel

Lundberg

Samson

et al. 2020

The Cleft Palate Craniofacial Journal

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Objective: To provide an inventory of oronasal fistula repair techniques alongside expert commentary on which techniques are appropriate for each fistula type. Design: A 4-stage approach was used to develop a consensus on surgical techniques available for fistula repair: (1) in-person discussion of oronasal fistula cases among cleft surgeons, (2) development of a schema for fistula management using transcripts of the in-person case discussion, (3) evaluation of the preliminary schema via a web-based survey of additional cleft surgeons, and (4) revision of the management schema using survey responses. Participants: Six cleft surgeons participated in the in-person case discussion. Eleven additional surgeons participated in the web-based survey. Participants had diverse training experiences, having completed residency and fellowship at 20 different hospitals. Results: A schema for fistula management was developed, organized by fistula location. The schema catalogues all viable approaches for each location. For fistulae involving the soft palate, the schema stresses the importance of evaluating for velopharyngeal insufficiency (VPI) and incorporating VPI management into fistula repair. For fistulae involving the hard palate, the schema separately enumerates the techniques available for nasal lining repair and for oral lining repair in each region. The schema also catalogues the diversity of approaches to lingual- and labioalveolar fistula, including variation in timing, orthodontic preparation, and simultaneous alveolar bone grafting. Conclusions: This study employed consensus methods to create a comprehensive inventory of available fistula repair techniques and to identify preferential techniques among a diverse group of surgeons.

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“…Palatal fistula has a high rate of recurrence following repair. It was reported by Strujak et al, that fistula rates range as high as 58% after primary repair, and up to an average recurrence rate of nearly 33% after fistula repair [10] we thought of improving the wound healing process, and having noted the benefits of PRP offered in other surgical procedures, we decided to study if its application with palatal fistula repair could decrease the recurrence rate.…”

Section: Discussionmentioning

confidence: 99%

PRP Injection Effect on Palatal Fistula Repair: A Comparative Study

Emara

Makeen

Aboulhassan

2020

The Egyptian Journal of Plastic and Reconstructive Surgery

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Background: Palatal fistula after primary palate repair is an annoying problem for both patients and plastic surgeons. The incidence of fistula depends on the severity of the primary defect, the technique used for repair and the tension applied over the wound. Different methods are described for palatal fistula repair, starting from local mucoperiosteal flaps to free flaps.The recurrence rate of fistula after primary repair is about 23%, on the other hand the recurrence rate of fistula after its repair is higher as 25-33% up to 100%. Fistulas are classified according to its site and size. PRP is an autologous blood product, it promotes healing of wounds by its high platelet concentration and multiple growth factors, and also it decreases the risk of infection and increases neovascularization. PRP is used in several clinical applications as in oral maxillofacial, cardiac and plastic surgery.Methods: A comparative study was conducted on 20 patients with posterior palatal fistulas, who were divided into two groups, group A in which PRP was injected with fistula repair and group B fistula was repaired without PRP injection. Two flap palatoplasty (9 cases in each group) and Furlow technique (one case in each group) were used for both groups.Results: A total of 16 patients were followed-up for recurrence rate of fistulas, statistical analysis showed that in group A 25% had a recurrence, while in group B 50% of cases showed recurrence.Conclusion: PRP injection with the surgical repair of the palatal fistula has a role in decreasing the recurrence rate of the fistula and decreasing the need for further surgical interventions also, it is an easy, safe procedure and at an economic price.

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Pedicle Tongue Flap for Palatal Fistula Closure

Abstract: The use of anterior pedicle tongue flap for closing palatal fistulae demonstrates to be a safe procedure with high success rates (81% in this paper) when correctly indicated.

Cited by 13 publications

References 15 publications

Double Tongue Flaps for Anterior Huge Palatal Fistula Closure

Double Tongue Flaps for Anterior Huge Palatal Fistula Closure

A Toolbox of Surgical Techniques for Palatal Fistula Repair

PRP Injection Effect on Palatal Fistula Repair: A Comparative Study

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