Repair of cleft palate by rotation–transposition of the two mucoperiosteal flaps: can this reduce the incidence of postoperative fistula?

Repair of cleft palate by rotation–transposition of the two mucoperiosteal flaps: can this... Successful primary closure of cleft palate is the only prophylaxis against postoperative fistula. Many factors are accused of causing fistula, but the most important factor is the repair under tension. We tried in this work to rotate one of the mucoperiosteal flaps backward (90–180°) to fill the midline gap at the point of maximum tension. The other flap is then transposed medially to fill the anterior gap of the cleft. This work was conducted in the Plastic Surgery Unit in Suez Canal University Hospital from March 2007 to March 2010. Forty-eight patients were operated on using with the modified technique. Fistula occurred in one patient (2.1% of patients). With the simplicity of this procedure and its success rates we recommend this method as an alternative to the standard von Langenbeck cleft palate repair especially with wide cleft palate or when there is much tension when suturing the oral mucosa. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png European Journal of Plastic Surgery Springer Journals

Repair of cleft palate by rotation–transposition of the two mucoperiosteal flaps: can this reduce the incidence of postoperative fistula?

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Publisher
Springer-Verlag
Copyright
Copyright © 2011 by Springer-Verlag
Subject
Medicine & Public Health; Plastic Surgery
ISSN
0930-343X
eISSN
1435-0130
D.O.I.
10.1007/s00238-010-0517-2
Publisher site
See Article on Publisher Site

Abstract

Successful primary closure of cleft palate is the only prophylaxis against postoperative fistula. Many factors are accused of causing fistula, but the most important factor is the repair under tension. We tried in this work to rotate one of the mucoperiosteal flaps backward (90–180°) to fill the midline gap at the point of maximum tension. The other flap is then transposed medially to fill the anterior gap of the cleft. This work was conducted in the Plastic Surgery Unit in Suez Canal University Hospital from March 2007 to March 2010. Forty-eight patients were operated on using with the modified technique. Fistula occurred in one patient (2.1% of patients). With the simplicity of this procedure and its success rates we recommend this method as an alternative to the standard von Langenbeck cleft palate repair especially with wide cleft palate or when there is much tension when suturing the oral mucosa.

Journal

European Journal of Plastic SurgerySpringer Journals

Published: Aug 1, 2011

References

  • Surgical repair of cleft lip and cleft palate
    Tibesar, RJ; Black, A; Sidman, JD
  • Increased fistula risk following palatoplasty in Treacher Collins syndrome
    Bresnick, S; Walker, J; Clarke-Sheehan, N; Reinisch, J
  • Modified Von Langenbeck cleft palate repair using an anterior triangular flap: decreased incidence of anterior oronasal fistulas
    Stewart, TL; Fisher, DM; Olson, JL

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