scholarly journals The Incidence of Palatal Fistula Postpalatoplasty in Children with Dental Caries: A Multi Centre Study

1970 ◽  
Vol 2 (2) ◽  
Author(s):  
Defry Utama ◽  
Frank Buchari ◽  
Gentur Sudjatmiko
Keyword(s):  
Dental Caries ◽  
Cleft Palate ◽  
Cleft Lip ◽  
Multi Centre Study ◽  
Palatal Fistula ◽  
Cleft Palate Repair ◽  
Palate Repair ◽  
Plaque Control ◽  
Craniofacial Abnormality

Background: Cleft lip and/or palate (CL&/P) is the most common congenital craniofacial abnormality, affecting approximately 1 in every 700 newborns. Patients with cleft lip and/or palate (CL&/P) generally display poor oral hygiene and a higher prevalence of caries. This may be due to the difficulty in achieving adequate plaque control associated with dental anomalies and defects from the lips and/or palate. Palatal fistula is a significant complication following cleft palate repair. It is the aim of this research to find correlation between palatal fistula and dental caries. Patient and Method: Patients with unilateral complete cleft palates admitted to the Cipto Mangunkusumo hospital, Adam Malik hospital within the period July 2012 till March 2013 were included in this study. All cases underwent modified two flap palatoplasty leaving lateral periosteum technique and follow-up were done in two weeks to see if there are any palatal fistula. Result: Thirty eight patients with unilateral cleft palate were enrolled in the study. Fifteen (39.5%) of them are boys and 23 (60.5%) are girls. Fifteen of the patients (41.7%) had dental caries, with six patients (40%) had palatal fistula in the follow up after palatoplasty, while there was none (0%) of the 21 (58.3%) patients that were found negative for dental caries developed a fistula. Conclusion: Dental caries is one of the important predisposing factors of palatal fistula in patients who undergo palatoplasty.

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 Cleft Palate Outcomes and Prognostic Impact of Palatal Fistula on Subsequent Velopharyngeal Function—A Retrospective Cohort Study

2019 ◽  
Vol 56 (8) ◽  
pp. 1008-1012 ◽  
Author(s):  
Alistair G. Smyth ◽  
Jianhua Wu
Keyword(s):  
Cleft Palate ◽  
Retrospective Cohort ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Prognostic Impact ◽  
Palatal Fistula ◽  
Primary Surgery ◽  
Cleft Palate Repair ◽  
Palate Repair ◽  
Velopharyngeal Function

Objective: To assess outcomes from cleft palate repair and define the level of impact of palatal fistula on subsequent velopharyngeal function. Design: A retrospective cohort study. Setting: A regional specialist cleft lip and palate center within United Kingdom. Patients, Participants: Nonsyndromic infants born between 2002 and 2009 undergoing cleft palate primary surgery by a single surgeon with audited outcomes at 5 years of age. Four hundred ten infants underwent cleft palate surgery within this period and 271 infants met the inclusion criteria. Interventions: Cleft palate repair including levator palati muscle repositioning with or without lateral palatal release. Main Outcome Measures: Postoperative fistula development and velopharyngeal function at 5 years of age. Results: Lateral palatal incisions were required in 57% (156/271) of all cases. The fistula rate was 10.3% (28/271). Adequate palatal function with no significant velopharyngeal insufficiency (VPI) was achieved in 79% of patients (213/271) after primary surgery only. Palatal fistula was significantly associated with subsequent VPI (risk ratio = 3.03, 95% confidence interval: 1.95-4.69; P < .001). The rate of VPI increased from 18% to 54% when healing was complicated by fistula. Bilateral cleft lip and palate (BCLP) repair complicated by fistula had the highest incidence of VPI (71%). Conclusions: Cleft palate repair with levator muscle repositioning is an effective procedure with good outcomes. The prognostic impact of palatal fistula on subsequent velopharyngeal function is defined with a highly significant 3-fold increase in VPI. Early repair of palatal fistula should be considered, particularly for large fistula and in BCLP cases.

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.

Impact of cleft palate repair on speech and development of dentoalveolar deformities

2021 ◽  
Vol 16 (3) ◽  
pp. 47-53
Author(s):  
Yu.V. Stebeleva ◽  
◽  
Ad.A. Mamedov ◽  
Yu.O. Volkov ◽  
A.B. McLennan ◽  
...  
Keyword(s):  
Cleft Palate ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Surgical Techniques ◽  
Normal Functioning ◽  
Primary Surgery ◽  
Cleft Palate Repair ◽  
Congenital Cleft ◽  
Palate Repair ◽  
Late Postoperative Period

Surgical repair of cleft palate is quite difficult because it aims not only to eliminate the anatomical defect of the palate, but also to ensure normal functioning, including speech. Moreover, successful surgery implies no or minimal deformation of the middle face that can be corrected in the late postoperative period. No doubt that primary surgery (both in terms of technique and time) is crucial for further growth and development of the maxilla. However, surgical techniques and the age of primary cleft palate repair vary between different clinics, which makes this literature review highly relevant. Key words: cleft palate repair, cleft palate, congenital cleft lip and palate

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 Corelation Of Parents’ Profiles Of Children With Late Cleft Repair In Surabaya Cleft Lip And Palate Centre (January 2015 – December 2017)

2021 ◽  
Vol 5 (1) ◽  
pp. 18
Author(s):  
Laras Puspita Ningrum ◽  
Iswinarno Doso Saputro ◽  
Lobredia Zarasade
Keyword(s):  
Cleft Palate ◽  
Primary Care Physicians ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Speech Disorders ◽  
Education Level ◽  
Optimal Time ◽  
Cross Sectional ◽  
Cleft Palate Repair ◽  
Palate Repair

Background : Optimal time of  Cleft palate repair is during the 10 to 12  month of age. In this time produce far natural results in terms of speech because it enabled the maturation of scar tissue postoperatively. The soft palate must function properly before the patient starts learning to talk, otherwise speech disorders such as persistent rhinolalia aperta might arise. In pediatric patients, the role of parents is very important on adherence to therapy.Methods: This is a cross-sectional study. The first study group was parents of patients who had surgical repair before two years old and the second group was the parents of patients who had repair after two years old. We compared age, monthly income, education level, number of children, and residential distance from Surabaya of the two groups.Results : The data of this study were obtained from the medical records of patients with cleft lip surgery at CLP Center Surabaya in 2015th – 2017th with total of 358 patients, 172 were female and 186 were male. 52 patients with delayed cleft palate surgery. Patients’ parents in both groups were mostly 31-40 years old, were high school graduated, has one child, earned less than 1.5 million rupiah a month, and lived less than 100 kms from Surabaya. From the statistical results, parent’s income has the strongest correlation with the patient’s age in cleft palate surgery (-2.7). A negative coefficient means that the less parent’s income, the more patient likely had delayed cleft palate surgery. While other factors found weak and very weak correlations.Conclusions: The results form patient's parents' interview, concluded that besides economic factors, the lack of information cleft palate treatment is the key factors that contributed to the delay of cleft palate repair. The education level does not affect the delay in cleft palate surgery, because even in high educated parents, sometimes they don’t understand the stages of cleft lip and palate treatment. This study emphasized the necessity to educate about the stages of surgery by primary care physicians, to minimize delays.

Effects of Cleft Width and Veau Type on Rates of Palatal Fistula and Velopharyngeal Insufficiency after Cleft Palate Repair

2012 ◽  
Vol 130 ◽  
pp. 23 ◽  
Author(s):  
Nance Yuan ◽  
Amir H. Dorafshar ◽  
Keith E. Follmar ◽  
Courtney Pendleton ◽  
Richard J. Redett
Keyword(s):  
Cleft Palate ◽  
Velopharyngeal Insufficiency ◽  
Palatal Fistula ◽  
Cleft Palate Repair ◽  
Palate Repair

Improved Early Cleft Lip and Palate Complications at a Surgery Specialty Center in the Developing World

2018 ◽  
Vol 55 (8) ◽  
pp. 1145-1152 ◽  
Author(s):  
Eugene Park ◽  
Gaurav Deshpande ◽  
Bjorn Schonmeyr ◽  
Carolina Restrepo ◽  
Alex Campbell
Keyword(s):  
Cleft Palate ◽  
Cleft Lip ◽  
Developing World ◽  
Cleft Lip And Palate ◽  
Care Delivery ◽  
Complication Rates ◽  
Surgical Mission ◽  
Cleft Palate Repair ◽  
Cleft Lip Repair ◽  
Palate Repair

Objective: To evaluate complication rates following cleft lip and cleft palate repairs during the transition from mission-based care to center-based care in a developing region. Patients and Design: We performed a retrospective review of 3419 patients who underwent cleft lip repair and 1728 patients who underwent cleft palate repair in Guwahati, India between December 2010 and February 2014. Of those who underwent cleft lip repair, 654 were treated during a surgical mission and 2765 were treated at a permanent center. Of those who underwent cleft palate repair, 236 were treated during a surgical mission and 1491 were treated at a permanent center. Setting: Two large surgical missions to Guwahati, India, and the Guwahati Comprehensive Cleft Care Center (GCCCC) in Assam, India. Main Outcome Measure: Overall complication rates following cleft lip and cleft palate repair. Results: Overall complication rates following cleft lip repair were 13.2% for the first mission, 6.7% for the second mission, and 4.0% at GCCCC. Overall complication rates following cleft palate repair were 28.0% for the first mission, 30.0% for the second mission, and 15.8% at GCCCC. Complication rates following cleft palate repair by the subset of surgeons permanently based at GCCCC (7.2%) were lower than visiting surgeons ( P < .05). Conclusions: Our findings support the notion that transitioning from a mission-based model to a permanent facility-based model of cleft care delivery in the developing world can lead to decreased complication rates.

Association Between Palatal Index and Cleft Palate Repair Outcomes in Patients With Complete Unilateral Cleft Lip and Palate

2014 ◽  
Vol 16 (3) ◽  
pp. 206-210 ◽  
Author(s):  
Percy Rossell-Perry ◽  
Evelyn Caceres Nano ◽  
Arquímedes M. Gavino-Gutierrez
Keyword(s):  
Cleft Palate ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Cleft Palate Repair ◽  
Palate Repair
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