OBJECTIVE: To evaluate the prevalence of fistulas after palate repair and analyze their location and association with possible causal factors. DESIGN: Retrospective analysis of patient records and evaluation of preoperative initial photographs. SETTING: Tertiary craniofacial center. PARTICIPANTS: Five hundred eighty-nine individuals with complete unilateral cleft lip and palate that underwent palate repair at the age of 12 to 36 months by the von Langenbeck technique, in a single stage, by the plastic surgery team of the hospital, from January 2003 to July 2007. INTERVENTIONS: The cleft width was visually classified by a single examiner as narrow, regular, or wide. The following regions of the palate were considered for the location: anterior, medium, transition (between hard and soft palate), and soft palate. MAIN OUTCOME MEASURES: Descriptive statistics and analysis of association between the occurrence of fistula and the different parameters were evaluated. RESULTS: Palatal fistulas were observed in 27% of the sample, with a greater proportion at the anterior region (37.11%). The chi-square statistical test revealed statistically significant association (P ≤ .05) between the fistulas and initial cleft width (P = .0003), intraoperative problems (P = .0037), and postoperative problems (P = .00002). CONCLUSIONS: The prevalence of palatal fistula was similar to mean values reported in the literature. Analysis of causal factors showed a positive association between palatal fistulas with wide and regular initial cleft width and intraoperative and postoperative problems. The anterior region presented the greatest occurrence of fistulas.
OBJECTIVE: To evaluate the prevalence of fistulas after palate repair and analyze their location and association with possible causal factors. DESIGN: Retrospective analysis of patient records and evaluation of preoperative initial photographs. SETTING: Tertiary craniofacial center. PARTICIPANTS: Five hundred eighty-nine individuals with complete unilateral cleft lip and palate that underwent palate repair at the age of 12 to 36 months by the von Langenbeck technique, in a single stage, by the plastic surgery team of the hospital, from January 2003 to July 2007. INTERVENTIONS: The cleft width was visually classified by a single examiner as narrow, regular, or wide. The following regions of the palate were considered for the location: anterior, medium, transition (between hard and soft palate), and soft palate. MAIN OUTCOME MEASURES: Descriptive statistics and analysis of association between the occurrence of fistula and the different parameters were evaluated. RESULTS:Palatal fistulas were observed in 27% of the sample, with a greater proportion at the anterior region (37.11%). The chi-square statistical test revealed statistically significant association (P ≤ .05) between the fistulas and initial cleft width (P = .0003), intraoperative problems (P = .0037), and postoperative problems (P = .00002). CONCLUSIONS: The prevalence of palatal fistula was similar to mean values reported in the literature. Analysis of causal factors showed a positive association between palatal fistulas with wide and regular initial cleft width and intraoperative and postoperative problems. The anterior region presented the greatest occurrence of fistulas.
Authors: Thomas J Sitzman; Adam C Carle; Jaclyn N Lundberg; Pamela C Heaton; Michael A Helmrath; Carroll-Ann Trotman; Maria T Britto Journal: Cleft Palate Craniofac J Date: 2019-10-09