Abdaly Hosein, Omranyfard Mahmood, Ardekany Mehdy Rasty, Babaei Kamran
Department of General and Plastic Surgery, Alzahra Hospital, Isfahan University of Medical Sciences, Isfahan, Iran.
Adv Biomed Res. 2015 Jul 27;4:135. doi: 10.4103/2277-9175.161529. eCollection 2015.
Secondary palatal fistula and velopharyngeal insufficiency (VPI) are two major complications of palatoplasty. Various methods have been introduced for surgical repair of these complications; however, most of them are associated with a high recurrence rate and morbidity. This study was designed to evaluate the use of the buccinator myomucosal flap in the reconstruction of palatal fistula and velopharyngeal insufficiency following primary palatoplasty.
This study was performed on 25 patients who had either secondary palatal fistula or velopharyngeal insufficiency. Their defects were repaired by buccinator myomucosal flaps (BMFs). Patients were followed for 8 weeks and follow-up visits were arranged at 1, 2, 4, and 8 weeks after discharge.
All BMFs were harvested and transposed successfully. The length of the soft palate increased 15.14 ± 1.13 mm postoperatively. One patient (4%) had flap dehiscence 6 days after the operation with no flap ischemia or necrosis. Another patient (4%) experienced recurrence of the palatal fistula with marginal necrosis of the BMF 6 weeks after the operation. Otherwise, no case of fistula recurrence, infection, flap ischemia or necrosis and donor-site morbidity was observed during follow-up sessions.
This study demonstrated that using BMFs could be a safe, effective and promising method of treatment for post palatoplasty fistula and VPI. However, further investigations on a larger sample size with longer follow-up are recommended for more accurate conclusion.
继发腭瘘和腭咽闭合不全（VPI）是腭裂修复术的两大主要并发症。已经引入了各种方法来手术修复这些并发症；然而，它们中的大多数都与高复发率和发病率相关。本研究旨在评估颊肌黏膜瓣在一期腭裂修复术后腭瘘和腭咽闭合不全重建中的应用。
本研究对25例患有继发腭瘘或腭咽闭合不全的患者进行。他们的缺损通过颊肌黏膜瓣（BMF）修复。对患者进行了8周的随访，并在出院后1、2、4和8周安排了随访。
所有颊肌黏膜瓣均成功采集并转移。术后软腭长度增加了15.14±1.13毫米。1例患者（4%）术后6天出现皮瓣裂开，无皮瓣缺血或坏死。另1例患者（4%）术后6周出现腭瘘复发，颊肌黏膜瓣边缘坏死。否则，在随访期间未观察到瘘复发、感染、皮瓣缺血或坏死以及供区并发症的病例。
本研究表明，使用颊肌黏膜瓣可能是一种安全、有效且有前景的腭裂修复术后瘘和腭咽闭合不全的治疗方法。然而，建议进行更大样本量、更长随访时间的进一步研究以得出更准确的结论。
