Caterson Edward J, Singh Mansher, Stephens Willie, Pribaz Julian J
Boston, Mass. From the Division of Plastic Surgery, Brigham and Women's Hospital.
Plast Reconstr Surg. 2015 Oct;136(4):834-837. doi: 10.1097/PRS.0000000000001618.
Palatal fistula is a known complication of cleft lip-cleft palate repair. Fistulas anterior to the incisive foramen can be particularly difficult to repair because of the lack of available tissue. Adjacent tissue has inherent limitations, and multiple free-flap techniques have been described; however, there remains no single solution for this difficult problem. The authors present an alternative strategy of replacing "like with like" by using an osteocutaneous free tissue transfer of the second toe for anterior oronasal fistulas. Use of the osteocutaneous second-toe free flap provides skin lining to both the oral side and the nasal side to close oronasal fistulas. It also bridges the alveolar gap with vascularized bone. This flap can be considered as an elegant alternative for anterior oronasal fistulas.
腭瘘是唇腭裂修复术后已知的并发症。由于缺乏可用组织，切牙孔前方的瘘管修复起来可能特别困难。相邻组织存在固有局限性，已有多种游离皮瓣技术被描述；然而，对于这个难题仍没有单一的解决方案。作者提出了一种替代策略，即通过使用第二趾骨皮瓣游离组织移植来修复前口鼻腔瘘，实现“同类组织替换同类组织”。使用第二趾骨皮瓣游离组织移植可为口腔侧和鼻腔侧提供皮肤内衬以关闭口鼻腔瘘。它还能用带血管的骨组织桥接牙槽间隙。对于前口鼻腔瘘，这种皮瓣可被视为一种巧妙的替代方案。
