Bonanthaya Krishnamurthy, Shetty Pritham, Sharma Abhimanyu, Ahlawat Jyoti, Passi Deepak, Singh Mahinder
Department of Oral and Maxillofacial Surgery, Bangalore Institute of Dental Science, Bengaluru, Karnataka, India; Department of Oral and Maxillofacial Surgery, Smile Train-Bhagwan Mahaveer Jain Hospital, Bengaluru, Karnataka, India.
Department of Oral and Maxillofacial Surgery, ESIC Dental College and Hospital, New Delhi, India.
Natl J Maxillofac Surg. 2016 Jul-Dec;7(2):148-152. doi: 10.4103/0975-5950.201357.
Aim of this retrospective study was to access the various surgical treatment options available for repair of Anterior palatal fistula depending upon their size and presenting age, and also to anticipate the treatment outcome.
The series include study report of forty patients with secondary anterior palatal fistula post cleft palate repair, reported in a single unit during a duration of 3 years. All the cases were managed surgically under general anesthesia. The patients were classified depending upon the location of anterior palatal fistula (APF), the quality of tissue and age of patients to chalk out a justified treatment option outlay.
Forty cases were split for surgical correction into various options depending on their size, site, and quality of the tissue. Most of the cases were operated with a Bardach's Redo for fistula closure ( = 16) (40%) and crevicular flap technique ( = 13) (32.5%). Our overall success (satisfactory results) was 77.5% as observed in 31 out of 40 cases with individual success rates for Bardach's and crevicular being 75% and 77%, respectively. There was reduction in size of fistula in three cases (7.5%) and a remnant pinpoint hole in four cases (10%) among all the operated cases.
Management of post palatoplasty fistulas of the hard palate presents a challenging situation for a clinician following the surgical correction of cleft palate. Current paper describes the diagnosis and clinical management of forty cases reporting with unilateral APF following cleft palate surgery, over 3 years. Authors have attempted to propose different treatment modalities for surgical management of unilateral APF. It was concluded in the primary review that the size of fistula was irrelevant in determining the clinical outcome. Instead, the quality and condition of the adjacent tissue appear to be the major governing factors for selecting treatment modality as well as the surgical consequences.
本回顾性研究的目的是根据前腭裂瘘的大小和就诊年龄，探讨可用于修复前腭裂瘘的各种手术治疗方案，并预测治疗效果。
该系列研究报告了40例腭裂修复术后继发前腭裂瘘患者的情况，这些病例来自同一科室，为期3年。所有病例均在全身麻醉下进行手术治疗。根据前腭裂瘘（APF）的位置、组织质量和患者年龄对患者进行分类，以制定合理的治疗方案。
40例患者根据瘘口大小、位置和组织质量分为不同的手术矫正方案。大多数病例采用Bardach再次手术关闭瘘口（n = 16）（40%）和龈沟瓣技术（n = 13）（32.5%）进行手术。我们的总体成功率（满意结果）为77.5%，40例中有31例取得该结果，Bardach手术和龈沟瓣技术各自的成功率分别为75%和77%。在所有手术病例中，有3例（7.5%）瘘口尺寸减小，4例（10%）残留针尖样小孔。
对于腭裂手术矫正后的临床医生来说，硬腭腭裂术后瘘的处理是一个具有挑战性的情况。本文描述了3年多来40例腭裂手术后单侧APF病例的诊断和临床处理。作者试图提出不同的手术治疗方式来处理单侧APF。初步回顾得出的结论是，瘘口大小与临床结果无关。相反邻近组织的质量和状况似乎是选择治疗方式以及手术结果的主要决定因素。
