Wu Min, Zhu Zhi-Bing, Shi Bing, Gong Cai-Xia, Zhang Bi-He, Li Yang
State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Dept. of Cleft Lip and Palate Surgery, West China Hospital of Stomatology, Chengdu 610041, China.
Hua Xi Kou Qiang Yi Xue Za Zhi. 2020 Apr 1;38(2):166-169. doi: 10.7518/hxkq.2020.02.010.
This study aimed to determine the palatal fistula rate, explore the influencing factors of Huaxi Sommerlad-Furlow (SF) palatoplasty.
A retrospective review of 385 consecutive cleft-palate cases was performed to determine the incidence of postoperative fistula and assess the possible contributing factors, such as sex, weight, age, cleft type, operator skills, preoperative white blood cell, preventive antibiotic use, and postoperative temperature.
RESULTS: Fistulas occurred in 15/385 patients (3.9%). Among them, 1 fistula was located at the junction of the hard and soft palates, 12 fistulas in hard palate, and 2 fistulas in alveolar near the hard palate. No evidence suggested that sex, weight, age, preoperative white blood cell, preventive antibiotic use, and postoperative temperature are associated with fistula formation. The incidences of cleft palate fistulas as encountered by senior professors (3.03%) and associate senior professors (2.23%) were significantly lower than those by attending doctors (14.29%, P<0.05). The incidences of cleft palate fistulas in bilateral completely cleft palate cases (20.6%) were significantly higher than those in hard and soft (3.6%) and unilateral cleft palate cases (2.6%, P< 0.05).
Huaxi SF palatoplasty can avoid the inhibited maxillary growth without requiring lateral relaxing incision, which poses an acceptable risk of fistula formation. The palatal fistula rate is not related to the sex, weight, age of operation, prophylactic use of antibiotics before operation, infection before operation, temperature after operation and other factors. The occurrence of the fistula is related mainly to cleft type and experience level of the surgeon.
本研究旨在确定腭瘘发生率,探讨华西Sommerlad-Furlow(SF)腭裂修复术的影响因素。
对385例连续性腭裂病例进行回顾性分析,以确定术后瘘的发生率,并评估可能的影响因素,如性别、体重、年龄、腭裂类型、术者技术、术前白细胞计数、预防性抗生素使用及术后体温。
385例患者中有15例(3.9%)发生腭瘘。其中,1例瘘位于硬腭与软腭交界处,12例位于硬腭,2例位于硬腭附近牙槽嵴。无证据表明性别、体重、年龄、术前白细胞计数、预防性抗生素使用及术后体温与瘘的形成有关。教授(3.03%)和副教授(2.23%)的腭裂瘘发生率显著低于主治医师(14.29%,P<0.05)。双侧完全性腭裂病例的腭裂瘘发生率(20.6%)显著高于软硬腭裂(3.6%)和单侧腭裂病例(2.6%,P<0.05)。
华西SF腭裂修复术无需侧方松弛切口即可避免上颌生长受限,且腭瘘形成风险可接受。腭瘘发生率与性别、体重、手术年龄、术前预防性使用抗生素、术前感染、术后体温等因素无关。瘘的发生主要与腭裂类型和术者经验水平有关。