Division of Plastic and Reconstructive Surgery, Department of Surgery, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand.
J Craniofac Surg. 2021;32(2):587-590. doi: 10.1097/SCS.0000000000007515.
Oronasal fistula (ONF) is a common complication following cleft palate surgery. This study aims to determine the prevalence of ONF and the factors that influence development of ONF following primary palatoplasty.
There were 234 patients undergoing primary palatoplasty during 2012 to 2016 included in this cross-sectional study. Patient demographics, surgeon's experience, age at the time of primary palatoplasty, cleft type by Veau classification, cleft width, and operative technique were recorded. The prevalence of fistulae was the primary outcome. Association of age at the time of repair, cleft type, cleft associated with syndromes, cleft width, and surgeon's experience with fistula rate were secondary outcomes.
There were 234 consecutive patients (128 boys [54.7%] and 106 girls [45.3%]). The mean age at primary palatoplasty was 13 months. Oronasal fistulae occurred in 61 (26.07%) patients. There was a statistically significant association between postoperative oronasal fistulae and the following independent variables: Veau classification (adjusted odds ratio 2.1; 95% confidence interval [CI] = 1.45-3.1, P < 0.01), cleft associated with syndromes (adjusted odds ratio 4.76; 95% CI = 1.48-15.2, P < 0.01) and cleft width more than 11.5 mm (adjusted odds ratio 1.96; 95% CI = 1.00-3.85, P = 0.04).
The overall number of fistulae was moderate in patients who had undergone primary palatoplasty in our center. Cleft severity as defined by the Veau classification, cleft width, and cleft associated with syndromes were predictive factors for development of postoperative fistulae.
腭裂术后发生口鼻瘘（ONF）是一种常见的并发症。本研究旨在确定行初次腭裂修复术后发生 ONF 的流行率，以及影响其发生的因素。
本研究为回顾性病例研究，纳入了 2012 年至 2016 年期间行初次腭裂修复术的 234 例患者。记录患者的人口统计学资料、术者经验、初次腭裂修复术时的年龄、按 Veau 分类的腭裂类型、裂隙宽度和手术技术。瘘管的发生率为主要结局。修复时的年龄、腭裂类型、伴发综合征的腭裂、裂隙宽度和术者经验与瘘管发生率的相关性为次要结局。
共有 234 例连续患者（男 128 例[54.7%]，女 106 例[45.3%]），初次腭裂修复术时的平均年龄为 13 个月。61 例（26.07%）患者术后发生了口鼻瘘。术后发生口鼻瘘与以下独立变量显著相关：Veau 分类（校正优势比 2.1；95%置信区间 [CI] = 1.45-3.1，P < 0.01）、伴发综合征的腭裂（校正优势比 4.76；95% CI = 1.48-15.2，P < 0.01）和裂隙宽度大于 11.5 mm（校正优势比 1.96；95% CI = 1.00-3.85，P = 0.04）。
在本中心行初次腭裂修复术的患者中，瘘管的总数量中等。腭裂严重程度（按 Veau 分类）、裂隙宽度和伴发综合征的腭裂是术后发生瘘管的预测因素。
