Giugliano Carlos, Roldán Nicole, Claure Pilar, Suarez Vivian
Department of Plastic Surgery, Hospital del Niño Fisurado, Fundación Gantz, Member of LATICFA.
Department of Plastic Surgery, Surgery Service, Clínica Alemana de Santiago; and.
J Craniofac Surg. 2022 Oct 1;33(7):2091-2094. doi: 10.1097/SCS.0000000000008600. Epub 2022 Jun 28.
One of the worst complications after a primary palatoplasty is the lesion of the neurovascular bundle, results into a type of flap necrosis, having as a final consequence a residual palatine fistula.In our institution the authors usually use tongue flap to repair large fistulas.The authors retrospectively reviewed all patients with large palatal fistulas that were repaired with tongue flap at Fundacion Gantz between January 2002 and December 2020.Fundacion Gantz has 1.067 patients with palatal surgeries, with an incidence of 5,8% for palatal fistulas and 3,2% (n = 2) were considered large.Surgery was done on 24 patients with large residual palatal fistula, all of them with tongue flaps as outpatient surgery. Fifteen were girls and 9 were boys, between 13 and 40 years.The average size of the fistula was 2,5 cm and 100% are localized in the anterior palate.The incidence of complications with tongue flap was 12, 5%: 2 dehiscences and 1 persistent residual fistula. The authors had no complications in phonation due to the lingual donor area.The authors consider that this outpatient surgery, is a reprodutible and safe technique, with a low rate of complications, which allows us to recommend it for the treatment of large palatal fistulas.
一期腭裂修复术后最严重的并发症之一是神经血管束损伤，可导致一种皮瓣坏死，最终结果是形成腭部残留瘘。在我们机构，作者通常使用舌瓣修复大型瘘管。作者回顾性分析了2002年1月至2020年12月期间在甘茨基金会接受舌瓣修复大型腭瘘的所有患者。甘茨基金会有1067例接受腭部手术的患者，腭瘘发生率为5.8%，其中3.2%（n = 2）被认为是大型瘘管。对24例大型腭部残留瘘患者进行了手术，所有患者均采用舌瓣作为门诊手术。15例为女孩，9例为男孩，年龄在13至40岁之间。瘘管平均大小为2.5厘米，100%位于腭前部。舌瓣并发症发生率为12.5%：2例裂开和1例持续性残留瘘。作者在舌供区未出现发音方面的并发症。作者认为这种门诊手术是一种可重复且安全的技术，并发症发生率低，因此推荐用于治疗大型腭瘘。
