Private Practice, Medellin, Colombia.
Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, Michigan, USA.
Clin Exp Dent Res. 2024 Aug;10(4):e914. doi: 10.1002/cre2.914.
Oronasal fistulas are common sequelae following cleft lip and palate surgery and can significantly impact a patient's quality of life. They result from various factors, including surgical techniques, tissue management, and patient-specific factors. This case report explores the modern approach to oronasal fistula closure using periodontal plastic surgery principles.
The report presents two cases of patients with oronasal fistulas due to previous maxillofacial surgical intervention. These patients underwent microsurgical procedures that involved partial flap thickness preparation of the fistula areas, the use of connective tissue grafts from the palate, and meticulous suturing techniques to ensure graft integrity. The procedures were performed in stages, and postoperative care was provided.
Both cases demonstrated successful fistula closure and graft survival. The patients reported improvements in breathing, speech, aesthetics, and quality of life. The second case also included guided bone regeneration and implant placement.
Oronasal fistulas resulting from maxillofacial surgery can be effectively treated using periodontal plastic surgery techniques, significantly improving patients' quality of life and aesthetic outcomes. This approach represents a valuable addition to the existing repertoire of oronasal fistula closure methods.
口鼻瘘是唇腭裂手术后常见的后遗症，会严重影响患者的生活质量。其发生原因包括手术技术、组织处理以及患者个体因素等。本病例报告探讨了应用牙周整形手术原则来关闭口鼻瘘的现代方法。
报告介绍了两例因先前颌面外科手术干预而导致口鼻瘘的患者。这些患者接受了微创手术，包括瘘管区域的部分瓣厚度制备、取自 palate 的结缔组织移植物，以及精细的缝合技术以确保移植物的完整性。手术分阶段进行，并提供术后护理。
两例患者均成功关闭瘘管并使移植物存活。患者报告呼吸、言语、美观和生活质量得到改善。第二例患者还包括引导骨再生和种植体植入。
应用牙周整形手术技术可有效治疗颌面外科手术后的口鼻瘘，显著改善患者的生活质量和美观效果。这种方法是口鼻瘘关闭方法的一个有价值的补充。
