Int J Stomatol

Int J Stomatol ›› 2021, Vol. 48 ›› Issue (6): 640-643.doi: 10.7518/gjkq.2021062

• Original Articles • Previous Articles     Next Articles

Effect of preoperative width of cleft palate on fistula formation after Sommerlad-Furlow technique

Wu Min(),Li Chenghao,Li Yang,Gong Caixia,Shi Bing()   

  1. 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, Sichuan University, Chengdu 610041, China
  • Received:2021-02-11 Revised:2021-06-15 Online:2021-11-01 Published:2021-10-28
  • Contact: Bing Shi E-mail:min-min-1984@163.com;shibingcn@vip.sina.com
  • Supported by:
    Research and Development Program, West China Hospital of Stomatology, Sichuan University(LCYJ2019-10)

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Abstract:

Objective This study aimed to evaluate the association between postoperative palatal fistula formation and the ratio of cleft width to the sum of palatal-shelf width by using the Sommerlad-Furlow technique (SF technique for short) for primary palate repair. Methods A total of 373 patients aged 8-18 months who underwent Huaxi SF technique for primary cleft palate without relaxation incision from April 2017 to December 2018 were included in the study. The incidence of palatal fistula was followed up 6 months after surgery. Gender, age, surgeon’s qualification, and the ratio of cleft width to the sum of palatal-shelf width were considered as the potential factors for affecting palatal fistula formation. Results The effect of gender, age, and surgeon’s qualification had no statistical significance (P>0.05). The effect of the ratio of cleft width to the sum of palatal-shelf width on postoperative fistula formation showed a strong association (P=0.048), with a width <5 mm (18 patients, no palatal fistula), from 5 mm to 10 mm (204 patients, 9 with palatal fistula), from 10 mm to 15 mm (137 patients, 11 with palatal fistula), and a cleft width >15 mm (14 patients, 3 with palatal fistula). Conclusion This study confirmed that the occurrence of palatal fistula was closely related to the preoperative cleft width repaired through the SF technique.

Key words: cleft palate, cleft width, palatal fistula, Sommerlad-Furlow technique

CLC Number: 

  • R782.2+2

TrendMD: 

Tab 1

The incidence of fistula formation in different cleft-width groups"

裂隙宽度组别/mm 患者例数/例 腭瘘例数
（腭瘘率/%）		 P值
<5 18 0（0） 0.048
5~10 204 9（4）
10~15 137 11（8）
>15 14 3（21）
[1] Muzaffar AR, Byrd HS, Rohrich RJ, et al. Incidence of cleft palate fistula: An institutional experience wi-th two-stage palatal repair[J]. Plast Reconstr Surg, 2001, 108(6):1515-1518.
pmid: 11711920
[2] Salimi N, Aleksejūnienė J, Yen EHK, et al. Fistula in cleft lip and palate patients-a systematic scoping review[J]. Ann Plast Surg, 2017, 78(1):91-102.
doi: 10.1097/SAP.0000000000000819
[3] Ogata H, Sakamoto Y, Kishi K. Cleft palate repair without lateral relaxing incision[J]. Plast Reconstr Surg Glob Open, 2017, 5(3):e1256.
doi: 10.1097/GOX.0000000000001256
[4] Lithovius RH, Ylikontiola LP, Sándor GK. Incidence of palatal fistula formation after primary palatoplasty in northern Finland[J]. Oral Surg Oral Med Oral Pathol Oral Radiol, 2014, 118(6):632-636.
doi: 10.1016/j.oooo.2014.07.002
[5] 王龑, 李承浩. 唇腭裂手术治疗[M]. 北京: 人民军医出版社, 2015: 129-132.
Wang Y, Li CH. Cleft lip and palate surgery[M]. Beijing: People’s Military Medical Press, 2015: 129-132.
[6] Isogawa N, Ochiai S, Mito T, et al. Three-dimensional comparison in palatal forms between modified presurgical nasoalveolar molding plate and hotz’s plate applied to the infants with unilateral cleft lip and palate[J]. Singapore Dent J, 2010, 31(1):36-42.
doi: 10.1016/S0377-5291(12)70008-1
[7] Darvann TA, Hermann NV, Ersbøll BK, et al. Palatal surface area of maxillary plaster casts: a comparison between two-dimensional and three-dimensio-nal measurements[J]. Cleft Palate Craniofac J, 2007, 44(4):381-390.
doi: 10.1597/05-213.1
[8] 柳春明, 梁立民, 宋儒耀, 等. 骨缝牵引成骨修复腭裂的临床初步研究[J]. 中华整形外科杂志, 2003, 19(4):261-264.
Liu CM, Liang LM, Song RY, et al. Sutural distrac-tion osteogenesis for primary cleft palate repair: a preliminary clinical report[J]. Chin J Plast Surg Burns, 2003, 19(4):261-264.
[9] 秦永平, 王春燕, 赵振民. 腭瘘的发病与修复进展[J]. 中国美容医学, 2008, 17(8):1246-1249.
Qin YP, Wang CY, Zhao ZM. The morbidity and re-pair advancement of palate fistula[J]. Chin J Aesthe-tic Med, 2008, 17(8):1246-1249.
[10] Maeda K, Ojimi H, Utsugi R, et al. A T-shaped musculomucosal buccal flap method for cleft palate surgery[J]. Plast Reconstr Surg, 1987, 79(6):888-896.
pmid: 3588727
[11] Senders CW, Sykes JM. Modifications of the Furlow palatoplasty (six- and seven-flap palatoplasties)[J]. Arch Otolaryngol Head Neck Surg, 1995, 121(10):1101-1104.
doi: 10.1001/archotol.1995.01890100017003
[12] Inman DS, Thomas P, Hodgkinson PD, et al. Oro-nasal fistula development and velopharyngeal insufficiency following primary cleft palate surgery: an audit of 148 children born between 1985 and 1997[J]. Br J Plast Surg, 2005, 58(8):1051-1054.
pmid: 16084930
[13] Phua YS, de Chalain T. Incidence of oronasal fistulae and velopharyngeal insufficiency after cleft pa-late repair: an audit of 211 children born between 1990 and 2004[J]. Cleft Palate Craniofac J, 2008, 45(2):172-178.
doi: 10.1597/06-205.1
[14] Lu Y, Shi B, Zheng Q, et al. Incidence of palatal fistula after palatoplasty with levator veli palatini retropositioning according to Sommerlad[J]. Br J Oral Maxillofac Surg, 2010, 48(8):637-640.
doi: 10.1016/j.bjoms.2009.10.018
[15] Landheer JA, Breugem CC, van der Molen AB . Fistula incidence and predictors of fistula occurrence after cleft palate repair: two-stage closure versus one-stage closure[J]. Cleft Palate Craniofac J, 2010, 47(6):623-630.
doi: 10.1597/09-069
[16] Schultz RC. Management and timing of cleft palate fistula repair[J]. Plast Reconstr Surg, 1986, 78(6):739-747.
pmid: 3538077
[17] Amaratunga NA. Occurrence of oronasal fistulas in operated cleft palate patients[J]. J Oral Maxillofac Surg, 1988, 46(10):834-838.
doi: 10.1016/0278-2391(88)90044-4
[18] Andersson EM, Sandvik L, Semb G, et al. Palatal fistulas after primary repair of clefts of the secon-dary palate[J]. Scand J Plast Reconstr Surg Hand Surg, 2008, 42(6):296-299.
doi: 10.1080/02844310802299676
[19] MacKay D, Mazahari M, Graham WP, et al. Incidence of operative procedures on cleft lip and palate patients[J]. Ann Plast Surg, 1999, 42(4):445-448.
doi: 10.1097/00000637-199904000-00017
[20] Pulkkinen J, Haapanen ML, Paaso M, et al. Velopharyngeal function from the age of three to eight years in cleft palate patients[J]. Folia Phoniatr Logop, 2001, 53(2):93-98.
doi: 10.1159/000052659
[21] Cohen SR, Kalinowski J, LaRossa D, et al. Cleft palate fistulas: a multivariate statistical analysis of prevalence, etiology, and surgical management[J]. P-last Reconstr Surg, 1991, 87(6):1041-1047.
[22] Parwaz MA, Sharma RK, Parashar A, et al. Width of cleft palate and postoperative palatal fistula: do they correlate[J]. J Plast Reconstr Aesthet Surg, 2009, 62(12):1559-1563.
doi: 10.1016/j.bjps.2008.05.048 pmid: 18838320
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