Badawy, M., Gad, A., Amin, E. (2024). Large Anterior Oronasal Fistula with Short Palate: New Technique for Fistula Closure and Palatal Lengthening. The Egyptian Journal of Plastic and Reconstructive Surgery, 48(3), 223-227. doi: 10.21608/ejprs.2024.365341
Mohamed Samir Badawy; Ahmed Mohamed Gad; Ebrahim Amin. "Large Anterior Oronasal Fistula with Short Palate: New Technique for Fistula Closure and Palatal Lengthening". The Egyptian Journal of Plastic and Reconstructive Surgery, 48, 3, 2024, 223-227. doi: 10.21608/ejprs.2024.365341
Badawy, M., Gad, A., Amin, E. (2024). 'Large Anterior Oronasal Fistula with Short Palate: New Technique for Fistula Closure and Palatal Lengthening', The Egyptian Journal of Plastic and Reconstructive Surgery, 48(3), pp. 223-227. doi: 10.21608/ejprs.2024.365341
Badawy, M., Gad, A., Amin, E. Large Anterior Oronasal Fistula with Short Palate: New Technique for Fistula Closure and Palatal Lengthening. The Egyptian Journal of Plastic and Reconstructive Surgery, 2024; 48(3): 223-227. doi: 10.21608/ejprs.2024.365341
Large Anterior Oronasal Fistula with Short Palate: New Technique for Fistula Closure and Palatal Lengthening
The Department of Plastic, Burn and Maxillofacial Surgery, Faculty of Medicine, Ain Shams University
Abstract
Background: Oro-nasal fistulae (ONF) is considered one of the commonest sequelae of cleft palate repair. Fistulae closure can represent a simple procedure or a great challenge. Usually, it is not easy to close large ONF using adjacent local tissues, which necessitates the displacement of tissues from nearby anatomical regions. Objective: Evaluation of a new technique for fistula closure and palatal lengthening in ONF. Patients and Methods: Between the period of 2017 to 2020 this prospective study was performed on seven cases with large anterior ONF underwent surgical repair using bilateral Buccinator Myomucosal Flaps (BMMF), one acts as a second layer for fistula closure and the second one added more length to the palate. Patient evaluation was based on clinical evaluation for fistulas recurrence, speech intangibility using Intelligibility in Context Scale (ICS) which performed preoperatively and one year post-operatively, and improvement of nasal regurgitation. Results: Seven non syndromic cases with large anterior ONF were included in this study of them five females and two males with mean age (7.57±1.90) underwent fistula closure with our new technique. On postoperative follow-up one case (14.3%) complicated with oral layer disruption that resolved conservatively, also two cases (28.6%) suffered from chest infection which required prolonged hospitalization. Improvement of nasal regurgitation, with no fistula recurrence occur in all seven cases. Assessment of speech intelligibility was done using Intelligibility in Context Scale (ICS) showing that (71.4%) were improved to score >3.5 which means that their speech is usually to sometimes understood to others. Conclusion: The use of our new technique is a reliable method that may be used for large anterior ONF closure and lengthening of short scarred palate with few drawbacks and multiple benefits.
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