A 5-Year Retrospective Review of Primary Palatoplasty Cases Utilizing an Acellular Collagen Interpositional Graft.

Abstract

PURPOSE:

Multiple palatoplasty techniques have been developed, but a technique involving a partial 2-layer soft tissue closure of the posterior hard palate and nasal floor and a 3-layer soft tissue closure of the soft palate with reorientation of the levator and tensor veli muscles across the midline has been the gold standard for cleft repair. This report describes a series of primary palatoplasties reconstructed with a middle layer of acellular collagen membrane that aided in maintaining closure between the oral and nasal cavities without the development of an oronasal fistula.

MATERIALS AND METHODS:

An acellular collagen membrane was placed between the muscular layer and the oral mucosa during primary palatoplasty. Six patients with primary cleft palatoplasty were identified and followed for 1 year (patient 1, a 10-month-old boy; patient 2, a 12-month-old girl; patient 3, a 12-month-old girl; patient 4, a 6-year-old boy; patient 5, a 12-month-old girl; and patient 6, an 18-month-old girl).

RESULTS:

At 1 year, no oronasal fistulas had developed where augmentation with the acellular collagen membrane was used.

CONCLUSIONS:

The use of an acellular collagen graft to aid in the 3-layer closure of primary palatoplasty surgery is a very effective strategy in primary and secondary healing and in preventing oronasal fistulation. The risk associated with the use of acellular collagen membranes appears nonexistent.

• Authors: John W Hudson, David O Pickett
• Journal: Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons (J Oral Maxillofac Surg) Vol. 73 Issue 7 Pg. 1393.e1-3 (Jul 2015) ISSN: 1531-5053 [Electronic] United States
• PMID: 25871898 (Publication Type: Journal Article)
• Copyright: Copyright © 2015 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

Chemical References

• Fibrin Tissue Adhesive
• Tissue Adhesives
• Collagen

Topics

• Acellular Dermis
• Child
• Cleft Palate (surgery)
• Collagen (therapeutic use)
• Female
• Fibrin Tissue Adhesive (therapeutic use)
• Follow-Up Studies
• Humans
• Infant
• Male
• Mouth Mucosa (surgery)
• Nasal Cavity (surgery)
• Nose Diseases (prevention & control)
• Oral Fistula (prevention & control)
• Palate (surgery)
• Palate, Soft (surgery)
• Pharyngeal Muscles (surgery)
• Plastic Surgery Procedures (methods)
• Respiratory Tract Fistula (prevention & control)
• Retrospective Studies
• Tissue Adhesives (therapeutic use)