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Buccinator flap as a method for palatal fistula and VPI management

BACKGROUND: Secondary palatal fistula and velopharyngeal insufficiency (VPI) are two major complications of palatoplasty. Various methods have been introduced for surgical repair of these complications; however, most of them are associated with a high recurrence rate and morbidity. This study was de...

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Autores principales: Abdaly, Hosein, Omranyfard, Mahmood, Ardekany, Mehdy Rasty, Babaei, Kamran
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Medknow Publications & Media Pvt Ltd 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4544118/
https://www.ncbi.nlm.nih.gov/pubmed/26322283
http://dx.doi.org/10.4103/2277-9175.161529
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author Abdaly, Hosein
Omranyfard, Mahmood
Ardekany, Mehdy Rasty
Babaei, Kamran
author_facet Abdaly, Hosein
Omranyfard, Mahmood
Ardekany, Mehdy Rasty
Babaei, Kamran
author_sort Abdaly, Hosein
collection PubMed
description BACKGROUND: Secondary palatal fistula and velopharyngeal insufficiency (VPI) are two major complications of palatoplasty. Various methods have been introduced for surgical repair of these complications; however, most of them are associated with a high recurrence rate and morbidity. This study was designed to evaluate the use of the buccinator myomucosal flap in the reconstruction of palatal fistula and velopharyngeal insufficiency following primary palatoplasty. MATERIALS AND METHODS: This study was performed on 25 patients who had either secondary palatal fistula or velopharyngeal insufficiency. Their defects were repaired by buccinator myomucosal flaps (BMFs). Patients were followed for 8 weeks and follow-up visits were arranged at 1, 2, 4, and 8 weeks after discharge. RESULTS: All BMFs were harvested and transposed successfully. The length of the soft palate increased 15.14 ± 1.13 mm postoperatively. One patient (4%) had flap dehiscence 6 days after the operation with no flap ischemia or necrosis. Another patient (4%) experienced recurrence of the palatal fistula with marginal necrosis of the BMF 6 weeks after the operation. Otherwise, no case of fistula recurrence, infection, flap ischemia or necrosis and donor-site morbidity was observed during follow-up sessions. CONCLUSION: This study demonstrated that using BMFs could be a safe, effective and promising method of treatment for post palatoplasty fistula and VPI. However, further investigations on a larger sample size with longer follow-up are recommended for more accurate conclusion.
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spelling pubmed-45441182015-08-28 Buccinator flap as a method for palatal fistula and VPI management Abdaly, Hosein Omranyfard, Mahmood Ardekany, Mehdy Rasty Babaei, Kamran Adv Biomed Res Original Article BACKGROUND: Secondary palatal fistula and velopharyngeal insufficiency (VPI) are two major complications of palatoplasty. Various methods have been introduced for surgical repair of these complications; however, most of them are associated with a high recurrence rate and morbidity. This study was designed to evaluate the use of the buccinator myomucosal flap in the reconstruction of palatal fistula and velopharyngeal insufficiency following primary palatoplasty. MATERIALS AND METHODS: This study was performed on 25 patients who had either secondary palatal fistula or velopharyngeal insufficiency. Their defects were repaired by buccinator myomucosal flaps (BMFs). Patients were followed for 8 weeks and follow-up visits were arranged at 1, 2, 4, and 8 weeks after discharge. RESULTS: All BMFs were harvested and transposed successfully. The length of the soft palate increased 15.14 ± 1.13 mm postoperatively. One patient (4%) had flap dehiscence 6 days after the operation with no flap ischemia or necrosis. Another patient (4%) experienced recurrence of the palatal fistula with marginal necrosis of the BMF 6 weeks after the operation. Otherwise, no case of fistula recurrence, infection, flap ischemia or necrosis and donor-site morbidity was observed during follow-up sessions. CONCLUSION: This study demonstrated that using BMFs could be a safe, effective and promising method of treatment for post palatoplasty fistula and VPI. However, further investigations on a larger sample size with longer follow-up are recommended for more accurate conclusion. Medknow Publications & Media Pvt Ltd 2015-07-27 /pmc/articles/PMC4544118/ /pubmed/26322283 http://dx.doi.org/10.4103/2277-9175.161529 Text en Copyright: © 2015 Abdaly. http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Original Article
Abdaly, Hosein
Omranyfard, Mahmood
Ardekany, Mehdy Rasty
Babaei, Kamran
Buccinator flap as a method for palatal fistula and VPI management
title Buccinator flap as a method for palatal fistula and VPI management
title_full Buccinator flap as a method for palatal fistula and VPI management
title_fullStr Buccinator flap as a method for palatal fistula and VPI management
title_full_unstemmed Buccinator flap as a method for palatal fistula and VPI management
title_short Buccinator flap as a method for palatal fistula and VPI management
title_sort buccinator flap as a method for palatal fistula and vpi management
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4544118/
https://www.ncbi.nlm.nih.gov/pubmed/26322283
http://dx.doi.org/10.4103/2277-9175.161529
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