Palatal fistula closure with lengthening of soft palate using a pedicled buccal fat and a buccinator flap: a case report
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A 49-month-old male patient was diagnosed with a postoperative mid-palatal fistula and mild velopharyngeal insufficiency. The fistula was 7 mm in size and surrounded by contracted scar tissues. Therefore, we performed fistula closure using a pedicled buccal fat pad to reduce the risk of recurrence and posteriorly-based buccinator myomucosal flap to lengthen the soft palate. The fistula was closed using mucosalization without any complications, and patient’s hypernasality decreased after 13 months of follow-up. This surgical treatment enhanced tension-free closure of the fistula and velopharyngeal sphincter function and minimized the possibility of maxillary hypoplasia after wide dissection of the palatal mucoperiosteum. These findings suggests that buccinator myomucosal flaps and pedicled buccal fat represent a favorable treatment option for the closure of fistulae associated with veloplaryngeal insufficiency.
Abstract
A 49-month-old male patient was diagnosed with a postoperative mid-palatal fistula and mild velopharyngeal insufficiency. The fistula was 7 mm in size and surrounded by contracted scar tissues. Therefore, we performed fistula closure using a pedicled buccal fat pad to reduce the risk of recurrence and posteriorly-based buccinator myomucosal flap to lengthen the soft palate. The fistula was closed using mucosalization without any complications, and patient’s hypernasality decreased after 13 months of follow-up. This surgical treatment enhanced tension-free closure of the fistula and velopharyngeal sphincter function and minimized the possibility of maxillary hypoplasia after wide dissection of the palatal mucoperiosteum. These findings suggests that buccinator myomucosal flaps and pedicled buccal fat represent a favorable treatment option for the closure of fistulae associated with veloplaryngeal insufficiency.
참고문헌 (14)
- Hardwicke JT, "Fistula incidence after primary cleft palate repair : a systematic review of the literature", Plast Reconstr Surg, 134, pp.618e~627e (2014)[DOI]
- Garg R, "A statistical analysis of incidence, etiology, and management of palatal fistula", Natl J Maxillofac Surg, 10, pp.43~46 (2019)[DOI]
- Tezuka M, "Comparison of recurrence rate and speech outcome between two different techniques for cleft palatal fistula closure : a retrospective cohort study", J Craniomaxillofac Surg, 50, pp.86~92 (2022)[DOI]
- Richardson S, "Palatal fistulae : a comprehensive classification and difficulty index", J Maxillofac Oral Surg, 13, pp.305~309 (2014)[DOI]
- Park YW, "A clinical study on secondary cleft lip and", or palate deformity, 1990, pp.16, 101~111
- Ysunza PA, "Current controversies in diagnosis and management of cleft palate and velopharyngeal insufficiency", Biomed Res Int, 2015, pp.196240~ (2015)[DOI]
- Bonanthaya K, "Furlow palatoplasty for velopharyngeal dysfunction management : auditing and predicting outcomes", Cleft Palate Craniofac J, 59, pp.1097~1106 (2022)[DOI]
- Ferrari S, "Donor site morbidity using the buccinator myomucosal island flap", Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 111, pp.306~311 (2011)[DOI]
- Bozola AR, "The buccinator musculomucosal flap : anatomic study and clinical application", Plast Reconstr Surg, 84, pp.250~257 (1989)[DOI]
- Mishra M, "Use of a versatile buccinator myomucosal flap in the palatal defect", J Maxillofac Oral Surg, 18, pp.388~390 (2019)[DOI]
- Denadai R, "Buccinator myomucosal flap for the treatment of velopharyngeal insufficiency in patients with cleft palate and", or lip, 2018, pp.84, 697~707
- Kalmar CL, "Modified buccal myomucosal flap closure of large anterior palatal oronasal fistulas", Plast Reconstr Surg, 147, pp.94e~97e (2021)[DOI]
- Rahpeyma A, "Buccinator-based myomucosal flaps in intraoral reconstruction : a review and new classification", Natl J Maxillofac Surg, 4, pp.25~32 (2013)[DOI]
- Kim JY, "The effect of buccal fat pad graft in the palatoplasty and the risk factor of postoperative palatal fistula", J Craniofac Surg, 31, pp.658~661 (2020)[DOI]
