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Use of the Sphenoid Flap in Repair of the Wide Cleft Palate.
Khan, Khurram; Hardwicke, Joseph; Seselgyte, Rimante; Morris, Paul; Thorburn, Guy; Kangesu, Loshan; Swan, Marc C; Richard, Bruce.
Afiliação
  • Khan K; 1 West Midlands Regional Centre for Cleft Lip & Palate, Birmingham Children's Hospital, Birmingham, United Kingdom.
  • Hardwicke J; 1 West Midlands Regional Centre for Cleft Lip & Palate, Birmingham Children's Hospital, Birmingham, United Kingdom.
  • Seselgyte R; 2 Great Ormond Street Hospital for Children, London, United Kingdom.
  • Morris P; 2 Great Ormond Street Hospital for Children, London, United Kingdom.
  • Thorburn G; 2 Great Ormond Street Hospital for Children, London, United Kingdom.
  • Kangesu L; 2 Great Ormond Street Hospital for Children, London, United Kingdom.
  • Swan MC; 2 Great Ormond Street Hospital for Children, London, United Kingdom.
  • Richard B; 1 West Midlands Regional Centre for Cleft Lip & Palate, Birmingham Children's Hospital, Birmingham, United Kingdom.
Cleft Palate Craniofac J ; 55(3): 437-441, 2018 03.
Article em En | MEDLINE | ID: mdl-29437500
ABSTRACT

OBJECTIVE:

In wide palatal defects, closure of the nasal layer can prove a considerable challenge. Mobilizing nasal flaps posteriorly usually facilitates soft palate closure. However, the defect is often too wide within the hard palate; hence, bilateral vomerine flaps are frequently required. Despite this, there is often a small defect in the nasal layer at the posterior septum (typically equating to the hard-soft palate junction), which has to be left to heal by secondary intention with the resulting increased risk of fistula formation and the potential deleterious long-term effect on speech due to cicatricial migration of the reconstructed levator sling anteriorly. We describe our experience in the use of the sphenoid flap to obtain tension-free primary closure of the nasal layer.

METHODS:

A retrospective multi-center study assessing all sphenoid flap procedures undertaken at both Birmingham Children's Hospital and Great Ormond Street Hospital. Key demographic and medical data was collected pre-, peri-, and postoperatively across the 2 sites.

RESULTS:

A total of 66 patients underwent the use of a sphenoid flap to aid closure of the nasal layer. The average age at time of repair was 9.7 months. More than half (55%, n = 36) were isolated cleft palates, and 35% (n = 23) were BCLPs. Forty-two percent of all patients had Robin sequence. The average cleft width was 14.4 mm. The overall fistula rate was 25.8% (n = 17).

CONCLUSIONS:

We describe the operative technique, indications, and our experience in the use of the sphenoid flap in wide cleft palate repair.
Assuntos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Osso Esfenoide / Retalhos Cirúrgicos / Fissura Palatina Tipo de estudo: Observational_studies / Risk_factors_studies Limite: Child, preschool / Female / Humans / Infant / Male País/Região como assunto: Europa Idioma: En Revista: Cleft Palate Craniofac J Assunto da revista: ODONTOLOGIA Ano de publicação: 2018 Tipo de documento: Article País de afiliação: Reino Unido

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Osso Esfenoide / Retalhos Cirúrgicos / Fissura Palatina Tipo de estudo: Observational_studies / Risk_factors_studies Limite: Child, preschool / Female / Humans / Infant / Male País/Região como assunto: Europa Idioma: En Revista: Cleft Palate Craniofac J Assunto da revista: ODONTOLOGIA Ano de publicação: 2018 Tipo de documento: Article País de afiliação: Reino Unido