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Superiorly Based Facial Artery Musculomucosal Flap for Large Anterior Palatal Fistulae in Clefts
- Source :
- The Cleft Palate-Craniofacial Journal. 44:523-527
- Publication Year :
- 2007
- Publisher :
- SAGE Publications, 2007.
-
Abstract
- Objective: An anterior hard palate fistula for which more than one attempt at repair using local tissue has failed is a difficult complication in cleft surgery. Prior to alveolar bone grafting, cleft patients have an open anterior maxillary arch that allows passage of a pedicled flap from cheek to hard palate. The superiorly based facial artery musculomucosal flap passed through the clefted alveolus is one of the newer techniques to solve this difficult problem. The aim of this study was to assess the validity of using a facial artery musculomucosal flap with an anterosuperiorly based pedicle with retrograde blood flow to repair a large anterior hard palate fistula when a lack of adequate local soft tissue precludes a local flap closure and the patient otherwise would need a tongue flap. Results: Of 16 facial artery musculomucosal flaps in 14 children, 12 were successful, 2 suffered partial flap loss secondary to venous congestion, and 2 had complete flap failure. One had a small wound dehiscence that resulted in a small posterior fistula. Conclusion: An anterosuperiorly based facial artery musculomucosal flap is a viable option to close large anterior hard palate defects. Care needs to be taken to ensure adequate venous drainage. This flap obviates the need for a staged tongue flap repair for those patients with an open maxillary arch.
- Subjects :
- Male
Palate, Hard
Difficult problem
medicine.medical_specialty
Adolescent
Fistula
Oral Surgical Procedures
Facial Muscles
Facial artery
Surgical Flaps
03 medical and health sciences
0302 clinical medicine
medicine.artery
Nose Diseases
medicine
Humans
Child
030223 otorhinolaryngology
Wound dehiscence
business.industry
Mouth Mucosa
Soft tissue
Arteries
030206 dentistry
Pedicled Flap
Cheek
medicine.disease
Surgery
Cleft Palate
Treatment Outcome
medicine.anatomical_structure
Otorhinolaryngology
Child, Preschool
Female
Hard palate
Oral Surgery
business
Oral Fistula
Subjects
Details
- ISSN :
- 15451569 and 10556656
- Volume :
- 44
- Database :
- OpenAIRE
- Journal :
- The Cleft Palate-Craniofacial Journal
- Accession number :
- edsair.doi.dedup.....2e3f006a7f72fab2d329d3ca9aa3001c