Incidence of cleft palate fistula

An institutional experience with two-stage palatal repair

A. R. Muzaffar, H. Steve Byrd, R. J. Rohrich, D. F. Johns, D. LeBlanc, S. J. Beran, C. Anderson, A. Papaioannou

Research output: Contribution to journalArticle

133 Citations (Scopus)

Abstract

The purpose of this study was to determine the incidence of cleft palatal fistula in a series of nonsyndromic children treated at the authors' institution. This retrospective analysis of 103 patients with cleft palate treated by five surgeons between 1989 and 1995 includes 60 boys and 33 girls, whose median age was 18.4 months at the time of surgery. The median length of follow-up was 4.9 years after primary palatoplasty. Cleft palatal fistula was defined as a failure of healing ora breakdown in the primary surgical repair of the palate. Intentionally unrepaired fistulas of the primary and secondary palate were excluded. Extent of clefting was described according to the Veau classification. Statistical examination of multiple variables was performed using contingency table analysis, multivariate logistic regression, and the Wilcoxon rank sum test. The incidence of cleft palatal fistula in this series was 8.7 percent. All of these fistulas were clinically significant. The rate of fistula recurrence was 33 percent. The incidence of cleft palatal fistula when compared by Veau classification was statistically significant, with nine fistulas occurring in patients with Veau 3 and 4 clefts and no fistulas occurring in patients with Veau 1 and 2 clefts (p = 0.0441). No significant differences between patients with and without fistulas were identified with respect to operating surgeon, patient sex, patient age at palatoplasty, type of palatoplasty, and use of presurgical orthopedics or palatal expansion. All three recurrent fistulas occurred in the anterior palate, two in patients with Veau class 3 clefts and one in a patient with a Veau class 4 cleft. The low rate of clinically significant fistula was attributed to early delayed primary, closure, with smaller secondary clefts allowing repair with a minimum of dissection and disruption of vascularity.

Original languageEnglish (US)
Pages (from-to)1515-1518
Number of pages4
JournalPlastic and Reconstructive Surgery
Volume108
Issue number6
StatePublished - 2001

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Cleft Palate
Fistula
Incidence
Palate
Nonparametric Statistics
Orthopedics
Dissection
Multivariate Analysis
Logistic Models

ASJC Scopus subject areas

  • Surgery

Cite this

Muzaffar, A. R., Steve Byrd, H., Rohrich, R. J., Johns, D. F., LeBlanc, D., Beran, S. J., ... Papaioannou, A. (2001). Incidence of cleft palate fistula: An institutional experience with two-stage palatal repair. Plastic and Reconstructive Surgery, 108(6), 1515-1518.

Incidence of cleft palate fistula : An institutional experience with two-stage palatal repair. / Muzaffar, A. R.; Steve Byrd, H.; Rohrich, R. J.; Johns, D. F.; LeBlanc, D.; Beran, S. J.; Anderson, C.; Papaioannou, A.

In: Plastic and Reconstructive Surgery, Vol. 108, No. 6, 2001, p. 1515-1518.

Research output: Contribution to journalArticle

Muzaffar, AR, Steve Byrd, H, Rohrich, RJ, Johns, DF, LeBlanc, D, Beran, SJ, Anderson, C & Papaioannou, A 2001, 'Incidence of cleft palate fistula: An institutional experience with two-stage palatal repair', Plastic and Reconstructive Surgery, vol. 108, no. 6, pp. 1515-1518.
Muzaffar AR, Steve Byrd H, Rohrich RJ, Johns DF, LeBlanc D, Beran SJ et al. Incidence of cleft palate fistula: An institutional experience with two-stage palatal repair. Plastic and Reconstructive Surgery. 2001;108(6):1515-1518.
Muzaffar, A. R. ; Steve Byrd, H. ; Rohrich, R. J. ; Johns, D. F. ; LeBlanc, D. ; Beran, S. J. ; Anderson, C. ; Papaioannou, A. / Incidence of cleft palate fistula : An institutional experience with two-stage palatal repair. In: Plastic and Reconstructive Surgery. 2001 ; Vol. 108, No. 6. pp. 1515-1518.
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