[Repair of palatal fistulae in cleft XXXX ].

@entity1 @entity292 @entity1021 @entity146
OBJECTIVES: Treatment of oronasal fistulae in cleft @entity1 remains a surgical challenge because of its high failure rate. The authors report the results of an @entity146 surgical technique using the total elevation of palatal mucoperiosteum, even for small fistulae. METHODS: This approach was used on twelve consecutive @entity1 , from five to 33 years of age, presenting with a Pittsburgh classification type IV palatal fistulae. The surgical procedure was total elevation of the hard palate mucoperiosteum @entity1021 from the dental sulcus combined with sealed double layer sutures. Clinical and photographical control was made at least 6 months after to detect a possible relapse. RESULTS: The success rate was 100%. No relapsing @entity292 was observed with follow-up ranging from 6 to 36 months. DISCUSSION: This technique allows wide exposure and safe closure of the nasal layer. It is simple and leaves no raw bone surface exposed and no additional scar. The authors think it can be used in all type IV fistulae less than 1cm wide. Several other surgical techniques have been described to close palatal fistulae: local turnover flaps, pedicled flaps from adjacent oral tissue, tongue flaps, tissue expansion, and even free flaps. Obturator prostheses have also been used. The technique we report, even if more @entity146 , seems to be more reliable with fewer relapse and sequelae.
