title: Simultaneous cortex bone plate graft with particulate marrow and cancellous bone for reliable closure of palatal fistulae associated with cleft deformities.
abstract: OBJECTIVE
  The purpose of this study was to evaluate the effectiveness of simultaneous cortex bone plate (CBP) graft with particulate marrow and cancellous bone (PMCB) graft for reliable closure of palatal fistulae associated with alveolar clefts.
  
  
  METHODS
  Following standard secondary bone graft preparation of the cleft site, CBP harvested from the medial iliac crest was inserted into the palatal deficiency. This was followed by suturing the palatal mucosa. PMCB was then packed between the cortical bone and the reconstructed nasal floor.
  
  
  METHODS
  Ten consecutive patients with palatal fistula were operated on at Tokyo Medical and Dental University Hospital from 1998 to 2000. Primary palatal repair was performed in 7 out of 10 patients at our center and in 3 out of 10 patients at other hospitals.
  
  
  METHODS
  Ten patients (6 boys and men, 4 girls and women) with a palatal fistula associated with an alveolar cleft were studied. Ages ranged from 12 to 26 years.
  
  
  METHODS
  All patients underwent simultaneous CBP graft with PMCB graft for closure of palatal fistula under general anesthesia.
  
  
  RESULTS
  Complete closure of palatal fistulae were obtained in 8 out of 10 cases. A very small asymptomatic fistula remained in one patient. Total necrosis of the labial flap with a residual palatal fistula occurred in one patient.
  
  
  CONCLUSIONS
  Simultaneous CBP graft with PMCB graft could be more reliable than PMCB alone for closure of a cleft associated palatal fistula.
authors.affiliation: Oral Surgery, Oral Restitution, Oral Health Science, Graduate School, Tokyo Medical and Dental University, Tokyo, Japan. ishii.osur@tmc.ac.jp
authors.forename: Masatoshi
authors.initials: M
authors.lastname: Ishii
authors.forename: Yoshimasa
authors.initials: Y
authors.lastname: Ishii
authors.forename: Takashi
authors.initials: T
authors.lastname: Moriyama
authors.forename: Akemi
authors.initials: A
authors.lastname: Gunji
authors.forename: Keiichi
authors.initials: K
authors.lastname: Morita
authors.forename: Fumiko
authors.initials: F
authors.lastname: Imaizumi
authors.forename: Shoji
authors.initials: S
authors.lastname: Enomoto
mesh_terms: D000293:Adolescent; D000328:Adult; D016026:Bone Marrow Transplantation / Q000379:methods*; D016025:Bone Transplantation / Q000379:methods*; D002648:Child; D002971:Cleft Lip / Q000150:complications / Q000601:surgery; D002972:Cleft Palate / Q000150:complications* / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D008439:Maxillary Diseases / Q000601:surgery*; D009061:Mouth Mucosa / Q000637:transplantation; D009296:Nasal Cavity / Q000601:surgery; D009336:Necrosis; D009668:Nose Diseases / Q000601:surgery*; D016155:Oral Fistula / Q000601:surgery*; D010159:Palate / Q000601:surgery*; D010521:Periosteum / Q000637:transplantation; D011183:Postoperative Complications; D015203:Reproducibility of Results; D016156:Respiratory Tract Fistula / Q000601:surgery*; D013524:Surgical Flaps / Q000473:pathology; D014059:Tongue / Q000637:transplantation