title: [Repair of palatal fistulae in cleft patients].
abstract: OBJECTIVE
  Treatment of oronasal fistulae in cleft patients remains a surgical challenge because of its high failure rate. The authors report the results of an aggressive surgical technique using the total elevation of palatal mucoperiosteum, even for small fistulae.
  
  
  METHODS
  This approach was used on twelve consecutive patients, 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 starting 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 fistula was observed with follow-up ranging from 6 to 36 months.
  
  
  CONCLUSIONS
  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 aggressive, seems to be more reliable with fewer relapse and sequelae.
authors.affiliation: Service de chirurgie maxillo-faciale, CHU de Caen, avenue de la Cote-de-Nacre, 14033 Caen cedex, France. benateau-h@chu-caen.fr
authors.forename: H
authors.initials: H
authors.lastname: Bénateau
authors.forename: H
authors.initials: H
authors.lastname: Traoré
authors.forename: B
authors.initials: B
authors.lastname: Gilliot
authors.forename: A
authors.initials: A
authors.lastname: Taupin
authors.forename: L
authors.initials: L
authors.lastname: Ory
authors.forename: M-R
authors.initials: MR
authors.lastname: Guillou Jamard
authors.forename: D
authors.initials: D
authors.lastname: Labbé
authors.forename: J-F
authors.initials: JF
authors.lastname: Compère
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D002972:Cleft Palate / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D058752:Free Tissue Flaps; D006801:Humans; D008297:Male; D009061:Mouth Mucosa / Q000601:surgery; D009297:Nasal Mucosa / Q000601:surgery; D009668:Nose Diseases / Q000601:surgery*; D016155:Oral Fistula / Q000601:surgery*; D021362:Palate, Hard / Q000601:surgery; D010521:Periosteum / Q000601:surgery; D010781:Photography; D011446:Prospective Studies; D016156:Respiratory Tract Fistula / Q000601:surgery*; D013536:Suture Techniques; D016896:Treatment Outcome; D055815:Young Adult