title: [Closure of recurrent cleft palate fistulas with plasma rich in growth factors].
abstract: OBJECTIVE
  Fistulas represent a significant challenge in the treatment of cleft palate. The best outcome of a palatoplasty is obtained with a competent velopharyngeal sphincter and a palate without fistulas. The recurrence of primary cleft palate fistula is reported as high as up to 76%, and to nearly 100% in recurrent fistulas. Plasma rich in growth factors (PRGF) is an autologous blood product with biologically active substances that enhance tissue repair mechanisms such as chemotaxis, cell proliferation, angiogenesis, osteogenesis and remodeling. Its use in cleft palate fistulas has not been reported. Our objective was to evaluate closure of recurrent cleft palate fistulas using PRGF mixed with autologous bone graft.
  
  
  METHODS
  An experimental, prospective, longitudinal study was carried out from April 2008 to July 2010 on 11 recurrent cleft palate fistulas that were closed with local mucoperiosteal flaps and placement of autologous bone graft mixed with PRGF.
  
  
  RESULTS
  Complete closure of palate fistulas was achieved in 90.9% (follow-up of 6-24 months), decreasing the reported incidence for the recurrence by other authors with other techniques.
  
  
  CONCLUSIONS
  The use of PRGF mixed with autologous bone graft seems to be an effective, safe and low-cost technique for the closure of recurrent cleft palate fistulas. However, we consider its study must be extended.
authors.affiliation: Servicio de Otorrinolaringología y Cirugía de Cabeza y Cuello, Hospital Dr. Valentín Gómez Farías, ISSSTE, Zapopan, Jalisco, México.
authors.forename: Jorge Glicerio
authors.initials: JG
authors.lastname: González-Sánchez
authors.forename: Karina
authors.initials: K
authors.lastname: Jiménez-Barragán
mesh_terms: D000293:Adolescent; D000328:Adult; D016025:Bone Transplantation; D002648:Child; D002972:Cleft Palate / Q000601:surgery*; D003131:Combined Modality Therapy; D005260:Female; D005402:Fistula / Q000601:surgery / Q000628:therapy*; D006801:Humans; D036341:Intercellular Signaling Peptides and Proteins / Q000008:administration & dosage / Q000627:therapeutic use*; D008297:Male; D016155:Oral Fistula / Q000601:surgery / Q000628:therapy*; D010159:Palate / Q000473:pathology* / Q000601:surgery; D053657:Platelet-Rich Plasma; D011183:Postoperative Complications / Q000601:surgery / Q000628:therapy*; D011446:Prospective Studies; D012008:Recurrence; D013524:Surgical Flaps; D014182:Transplantation, Autologous; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D036341:Intercellular Signaling Peptides and Proteins