title: Persistent oro-nasal fistula after primary cleft palate repair: minimizing the rate via a standardized protocol.
abstract: OBJECTIVE
  Multiple methods are described for cleft palate repair. Similarly, a wide range of postoperative oro-nasal fistula rates are described, depending on technique and series examined. We describe long-term outcomes and fistula rates for primary cleft palate repair for a single surgeon using a standardized protocol. Furlow palatoplasty was used for clefts limited to the soft palate, and two-flap palatoplasty was used for clefts involving both the hard and soft palate.
  
  
  METHODS
  Retrospective review of prospectively gathered data.
  
  
  RESULTS
  Eighty-two patients underwent cleft palate repair within the study period. Average age at time of repair was 1.69 years (range 0.47-12.1 years), 19 patients had cleft palate as a part of a known genetic syndrome, and male:female ratio was 1.05:1. Overall fistula rate requiring repair was 5.5%, and fistula development was not significantly associated with type of cleft repair or use of AlloDerm in the repair.
  
  
  CONCLUSIONS
  A very low rate of oro-nasal fistula and good postoperative outcomes were achieved utilizing this protocol for cleft palate repair. It is effective both in isolated cleft palate, as well as in more complicated syndromic patients. It is possible that significant associations between repair technique and fistula rate exist that were not elucidated in this study as a result of the small number of oro-nasal fistulas.
authors: Tulane University Department of Otolaryngology - Head & Neck Surgery, United States. Electronic address: rwinters@tulane.edu.
authors: Ryan
authors: R
authors: Winters
authors: Tulane University Department of Otolaryngology - Head & Neck Surgery, United States.
authors: John M
authors: JM
authors: Carter
authors: Louisiana State University - New Orleans School of Medicine, United States.
authors: Victoria
authors: V
authors: Givens
authors: Louisiana State University Division of Plastic & Reconstructive Surgery, United States.
authors: Hugo
authors: H
authors: St Hilaire
mesh_terms: D002648:Child; D002675:Child, Preschool; D002972:Cleft Palate / Q000601:surgery*; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D009668:Nose Diseases / Q000601:surgery*; D016155:Oral Fistula / Q000209:etiology* / Q000601:surgery; D011183:Postoperative Complications; D019651:Plastic Surgery Procedures / Q000009:adverse effects / Q000379:methods*; D012189:Retrospective Studies; D016896:Treatment Outcome
keywords: Cleft palate; Furlow palatoplasty; Two-flap palatoplasty