title: A 5-Year Retrospective Review of Primary Palatoplasty Cases Utilizing an Acellular Collagen Interpositional Graft.
abstract: OBJECTIVE
  Multiple palatoplasty techniques have been developed, but a technique involving a partial 2-layer soft tissue closure of the posterior hard palate and nasal floor and a 3-layer soft tissue closure of the soft palate with reorientation of the levator and tensor veli muscles across the midline has been the gold standard for cleft repair. This report describes a series of primary palatoplasties reconstructed with a middle layer of acellular collagen membrane that aided in maintaining closure between the oral and nasal cavities without the development of an oronasal fistula.
  
  
  METHODS
  An acellular collagen membrane was placed between the muscular layer and the oral mucosa during primary palatoplasty. Six patients with primary cleft palatoplasty were identified and followed for 1 year (patient 1, a 10-month-old boy; patient 2, a 12-month-old girl; patient 3, a 12-month-old girl; patient 4, a 6-year-old boy; patient 5, a 12-month-old girl; and patient 6, an 18-month-old girl).
  
  
  RESULTS
  At 1 year, no oronasal fistulas had developed where augmentation with the acellular collagen membrane was used.
  
  
  CONCLUSIONS
  The use of an acellular collagen graft to aid in the 3-layer closure of primary palatoplasty surgery is a very effective strategy in primary and secondary healing and in preventing oronasal fistulation. The risk associated with the use of acellular collagen membranes appears nonexistent.
authors: Professor, Department of Oral and Maxillofacial Surgery, University of Tennessee Medical Center, Knoxville, TN.
authors: John W
authors: JW
authors: Hudson
authors: Chief Resident, Department of Oral and Maxillofacial Surgery, University of Tennessee Medical Center, Knoxville, TN. Electronic address: elitekid@gmail.com.
authors: David O
authors: DO
authors: Pickett
mesh_terms: D062088:Acellular Dermis; D002648:Child; D002972:Cleft Palate / Q000601:surgery*; D003094:Collagen / Q000627:therapeutic use*; D005260:Female; D015718:Fibrin Tissue Adhesive / Q000627:therapeutic use; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D009061:Mouth Mucosa / Q000601:surgery; D009296:Nasal Cavity / Q000601:surgery; D009668:Nose Diseases / Q000517:prevention & control; D016155:Oral Fistula / Q000517:prevention & control; D010159:Palate / Q000601:surgery*; D010160:Palate, Soft / Q000601:surgery; D010609:Pharyngeal Muscles / Q000601:surgery; D019651:Plastic Surgery Procedures / Q000379:methods*; D016156:Respiratory Tract Fistula / Q000517:prevention & control; D012189:Retrospective Studies; D014014:Tissue Adhesives / Q000627:therapeutic use
chemical_list: D015718:Fibrin Tissue Adhesive; D014014:Tissue Adhesives; D003094:Collagen