title: Membrane Assisted Palatal Fistula Closure in a Cleft Palate Patient: A Novel Technique.
abstract: Palatal fistula following cleft palate repair, is one of the considerable complications and remains a challenging problem to the surgeons. The reported recurrence rate of the fistula is between 33% to 37%. Due to fibrosis and poor vascularity of adjacent tissues, high recurrence rates are typical. Closure of palatal fistulas can be achieved by different surgical techniques like local, regional and distant flaps, local turnover flaps, pedicled flaps from oral mucosa, buccal fat pad flaps, inter-positional cartilage grafts can be utilized for management of small fistulas. For larger fistualas, tongue flaps, temporalis muscle flaps, musculomucosal flaps, nasal septal flaps and free flaps can be used. These procedures are often cumbersome and leave a raw nasal or oral surface, which may increase the incidence of postoperative problems or some flaps can be bulky and may require a second-stage procedure. Different synthetic materials such as alloderm, Poly-D and L-Lactic Acid or "PdLLA" and collagen membrane are used in multilayer repair represented by the nasal mucosa, the inter-positional graft and oral mucosa. These interpositional grafts provide a scaffold for in growth of tissues, revascularization and mucosal epithelialization. We present a case of closure of an oronasal fistula, using resorbable collagen membrane in three layered repair to avoid recurrence.
authors.affiliation: Professor, Department of Oral and Maxillofacial Surgery, Panineeya Mahavidyalaya Institute of Dental Sciences and Research Centre, Dr. N.T.R. University of Health Sciences , India .
authors.forename: G Siva Prasad
authors.initials: GS
authors.lastname: Reddy
authors.affiliation: Professor and Head of the Department of OMFS, Department of Oral and Maxillofacial Surgery, Panineeya Mahavidyalaya Institute of Dental Sciences and Research Centre, Dr. N.T.R. University of Health Sciences , India .
authors.forename: G Venkateshwara
authors.initials: GV
authors.lastname: Reddy
authors.affiliation: Post Graduate Student, Department of Oral and Maxillofacial Surgery, Panineeya Mahavidyalaya Institute of Dental Sciences and Research Centre, Dr. N.T.R. University of Health Sciences , India .
authors.forename: P Karuna
authors.initials: PK
authors.lastname: Sree
authors.affiliation: Post Graduate Student, Department of Oral and Maxillofacial Surgery, Panineeya Mahavidyalaya Institute of Dental Sciences and Research Centre, Dr. N.T.R. University of Health Sciences , India .
authors.forename: K Sravan Kumar
authors.initials: KS
authors.lastname: Reddy
authors.affiliation: Post Graduate Student, Department of Oral and Maxillofacial Surgery, Panineeya Mahavidyalaya Institute of Dental Sciences and Research Centre, Dr. N.T.R. University of Health Sciences , India .
authors.forename: P Amarnath
authors.initials: PA
authors.lastname: Reddy
keywords: Collagen membrane; Guided tissue regeneration; Interpositional grafts; Oronasal fistula