title: Acellular Dermal Matrix as an Adjunct Material in Cleft Le Fort I Osteotomies.
abstract: OBJECTIVE
  To evaluate the use of acellular dermal matrix in the management of nasal lining deficiency at the time of Le Fort I osteotomy.
  
  
  METHODS
  This was a retrospective cohort study of patients with residual/recurrent oronasal fistulae who underwent Le Fort I osteotomy. In instances where there was an inadequate volume of nasal mucosa for tension-free closure or for defects >1 cm in width, the acellular dermal matrix was used for augmentation. Demographic and cleft-related factors were recorded. Complications (recurrent fistula, infection, seroma, and wound dehiscence) were recorded.
  
  
  RESULTS
  Over the 3-year period, the authors used acellular dermal matrix to augment nasal lining in 8 subjects. The sample's mean age was 18.7 ± 3.1 years; 5 subjects were male. Six patients had bilateral cleft defects. The mean follow-up time was 20.2 ± 3.2 years. There were no episodes of infection, seroma, wound dehiscence, or recurrent fistula.
  
  
  CONCLUSIONS
  Acellular dermal matrix is a useful adjunct for managing nasal liningdeficiency at the time of Le Fort I osteotomy. There were no episodes of bone graft extrusion, infection, tooth loss, or bone graft loss. The Enemark scores improved significantly across both subsets (P <0.001). There was 1 recurrent fistula in the allograft bone alone group.Residual alveolar clefts and oronasal fistulae can be successfully managed at the time of Le Fort I osteotomy using allograft bone and acellular dermal matrix.
authors.affiliation: *Craniofacial Center, Seattle Children's Hospital, Seattle, WA †Department of Plastic Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA ‡Department of Plastic Surgery, Johns Hopkins University School of Medicine, Baltimore, MD.
authors.forename: Srinivas M
authors.initials: SM
authors.lastname: Susarla
authors.forename: Zoe M
authors.initials: ZM
authors.lastname: MacIsaac
authors.forename: Edward
authors.initials: E
authors.lastname: Swanson
authors.forename: Edward
authors.initials: E
authors.lastname: Davidson
authors.forename: Anand
authors.initials: A
authors.lastname: Kumar
mesh_terms: D062088:Acellular Dermis; D000293:Adolescent; D003399:Craniotomy; D005260:Female; D005402:Fistula / Q000601:surgery; D005500:Follow-Up Studies; D005544:Forecasting; D006801:Humans; D008297:Male; D009668:Nose Diseases / Q000601:surgery*; D016155:Oral Fistula / Q000601:surgery*; D019340:Osteotomy, Le Fort / Q000379:methods*; D012189:Retrospective Studies