当前位置： SCI文献检索 > PLASTIC AND RECONSTRUCTIVE SURGERY期刊下所有文献 > Evolution in minimal-incision palatoplasty: surgical technique and outcomes in 67 consecutive cases.

Evolution in minimal-incision palatoplasty: surgical technique and outcomes in 67 consecutive cases.

Abstract：

BACKGROUND:Conventional palatoplasty relies on extensive mucosal incisions and isolation of flaps on the palatine vessels to facilitate midline closure and velar reconstruction. This introduces substantial scarring, which has adverse effects on vascularity and growth. The authors have developed a minimally invasive palatoplasty technique that may have advantages over traditional techniques. The authors present their operative experience and outcomes when using the minimally invasive method paired with a novel cranial base maneuver for nasal mucosa closure. METHODS:Based on cadaveric dissections, the authors developed a modified minimal-incision approach that permits anatomical reconstruction from a midline approach. From 2003 to 2010, a retrospective review was performed on 67 consecutive minimal-incision palatoplasties. Cases requiring relaxing incision and/or conversion to other palatoplasty techniques were compared with minimal incision alone. RESULTS:Minimally invasive palatoplasty alone was able to be performed in 78 percent (n=52) of all cases. Fistula rates were 7.6 percent (n=4) in the minimally invasive palatoplasty group and 20 percent (n=3) in the relaxing/conversion group (p=0.04). Of patients requiring relaxing incisions/conversion, a higher percentage were syndromic (73 percent; p=0.01). Eighty-nine percent of all Veau class I defects were able to be successfully closed with the minimally invasive palatoplasty approach (p=0.01). CONCLUSIONS:Minimal-incision palatoplasty paired with a cranial base maneuver for nasal mucosa elevation results in adequate soft-tissue mobility and length to arrive at a tension-free closure. Fistula and velopharyngeal insufficiency rates are comparable to that of other techniques, and theoretical advantages of this technique will be borne out by longer term follow-up. CLINICAL QUESTION/LEVEL OF EVIDENCE:Therapeutic, III.

journal_name

Plast Reconstr Surg

journal_title

Plastic and reconstructive surgery

authors

Pan BS,Rapp SJ,Vu A,Uribe-Rivera A,Billmire DA,Gordon CB

doi

10.1097/PRS.0000000000000280

subject

Has Abstract

pub_date

2014-07-01 00:00:00

pages

102-111

issue

eissn

0032-1052

issn

1529-4242

pii

00006534-201407000-00025

journal_volume

134

pub_type

杂志文章

在线工具

Evolution in minimal-incision palatoplasty: surgical technique and outcomes in 67 consecutive cases.