Oronasal Fistula Closure and Defect Reconstruction: Two Case Reports Using Periodontal Plastic Surgery Principles

IF 1.7 Q3 DENTISTRY, ORAL SURGERY & MEDICINE Clinical and Experimental Dental Research Pub Date : 2024-07-07 DOI:10.1002/cre2.914
Gerardo Chacon, Abdusalam Alrmali, Obada Mandil, Héctor Rodriguez, José Rodriguez, Anas Al-misurati, Hom-Lay Wang
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Abstract

Objectives

Oronasal fistulas are common sequelae following cleft lip and palate surgery and can significantly impact a patient's quality of life. They result from various factors, including surgical techniques, tissue management, and patient-specific factors. This case report explores the modern approach to oronasal fistula closure using periodontal plastic surgery principles.

Materials and Methods

The report presents two cases of patients with oronasal fistulas due to previous maxillofacial surgical intervention. These patients underwent microsurgical procedures that involved partial flap thickness preparation of the fistula areas, the use of connective tissue grafts from the palate, and meticulous suturing techniques to ensure graft integrity. The procedures were performed in stages, and postoperative care was provided.

Results

Both cases demonstrated successful fistula closure and graft survival. The patients reported improvements in breathing, speech, aesthetics, and quality of life. The second case also included guided bone regeneration and implant placement.

Conclusions

Oronasal fistulas resulting from maxillofacial surgery can be effectively treated using periodontal plastic surgery techniques, significantly improving patients' quality of life and aesthetic outcomes. This approach represents a valuable addition to the existing repertoire of oronasal fistula closure methods.

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口鼻瘘管闭合和缺损重建:利用牙周整形原理的两个病例报告。
目的:口鼻瘘是唇腭裂手术后常见的后遗症,会严重影响患者的生活质量。造成口鼻瘘的因素多种多样,包括手术技术、组织管理和患者特异性因素。本病例报告探讨了利用牙周整形外科原理进行口瘘闭合的现代方法:本报告介绍了两例因既往颌面外科手术干预而导致口鼻瘘的患者。这些患者接受了显微外科手术,包括瘘管部位的部分皮瓣厚度准备、腭结缔组织移植物的使用以及确保移植物完整性的细致缝合技术。手术分阶段进行,并提供术后护理:结果:两个病例均成功闭合瘘管,移植物存活。结果:两个病例都成功关闭了瘘管,移植物存活,患者的呼吸、言语、美观和生活质量都有所改善。第二个病例还包括引导骨再生和种植体植入:结论:利用牙周整形技术可以有效治疗颌面外科手术导致的口瘘,显著改善患者的生活质量和美观效果。这种方法是对现有口瘘闭合方法的重要补充。
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来源期刊
Clinical and Experimental Dental Research
Clinical and Experimental Dental Research DENTISTRY, ORAL SURGERY & MEDICINE-
CiteScore
3.30
自引率
5.60%
发文量
165
审稿时长
26 weeks
期刊介绍: Clinical and Experimental Dental Research aims to provide open access peer-reviewed publications of high scientific quality representing original clinical, diagnostic or experimental work within all disciplines and fields of oral medicine and dentistry. The scope of Clinical and Experimental Dental Research comprises original research material on the anatomy, physiology and pathology of oro-facial, oro-pharyngeal and maxillofacial tissues, and functions and dysfunctions within the stomatognathic system, and the epidemiology, aetiology, prevention, diagnosis, prognosis and therapy of diseases and conditions that have an effect on the homeostasis of the mouth, jaws, and closely associated structures, as well as the healing and regeneration and the clinical aspects of replacement of hard and soft tissues with biomaterials, and the rehabilitation of stomatognathic functions. Studies that bring new knowledge on how to advance health on the individual or public health levels, including interactions between oral and general health and ill-health are welcome.
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