Palatal Protective Stents Prevent Oro-Nasal Fistulas after Surgery for Velopharyngeal Insufficiency: A Preliminary Report

Background: One of the potential complications of surgery for velopharyngeal insufficiency (VPI) is postoperative oral-nasal fistula (ONF). Reported rates vary from 0 to 60%. Several factors are on account of these disproportionate rates. Objective: The purpose of this study was to describe the use...

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Main Authors: Kongkrit Chaiyasate, Pablo Antonio Ysunza, John Spolyar, Rafaella Genova, Peter Andrade
Format: Article
Language:English
Published: MDPI AG 2018-07-01
Series:Dentistry Journal
Subjects:
Online Access:http://www.mdpi.com/2304-6767/6/3/29
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author Kongkrit Chaiyasate
Pablo Antonio Ysunza
John Spolyar
Rafaella Genova
Peter Andrade
author_facet Kongkrit Chaiyasate
Pablo Antonio Ysunza
John Spolyar
Rafaella Genova
Peter Andrade
author_sort Kongkrit Chaiyasate
collection DOAJ
description Background: One of the potential complications of surgery for velopharyngeal insufficiency (VPI) is postoperative oral-nasal fistula (ONF). Reported rates vary from 0 to 60%. Several factors are on account of these disproportionate rates. Objective: The purpose of this study was to describe the use of a palatal protective stent (PPS) to preserve the VPI repair surgical site and to study its effectiveness for decreasing the incidence of postoperative ONF. Materials and Methods: A retrospective study was carried out. All patients undergoing surgery for VPI with complete preoperative and postoperative evaluations including at least one year follow up after surgery from 2012 to 2016 were studied. Some of the patients were operated on using a pre-molded palatal protective stent (PPS). Twenty-seven patients were included in the study group. Most of the patients underwent a customized pharyngeal flap according to findings of imaging procedures. The remaining cases underwent a Furlow palatoplasty. Twelve patients were operated on using PPS. Results: There were no surgical complications during the procedures. ONF was detected in four of the patients operated on without PPS. None of the patients undergoing surgery using PPS demonstrated ONF. All fistulas were located at the soft/hard palate junction. VPI was corrected in 92% of the cases. Conclusion: Although only a reduced number of cases were studied, these preliminary results suggest that using PPS during surgical procedures for correcting VPI is a safe and reliable tool for preventing ONF.
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spelling doaj.art-39e20b90ec894f17a5d343326cc93cb82022-12-22T03:59:57ZengMDPI AGDentistry Journal2304-67672018-07-01632910.3390/dj6030029dj6030029Palatal Protective Stents Prevent Oro-Nasal Fistulas after Surgery for Velopharyngeal Insufficiency: A Preliminary ReportKongkrit Chaiyasate0Pablo Antonio Ysunza1John Spolyar2Rafaella Genova3Peter Andrade4Ian Jackson Craniofacial and Cleft Palate Clinic of Beaumont Hospital, Royal Oak, MI 48073, USAIan Jackson Craniofacial and Cleft Palate Clinic of Beaumont Hospital, Royal Oak, MI 48073, USAIan Jackson Craniofacial and Cleft Palate Clinic of Beaumont Hospital, Royal Oak, MI 48073, USAOakland University William Beaumont School of Medicine, Rochester, MI 48309, USAIan Jackson Craniofacial and Cleft Palate Clinic of Beaumont Hospital, Royal Oak, MI 48073, USABackground: One of the potential complications of surgery for velopharyngeal insufficiency (VPI) is postoperative oral-nasal fistula (ONF). Reported rates vary from 0 to 60%. Several factors are on account of these disproportionate rates. Objective: The purpose of this study was to describe the use of a palatal protective stent (PPS) to preserve the VPI repair surgical site and to study its effectiveness for decreasing the incidence of postoperative ONF. Materials and Methods: A retrospective study was carried out. All patients undergoing surgery for VPI with complete preoperative and postoperative evaluations including at least one year follow up after surgery from 2012 to 2016 were studied. Some of the patients were operated on using a pre-molded palatal protective stent (PPS). Twenty-seven patients were included in the study group. Most of the patients underwent a customized pharyngeal flap according to findings of imaging procedures. The remaining cases underwent a Furlow palatoplasty. Twelve patients were operated on using PPS. Results: There were no surgical complications during the procedures. ONF was detected in four of the patients operated on without PPS. None of the patients undergoing surgery using PPS demonstrated ONF. All fistulas were located at the soft/hard palate junction. VPI was corrected in 92% of the cases. Conclusion: Although only a reduced number of cases were studied, these preliminary results suggest that using PPS during surgical procedures for correcting VPI is a safe and reliable tool for preventing ONF.http://www.mdpi.com/2304-6767/6/3/29cleft palatesurgeryfistulaspeechresonance
spellingShingle Kongkrit Chaiyasate
Pablo Antonio Ysunza
John Spolyar
Rafaella Genova
Peter Andrade
Palatal Protective Stents Prevent Oro-Nasal Fistulas after Surgery for Velopharyngeal Insufficiency: A Preliminary Report
Dentistry Journal
cleft palate
surgery
fistula
speech
resonance
title Palatal Protective Stents Prevent Oro-Nasal Fistulas after Surgery for Velopharyngeal Insufficiency: A Preliminary Report
title_full Palatal Protective Stents Prevent Oro-Nasal Fistulas after Surgery for Velopharyngeal Insufficiency: A Preliminary Report
title_fullStr Palatal Protective Stents Prevent Oro-Nasal Fistulas after Surgery for Velopharyngeal Insufficiency: A Preliminary Report
title_full_unstemmed Palatal Protective Stents Prevent Oro-Nasal Fistulas after Surgery for Velopharyngeal Insufficiency: A Preliminary Report
title_short Palatal Protective Stents Prevent Oro-Nasal Fistulas after Surgery for Velopharyngeal Insufficiency: A Preliminary Report
title_sort palatal protective stents prevent oro nasal fistulas after surgery for velopharyngeal insufficiency a preliminary report
topic cleft palate
surgery
fistula
speech
resonance
url http://www.mdpi.com/2304-6767/6/3/29
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AT johnspolyar palatalprotectivestentspreventoronasalfistulasaftersurgeryforvelopharyngealinsufficiencyapreliminaryreport
AT rafaellagenova palatalprotectivestentspreventoronasalfistulasaftersurgeryforvelopharyngealinsufficiencyapreliminaryreport
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