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CC BY 4.0 · Revista Brasileira de Cirurgia Plástica (RBCP) – Brazilian Journal of Plastic Surgery 2025; 40: s00451807281
DOI: 10.1055/s-0045-1807281
Artigo Original

Evaluation of a Surgical Tactic in the Prevention of Oronasal Fistula during Palatoplasty in Patients with Cleft Palate

Article in several languages: português | English
Géza Lászlo Urményi 
1   Serviço de Cirurgia Plástica, Hospital Santa Izabel, Salvador, BA, Brasil
,
Elizabeth Castineira Fernandes
1   Serviço de Cirurgia Plástica, Hospital Santa Izabel, Salvador, BA, Brasil
,
Lucas Gábor Urményi 
1   Serviço de Cirurgia Plástica, Hospital Santa Izabel, Salvador, BA, Brasil
› Author Affiliations

Financial Support The authors declare that they did not receive financial support from agencies in the public, private, or non-profit sectors to conduct the present study. Ensaios Clínicos Nenhum. | Clinical Trials None.
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Abstract

Oronasal fistula is a common complication in surgeries for the repair of cleft palate. It represents a challenge due to the scarcity of tissue in the affected area. The incidence of this complication ranges from 3% to 46%, and it is more prevalent in zone III of the Pittsburgh classification, which corresponds to the junction between the hard and soft palates. The present study aimed to evaluate a surgical tactic to reduce the incidence of oronasal fistulas. We conducted a retrospective study with 142 consecutive patients who underwent palatoplasty from January 2018 to June 2024 at Hospital Santa Izabel using the two-flap technique with a strategy to reduce suture tension. We analyzed factors such as cleft type (per the Veau classification), age at surgery, sex, cleft size, and fistula incidence (according to the Pittsburgh classification). The incidence of oronasal fistulas was of 1.4%, which is significantly lower than the rates reported in the literature, with no fistulas occurring in zone III, where they are more frequent. The tactic reduced fistula formation, even in patients with wide clefts and comorbidities, demonstrating its viability and benefits for the clinical practice.

Keywords

cleft palate - fistula - oral fistula - palate - hard - palate - soft

Authors' Contributions

GLU: data analysis and/or interpretation, final manuscript approval, and writing – review & editing; ECF: data collection and methodology; and LGU: data analysis and/or interpretation and writing – original draft.


Ethics Committee Number

CAAE 74866323.5.0000.5520.




Publication History

Received: 15 December 2024

Accepted: 06 February 2025

Article published online:
14 May 2025

© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit (https://creativecommons.org/licenses/by/4.0/)

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Bibliographical Record
Géza Lászlo Urményi, Elizabeth Castineira Fernandes, Lucas Gábor Urményi. Avaliação de uma tática cirúrgica na prevenção de fístula oronasal durante a palatoplastia em pacientes fissurados. Revista Brasileira de Cirurgia Plástica (RBCP) – Brazilian Journal of Plastic Surgery 2025; 40: s00451807281.
DOI: 10.1055/s-0045-1807281
 

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