Pakistan Comprehensive Fistula Classification: A Novel Scheme and Algorithm for Management of Palatal Fistula/Dehiscence.
Adolescent
Adult
Age Factors
Algorithms
Child
Child, Preschool
Cleft Palate
/ classification
Cohort Studies
Developing Countries
Female
Humans
Male
Middle Aged
Pakistan
Quality of Life
Plastic Surgery Procedures
/ methods
Retrospective Studies
Risk Assessment
Severity of Illness Index
Sex Factors
Surgical Flaps
/ transplantation
Treatment Outcome
Velopharyngeal Insufficiency
/ diagnosis
Young Adult
Journal
Plastic and reconstructive surgery
ISSN: 1529-4242
Titre abrégé: Plast Reconstr Surg
Pays: United States
ID NLM: 1306050
Informations de publication
Date de publication:
Jan 2019
Jan 2019
Historique:
pubmed:
16
11
2018
medline:
28
3
2019
entrez:
16
11
2018
Statut:
ppublish
Résumé
It is not easy to find a management-based classification of palatal fistula in the literature. A few attempts have been made to classify the wide variety of fistulae that do not describe the fistula details comprehensively and guide toward its management. The authors have come across a wide variety of fistulae that could not be classified according to any of the prevailing classification systems. The presented classification gives a clear and exact understanding of location and size of fistula/dehiscence. Palatal function has been included as one of the important determinants for devising a management plan. Based on this classification, the authors have proposed an algorithm that encompasses clear guidelines for surgical treatment of these fistulae. Over the past 15 years, the authors' team operated on 2537 palatal fistula patients. The medical records of these patients were reviewed to determine the location, size, and velopharyngeal competence. A new classification and algorithm were developed. Of 2537 patients, 2258 had midline fistulae, 208 had lateral fistulae, and 53 had subtotal fistulae. There were 18 patients with dehiscence. Recurrence developed in 181 patients. The authors believe that this classification and algorithm can help follow a practical approach to manage palatal fistulae and dehiscence.
Sections du résumé
BACKGROUND
BACKGROUND
It is not easy to find a management-based classification of palatal fistula in the literature. A few attempts have been made to classify the wide variety of fistulae that do not describe the fistula details comprehensively and guide toward its management. The authors have come across a wide variety of fistulae that could not be classified according to any of the prevailing classification systems. The presented classification gives a clear and exact understanding of location and size of fistula/dehiscence. Palatal function has been included as one of the important determinants for devising a management plan. Based on this classification, the authors have proposed an algorithm that encompasses clear guidelines for surgical treatment of these fistulae.
METHODS
METHODS
Over the past 15 years, the authors' team operated on 2537 palatal fistula patients. The medical records of these patients were reviewed to determine the location, size, and velopharyngeal competence. A new classification and algorithm were developed.
RESULTS
RESULTS
Of 2537 patients, 2258 had midline fistulae, 208 had lateral fistulae, and 53 had subtotal fistulae. There were 18 patients with dehiscence. Recurrence developed in 181 patients.
CONCLUSION
CONCLUSIONS
The authors believe that this classification and algorithm can help follow a practical approach to manage palatal fistulae and dehiscence.
Identifiants
pubmed: 30431540
doi: 10.1097/PRS.0000000000005169
pii: 00006534-201901000-00045
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
140e-151eRéférences
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