Mucosal Rugosity Unfolding Technique: A Novel Technique for the Management of Anterior Palatal Fistulae
Background:. Palatal fistulae are a well-known complication after palatoplasty. In particular, anterior palatal fistulae (APF) pose a challenge for even the most experienced surgeons. In this study, we present a novel technique for APF repair that leverages the unfurling of epithelialized mucosal fo...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer
2025-08-01
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| Series: | Plastic and Reconstructive Surgery, Global Open |
| Online Access: | http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000006987 |
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| author | Muhammad Daiem, MBBS, MD Nauman Ahmad Gill, MRCS, FCPS Sadia Nosheen Jan, MBBS, FCPS Marvee Turk, MD, MPH Muhammad Ashraf Ganatra, MBBS, MS, MHPE Muhammad Mustehsan Bashir, MBBS, FCPS, PhD David Low, MD Corstiaan Breugem, MD, PhD Pang-Yun Chou, MD Ghulam Qadir Fayyaz, MBBS, DSS, MS |
| author_facet | Muhammad Daiem, MBBS, MD Nauman Ahmad Gill, MRCS, FCPS Sadia Nosheen Jan, MBBS, FCPS Marvee Turk, MD, MPH Muhammad Ashraf Ganatra, MBBS, MS, MHPE Muhammad Mustehsan Bashir, MBBS, FCPS, PhD David Low, MD Corstiaan Breugem, MD, PhD Pang-Yun Chou, MD Ghulam Qadir Fayyaz, MBBS, DSS, MS |
| author_sort | Muhammad Daiem, MBBS, MD |
| collection | DOAJ |
| description | Background:. Palatal fistulae are a well-known complication after palatoplasty. In particular, anterior palatal fistulae (APF) pose a challenge for even the most experienced surgeons. In this study, we present a novel technique for APF repair that leverages the unfurling of epithelialized mucosal folds to lengthen palatal mucoperiosteal flaps so they reach the anterior palate without other complex maneuvers.
Methods:. We conducted a retrospective review of patients with APF who presented to a cleft center in Lahore, Pakistan, between 2015 and 2020. Patients without mucosal rugosities on examination were excluded. Data collection included demographic characteristics, physical examination, operative management, and postoperative outcomes. Statistical analyses were conducted using SPSS.
Results:. A total of 30 patients with APF were treated using this technique. Patients had an average age at presentation of 11 years (range 3–25 y), with 17 (56.7%) men and 13 (43.3%) women. The average length gained in mucoperiosteal flaps was 12.57 mm on the left and 9.73 mm on the right. Five (16.7%) patients experienced fistula recurrence. Furthermore, 7 (23.3%) patients underwent a concomitant pharyngeal flap for insufficient palatal length at presentation, whereas 6 (20%) were scheduled for one later.
Conclusions:. Our study offered a promising single-stage solution for APF closure without donor-site morbidity. Further validation across centers is required to establish this technique as a standard of treatment for APF. However, the presence of a mucosal rugosity is a prerequisite for this technique. |
| format | Article |
| id | doaj-art-d016c8ee1fea4c15bddb1d9b7ebe0955 |
| institution | Kabale University |
| issn | 2169-7574 |
| language | English |
| publishDate | 2025-08-01 |
| publisher | Wolters Kluwer |
| record_format | Article |
| series | Plastic and Reconstructive Surgery, Global Open |
| spelling | doaj-art-d016c8ee1fea4c15bddb1d9b7ebe09552025-08-26T03:24:29ZengWolters KluwerPlastic and Reconstructive Surgery, Global Open2169-75742025-08-01138e698710.1097/GOX.0000000000006987202508000-00016Mucosal Rugosity Unfolding Technique: A Novel Technique for the Management of Anterior Palatal FistulaeMuhammad Daiem, MBBS, MD0Nauman Ahmad Gill, MRCS, FCPS1Sadia Nosheen Jan, MBBS, FCPS2Marvee Turk, MD, MPH3Muhammad Ashraf Ganatra, MBBS, MS, MHPE4Muhammad Mustehsan Bashir, MBBS, FCPS, PhD5David Low, MD6Corstiaan Breugem, MD, PhD7Pang-Yun Chou, MD8Ghulam Qadir Fayyaz, MBBS, DSS, MS9From the * Department of Plastic Surgery, CLAPP Hospital, Lahore, Pakistan‡ Department of Plastic Surgery, Services Institute of Medical Sciences, Lahore, Pakistan‡ Department of Plastic Surgery, Services Institute of Medical Sciences, Lahore, Pakistan§ Division of Plastic and Reconstructive Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA¶ Department of Plastic Surgery, Liaquat College of Medicine & Dentistry∥ Department of Plastic Surgery, King Edward Medical University, Lahore, Pakistan** Department of Plastic Surgery, Children’s Hospital of Philadelphia, Philadelphia, PA†† Division of Plastic and Reconstructive Surgery, Amsterdam UMC, Amsterdam, the Netherlands‡‡ Department of Plastic and Reconstructive Surgery and Craniofacial Research Center, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan.From the * Department of Plastic Surgery, CLAPP Hospital, Lahore, PakistanBackground:. Palatal fistulae are a well-known complication after palatoplasty. In particular, anterior palatal fistulae (APF) pose a challenge for even the most experienced surgeons. In this study, we present a novel technique for APF repair that leverages the unfurling of epithelialized mucosal folds to lengthen palatal mucoperiosteal flaps so they reach the anterior palate without other complex maneuvers. Methods:. We conducted a retrospective review of patients with APF who presented to a cleft center in Lahore, Pakistan, between 2015 and 2020. Patients without mucosal rugosities on examination were excluded. Data collection included demographic characteristics, physical examination, operative management, and postoperative outcomes. Statistical analyses were conducted using SPSS. Results:. A total of 30 patients with APF were treated using this technique. Patients had an average age at presentation of 11 years (range 3–25 y), with 17 (56.7%) men and 13 (43.3%) women. The average length gained in mucoperiosteal flaps was 12.57 mm on the left and 9.73 mm on the right. Five (16.7%) patients experienced fistula recurrence. Furthermore, 7 (23.3%) patients underwent a concomitant pharyngeal flap for insufficient palatal length at presentation, whereas 6 (20%) were scheduled for one later. Conclusions:. Our study offered a promising single-stage solution for APF closure without donor-site morbidity. Further validation across centers is required to establish this technique as a standard of treatment for APF. However, the presence of a mucosal rugosity is a prerequisite for this technique.http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000006987 |
| spellingShingle | Muhammad Daiem, MBBS, MD Nauman Ahmad Gill, MRCS, FCPS Sadia Nosheen Jan, MBBS, FCPS Marvee Turk, MD, MPH Muhammad Ashraf Ganatra, MBBS, MS, MHPE Muhammad Mustehsan Bashir, MBBS, FCPS, PhD David Low, MD Corstiaan Breugem, MD, PhD Pang-Yun Chou, MD Ghulam Qadir Fayyaz, MBBS, DSS, MS Mucosal Rugosity Unfolding Technique: A Novel Technique for the Management of Anterior Palatal Fistulae Plastic and Reconstructive Surgery, Global Open |
| title | Mucosal Rugosity Unfolding Technique: A Novel Technique for the Management of Anterior Palatal Fistulae |
| title_full | Mucosal Rugosity Unfolding Technique: A Novel Technique for the Management of Anterior Palatal Fistulae |
| title_fullStr | Mucosal Rugosity Unfolding Technique: A Novel Technique for the Management of Anterior Palatal Fistulae |
| title_full_unstemmed | Mucosal Rugosity Unfolding Technique: A Novel Technique for the Management of Anterior Palatal Fistulae |
| title_short | Mucosal Rugosity Unfolding Technique: A Novel Technique for the Management of Anterior Palatal Fistulae |
| title_sort | mucosal rugosity unfolding technique a novel technique for the management of anterior palatal fistulae |
| url | http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000006987 |
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