1/19. Spontaneous palatal fenestration: review of the literature and report of a case.A 42-year-old, edentulous man presented with a defect in his hard palate. He gave a history of a painless lump one year previously which had discharged after a week. Investigations showed only long-standing hypoplasia of the left palatine process, with no evidence of any destructive process. We assumed that the fistula had developed as a result of breakdown of the mucosa covering an isolated cleft of the hard palate. We offered him repair, but he preferred to rely on his maxillary complete denture to cover the defect, and this has worked.- - - - - - - - - - ranking = 1keywords = palate, cleft (Clic here for more details about this article) |
2/19. The sandwich technique for closure of a palatal fistula.A full-thickness fistula of the hard palate can be closed by various methods. Recurrences are seen many times and more stable methods of closure have been researched. The authors attempted to close a palatal fistula by adhering to the main rule of reconstruction as stated by Gillies, "replace the lost tissues in kind." They used a buccinator musculomucosal transposition flap for the nasal lining, a cranial bone graft for the palatal bone, and a local mucoperiosteal transposition flap for the oral closure. The flaps and bone adapted well to the fistula. There were no recurrences during 12 months of follow-up. This "sandwich flap"--a three-layer closure--is a reliable technique for the repair of a full-thickness palatal fistula.- - - - - - - - - - ranking = 0.40187578828502keywords = palate (Clic here for more details about this article) |
3/19. Oronasal fistula repair with three layers.We present an innovative method for closure of oronasal fistulas involving a three-layer repair, consisting of septal mucosa flap, bone or cartilage graft, and palatal mucosa flap. The septal mucosa flap closes the nasal side of the defect. This is an inferiorly based flap along the nasal floor and consists of septal mucosa from the side opposite the oronasal fistula. A slit is created in the remaining layers of the nasal septum, allowing the flap to be delivered into the defect. When the septal flap is folded down in this fashion, it exposes nasal septal bone and cartilage. The bone and cartilage are harvested and are used to create the middle layer of the three-layer fistula repair. The oral layer of the repair is provided by a palatal mucosa transposition flap. This method allows the bone/cartilage graft to be sandwiched between two vascular layers. We have successfully used the three-layer repair on three patients. All of the oronasal defects were 2 cm in size. All patients are at least 1 year after repair with 100 percent closure; thus, no oronasal leakage. The flaps both septal and palatal resulted in no morbidity once healed. Specifically, the surgically created slit in the nasal septum is well mucosalized and barely discernible. Also, no nasal obstruction occurs from the septal flap on the floor of the nose. We perform the procedure on an outpatient basis. The three-layer repair can be used in adult patients with oronasal fistulas of the middle and posterior hard palate up to 3 cm in size. This technique is not recommended for children.- - - - - - - - - - ranking = 0.40187578828502keywords = palate (Clic here for more details about this article) |
4/19. The dental management of a patient with a cocaine-induced maxillofacial defect: a case report.There are several dental complications associated with cocaine abuse, including adverse reactions to dental anesthetics, post-operative bleeding, and cellulitis, which can lead to necrosis of orbital, nasal, and palatal bones. Following is a report of the initial treatment rendered to a patient who had destroyed most of her hard palate over a ten-year period of cocaine abuse. There are no classic socio-economic or educational profiles for abusers of cocaine. Drug abuse victims may present as patients in any dental office. Though there are certain classic physiological and psychological symptoms of their condition, they may not display symptoms at all.- - - - - - - - - - ranking = 0.40187578828502keywords = palate (Clic here for more details about this article) |
5/19. Closure of an oronasal fistula in an irradiated palate by tissue and bone distraction osteogenesis.Uses for distraction osteogenesis in the craniofacial skeleton have expanded during the last decade. It has become an important rung in the reconstructive ladder for correction of difficult defects. Distraction of irradiated bone has been successfully performed in an animal model but has not been reported in human subjects. We present a case of distraction osteogenesis in a patient with multiple failed reconstructive attempts to close an irradiated palatal defect. An additional benefit included improvement in support of the upper lip from bone transported and the potential for placing dental implants.- - - - - - - - - - ranking = 1.6075031531401keywords = palate (Clic here for more details about this article) |
6/19. Simultaneous cortex bone plate graft with particulate marrow and cancellous bone for reliable closure of palatal fistulae associated with cleft deformities.OBJECTIVE: The purpose of this study was to evaluate the effectiveness of simultaneous cortex bone plate (CBP) graft with particulate marrow and cancellous bone (PMCB) graft for reliable closure of palatal fistulae associated with alveolar clefts. DESIGN: Following standard secondary bone graft preparation of the cleft site, CBP harvested from the medial iliac crest was inserted into the palatal deficiency. This was followed by suturing the palatal mucosa. PMCB was then packed between the cortical bone and the reconstructed nasal floor. SETTING: Ten consecutive patients with palatal fistula were operated on at tokyo Medical and Dental University Hospital from 1998 to 2000. Primary palatal repair was performed in 7 out of 10 patients at our center and in 3 out of 10 patients at other hospitals. patients: Ten patients (6 boys and men, 4 girls and women) with a palatal fistula associated with an alveolar cleft were studied. Ages ranged from 12 to 26 years. INTERVENTIONS: All patients underwent simultaneous CBP graft with PMCB graft for closure of palatal fistula under general anesthesia. RESULTS: Complete closure of palatal fistulae were obtained in 8 out of 10 cases. A very small asymptomatic fistula remained in one patient. Total necrosis of the labial flap with a residual palatal fistula occurred in one patient. CONCLUSIONS: Simultaneous CBP graft with PMCB graft could be more reliable than PMCB alone for closure of a cleft associated palatal fistula.- - - - - - - - - - ranking = 1.5699873874396keywords = cleft (Clic here for more details about this article) |
7/19. Upper lip fistulas: three new cases.OBJECTIVE: We present three new cases of congenital upper lip fistula. Two of them were located in the philtrum midline, one of which was associated to a double maxillary frenulum, a medial lip cleft, and a medial cleft of the primitive palate. The other was located in the left side of the vermilion. All three patients had clear fluid discharge through the fistulous orifice without pain. Two of them had a history of recurrent swelling of the philtrum area. CONCLUSIONS: A simple surgical excision is the treatment of choice in these cases, in which the anatomy is preserved; this fact is more consistent with a completed but aberrant development than with focal dysgenesis.- - - - - - - - - - ranking = 0.79437263514493keywords = palate, cleft (Clic here for more details about this article) |
8/19. Microsurgical tissue transfer for rehabilitation of the patient with cleft lip and palate.OBJECTIVE: Three case reports of microsurgically revascularized tissue transfer for secondary closure of complex oronasal fistulae in cleft lip and palate patients are reported. One scapular and two radial forearm flaps were used in that respect; the scapular flap was transferred without a skin paddle and was left for secondary epithelialization whereas iliac crest bone was transplanted in the two patients with the forearm flaps in a further surgical step. CONCLUSIONS: These microsurgical flaps represent solutions in selected cases of oronasal fistulae in patients with cleft lip and palate with extensive scarring, large defects, or both. Alternative free flaps of the vast spectrum available today, however, also deserve consideration.- - - - - - - - - - ranking = 3.5887452702899keywords = palate, cleft (Clic here for more details about this article) |
9/19. cocaine-induced oronasal fistulas with external nasal erosion but without palate involvement.The effects of chronic cocaine abuse have been widely described in the literature. Common complications include nasal septal perforation, saddle-nose deformity, and palatal perforation. Erosion of the external structures of the face has not been as extensively described, nor have oronasal fistulas that involve structures other than the hard or soft palate. In this article, we present the first reported case of cocaine-induced external nasal erosion that included multiple oronasal fistulas in the anterior gingival sulcus but did not involve the hard or soft palate. We stress the importance of a thorough history in such patients and consideration of all possible diagnoses, including drug abuse.- - - - - - - - - - ranking = 2.4112547297101keywords = palate (Clic here for more details about this article) |
10/19. Van der Woude syndrome: a case report.Among the many disturbances of development and growth that involve the oral and perioral structures, cleft lip and palate is perhaps the commonest. Dental literature is replete with syndromes associated with cleft lip and palate, one of which is Van der Woude syndrome. The characteristics of Van der Woude syndrome is the association of cleft lip and/or palate with distinctive lower lip pits. A case of Van der Woude syndrome in an 11-year-old boy and his sister is presented.- - - - - - - - - - ranking = 1.7943726351449keywords = palate, cleft (Clic here for more details about this article) |
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