Palatal fistula repair
Patients with cleft lip & palate deformities even after being treated for lip & palate repair have a lot of other problems that need surgical attention. Palatal fistula post palate repair is one of the most common issues seen in patients. It usually occurs due to an inefficient closure of palate the first time. It is important to close these fistulas or holes properly as the patients’ speech as well as function is affected due to their presence.
A 20-year-old female patient recently reported to Richardson Dental and Craniofacial Hospital with a chief complain of a defect in the palate and nasal regurgitation of fluids. She was previously treated for cleft palate repair elsewhere many years back. We examined the patient and found that she had a defect in her palate anteriorly known as an anterior palatal fistula. This usually occurs when the first palate closure surgery is not done properly and thus the patient ends up with a defect in the palate resulting in fluid regurgitation as well as will affect speech. All the pre-surgical workup was done and the patient was cleared for surgery under general anesthesia. The procedure took around one hour. The closure of the fistula was done in two layers i.e the nasal layer & the oral layer. Two layered closure make the chances of a residual fistula formation very less.
Palatal fistulas most commonly occur due to incomplete or inefficient cleft palate closure in the primary surgery. The patients with these deformities usually don’t seek help and the fistulas remain untreated for years together. It is important to get these fistulas closed as unoperated fistulas lead to functional as well as speech problems. These patients have nasal regurgitation of fluids as well as speech defects.