A trial to improve the outcome of cleft palate repair in pediatric age by using fibrin glue

Document Type : Original Article

Authors

1 General surgery department, Faculty of Medicine, Beni-Suef University, Egypt

2 Clinical Pathology department, Faculty of Medicine, Beni-Suef University, Egypt

3 Beni-Suef insurance hospital, Beni-Suef, Egypt

Abstract

Cleft palate is among the commonest craniofacial abnormality with an incidence of about 1 in every 2000 to 2500 births. Cleft palate repair is a challenging procedure with multiple operations described for the same anomaly. The aim of this study is to improve the outcome of cleft palate repair by using fibrin glue as an adjuvant in the  repair with its effect on lowering postoperative complications. A prospective study was carried on 30 patients for primary cleft palate repair operated upon by double flap palatoplasty with the use of human fibrin glue in the repair. Fibrin glue was injected between the oral and nasal layers of palate and at suture line. Six cases showed postoperative complications, with rate of complication 23.3 %, Three of them (10%) were complicated by oronasal palatal fistula. Two of them (6.6%) were small and closed spontaneously within 2 months postoperatively and the third case (3.3%) was presented primarily by local wound infection and later on had showed an oronasal fistula and needed surgical repair, two cases(6.6%) were complicated by upper airway obstruction immediately postoperative and one case (3.3%) was complicated by reactionary hemorrhage. It was concluded that fibrin glue is an adjuvant that can be used with surgical repair of cleft palate for improving surgical outcome and lowering postoperative complications.

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References

  1. Robert F and David H. Otolaryngology: Atlas of Pediatric Physical Diagnosis', 7th ed., ch24, pp868-915(2018).
  2. Veena S, and Arun Use of fibrin sealant in prevention of hanging palate: A rare complication after cleft palate surgery, Journal of Cleft Lip Palate and Craniofacial Anomalies,Vol 2 / Issue 1, pp. 74-76 (2015) .
  3. Spotnitz WD and Burks S. Hemostats, sealants, and adhesives: components of the surgical toolbox, Transfusion,Vol48/ Issue 7, pp1502–1516 (2008).
  4. Aronson J K and Meyler's. Side Effects of Drugs. 16th ed. Elsevier.pp.312-313. (2015).
  5. Basha, Salman, Srinath N et al. Role of Fibrin Glue in palatoplasty to prevent formation of oro-nasal fistula–An in vivo study. Asian Journal of Oral and Maxillofacial Surgery 23, no. 4: 177-180. (2011).
  6. Singh V, Singh AK and Kumar V. Use of fibrin sealant in prevention of hanging palate: A rare complication after cleft palate surgery. J Cleft Lip Palate Craniofac Anomal;2:74-6. (2015).
  7. Cohen SR, Kalinowski J, LaRossa D et al. Cleft palate fistulas: a multivariate statistical analysis of prevalence, etiology, and surgical management. Plast Reconstr Surg. Jun;87(6):1041-7. PMID: 2034725. (1991).
  8. Morris HL, Bardach J, Van Demark DR et al. Results of two-flap palatoplasty with regard to speech production. Eur J Plast Surg. 12:/19_/ (1989).
  9. Mommaerts M Y, Combes F, and Drake D. The Furlow Z-plasty in two-staged palatal repair modifications and complications. British Journal of Oral and Maxillofacial Surgery 44, no. 2: 94-99. (2006).
  10. Rohrich, Rod J, Anthony R et al. Timing of hard palatal closure: a critical long term analysis. Plastic and reconstructive surgery 98, no. 2: 236-246. (1996).
  11. Parwaz M A, Sharma R K, Parashar A et al. Width of cleft palate and postoperative palatal fistula – do they correlate? J Plast. Reconst. Aesth. Surg. 62 (12): 1559-1563. (2009).
  12. Zhang, Zhaoqiang, Fang S et al. "Analysis of complications in primary cleft lips and palates surgery." Journal of Craniofacial Surgery 25, no. 3: 968-971. (2014).
Egyptian Journal of Medical Research
Volume 4, Issue 2
April 2023
Pages 117-124

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