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ORIGINAL ARTICLE
Year : 2017  |  Volume : 4  |  Issue : 3  |  Page : 160-166

The relationship between cleft palate index and oronasal fistula


1 Department of Surgery, Plastic Surgery Unit, University of Port Harcourt Teaching Hospital, Port Harcourt; Department of Plastic Surgery, National Orthopaedic Hospital, Enugu, Nigeria
2 Department of Plastic Surgery, National Orthopaedic Hospital, Enugu, Nigeria
3 Department of Surgery, Plastic Surgery Unit, University of Port Harcourt Teaching Hospital, Port Harcourt, Nigeria
4 Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, College of Health Sciences, University of Port Harcourt Teaching Hospital, Port Harcourt, Nigeria

Correspondence Address:
Ezekwe Ekwueme Amirize
Department of Surgery, Plastic Surgery Unit, University of Port Harcourt Teaching Hospital, Port Harcourt
Nigeria
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jclpca.jclpca_30_17

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Aims and Objectives: To identify fistula rates and determine the relationship between cleft palate index (CPI) and oronasal fistula. To delineate palatal index with high risk of fistulation in our study population. Materials and Methods: A 1-year prospective study. All consecutive patients with cleft palate that presented to the study institutions within the period and met inclusion criteria were studied. Palatal cleft width was measured in millimeters using fine pointed calipers at the level of the tuberosities intra-operatively. Maxillary intertuberosity width was measured. CPI was calculated as a ratio of cleft width to maxillary width. Palatoplasty was by von Langenbeck repair or intravelar veloplasty. Data were documented and analyzed. P < 0.05 were considered statistically significant. Results: Forty-six patients were studied. Ages ranged from 10 months to 28 years. Ranges of measured parameters were cleft width 4–25 mm, maxillary width 35–82 mm and CPI 0.07–0.49. Nineteen patients developed oronasal fistula; 41.30% overall fistula rate. Likelihood of fistula occurring increased as palatal index increased. Fistula was common in patients with CPI in excess of 0.22. Risk of fistula formation was statistically significant, becoming higher with palatal index of 0.26 and above. Discussion and Conclusion: Cleft palate exhibits great variability in tissue deficiency and segments separation. This may influence cleft severity. Palatal index estimates cleft severity and allows identification of patients at risk of fistula formation thereby necessitating individualized surgical attention for a better outcome.


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