Abstract
Palatal fistulae are the common complication after palate repair in previously unoperated or operated cases. These are more common after repair of bilateral complete cleft palate or wide cleft palate cases. Recurrence of a fistula is not uncommon after palate re-repair. Different schemes have been proposed by some authors to classify palatal fistula. Some have described it as per size of the palatal fistula. Others have classified it into seven types of fistula in the midline, based on their locations within the palate. One author has described difficulty index for cleft palate repair.
Many of the palatal fistula found in locations different than the described by these authors, forced us to devise a new classification system for palatal fistula. Moreover, classification for dehiscence of the palate has been described first time in the literature. Fistulae have been divided into three main types: midline, lateral, and subtotal. Size of the fistula has been divided into four types. Velopharyngeal function has been taken into account first time in the management of palatal fistula.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Amaratunga NA (1988) Occurrence of oronasal fistulas in operated cleft palate patients. J Oral Maxillofac Surg 46:834–838
Bardach J, Morris H, Olin W, McDermott-Murray J, Mooney M, Bardach E (1984) Late results of multidisciplinary management of unilateral cleft lip and palate. Ann Plast Surg 12:235–242
Bozoala AR, Ja G, Carriquiry CE, Cardosos de Oliveira M (1989) The buccinator musculomucosal flap: anatomic study and clinical application. Plast Reconstr Surg 84(2):250–257
Chen HC, Ganos DL, Coessens BC, Kyutoku S, Noordhoff MS (1992) Free forearm flap for closure of difficult oronasal fistulas in cleft palate patients. Plast Reconstr Surg 90:757–762
Cohen SR, Kalinowski J, LaRossa D, Randall P (1991) Cleft palate fistulas: a multivariate statistical analysis of prevalence, etiology, and surgical management. Plast Reconstr Surg 87:1041–1047
Diah E, Lo LJ, Yun C, Wang R, Wahyuni LK, Chen YR (2007) Cleft oronasal fistula: a review of treatment results and a surgical management algorithm proposal. Chang Gung Med J 30:529–537
Elsherbiny M, Mebed A, Mebed H (2012) The versatility of the tongue flap in the closure of palatal fistula. Craniomaxillofac Trauma Reconstr 5(3):145–160
Emory RE Jr, Clay RP, Bite U, Jackson IT (1997) Fistula formation and repair after palatal closure: an institutional perspective. Plast Reconstr Surg 99:1535–1538
Fayyaz GQ, Gill NA (2019) Pakistan comprehensive fistula classification: a novel scheme and algorithm for management of palatal fistula/dehiscence. Plast Reconstr Surg 143:140–151
Fayyaz GQ, Gill NA, Ishaq I et al (2015) A model humanitarian cleft mission: 312 cleft surgeries in 7 days. Plast Reconstr Surg Glob Open 3:e313
Fayyaz GQ, Gill NA, Chaudry A et al (2017) Radical dissection of greater palatine artery and dynamic reconstruction of cleft palate. Plast Reconstr Surg Glob Open 5:e1235
Folk SN, D’Antonio LL, Hardesty RA (1997) Secondary cleft deformities. Clin Plast Surg 24:599–611
Muzaffar AR, Byrd HS, Rohrich RJ et al (2001) Incidence of cleft palate fistula: an institutional experience with two-stage palatal repair. Plast Reconstr Surg 108:1515–1518
Ohsumi N, Onizuka T, Ito Y (1993) Use of a free conchal cartilage graft for closure of a palatal fistula: an experimental study and clinical application. Plast Reconstr Surg 91(3):433–440
Pribaz J, Stephen W, Crespo L, Gifford G (1992) A new intraoral flap: facial artery musculomucosal (FAMM) flap. Plast Reconstr Surg 90(3):421–429
Richardson S, Agni NA (2014) Palatal fistulae: a comprehensive classification and difficulty index. J Maxillofac Oral Surg 13:305–309
Smith DM, Vecchione L, Jiang S et al (2007) The Pittsburgh fistula classification system: a standardized scheme for the description of palatal fistulas. Cleft Palate Craniofac J 44:590–594
Sommerlad BC (2003) A technique for cleft palate repair. Plast Reconstr Surg 112:1542–1548
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2022 Springer Nature Singapore Pte Ltd.
About this entry
Cite this entry
Fayyaz, G.Q., Elshazly, M. (2022). Pakistan Comprehensive Fistula Classification. In: Fayyaz, G.Q. (eds) Surgical Atlas of Cleft Palate and Palatal Fistulae. Springer, Singapore. https://doi.org/10.1007/978-981-15-3889-6_59-1
Download citation
DOI: https://doi.org/10.1007/978-981-15-3889-6_59-1
Received:
Accepted:
Published:
Publisher Name: Springer, Singapore
Print ISBN: 978-981-15-3889-6
Online ISBN: 978-981-15-3889-6
eBook Packages: Springer Reference MedicineReference Module Medicine