TY - JOUR
T1 - Pakistan comprehensive fistula classification
T2 - A novel scheme and algorithm for management of palatal fistula/Dehiscence
AU - Fayyaz, Ghulam Qadir
AU - Gill, Nauman Ahmad
AU - Ishaq, Irfan
AU - Aslam, Muhammad
AU - Chaudry, Ayesha
AU - Ganatra, Muhammad Ashraf
AU - Obaid, Obaidullah
AU - Tarar, Moazzam Nazeer
AU - Chen, Philip Kuo Ting
AU - Laub, Donald Rudolph
N1 - Publisher Copyright:
Copyright © 2018 by the American Society of Plastic Surgeons.
PY - 2019/1
Y1 - 2019/1
N2 - Background: It is not easy to find a management-based classification of palatal fistula in the literature. A few attempts have been made to classify the wide variety of fistulae that do not describe the fistula details comprehensively and guide toward its management. The authors have come across a wide variety of fistulae that could not be classified according to any of the prevailing classification systems. The presented classification gives a clear and exact understanding of location and size of fistula/dehiscence. Palatal function has been included as one of the important determinants for devising a management plan. Based on this classification, the authors have proposed an algorithm that encompasses clear guidelines for surgical treatment of these fistulae. Methods: Over the past 15 years, the authors' team operated on 2537 palatal fistula patients. The medical records of these patients were reviewed to determine the location, size, and velopharyngeal competence. A new classification and algorithm were developed. Results: Of 2537 patients, 2258 had midline fistulae, 208 had lateral fistulae, and 53 had subtotal fistulae. There were 18 patients with dehiscence. Recurrence developed in 181 patients. Conclusion: The authors believe that this classification and algorithm can help follow a practical approach to manage palatal fistulae and dehiscence.
AB - Background: It is not easy to find a management-based classification of palatal fistula in the literature. A few attempts have been made to classify the wide variety of fistulae that do not describe the fistula details comprehensively and guide toward its management. The authors have come across a wide variety of fistulae that could not be classified according to any of the prevailing classification systems. The presented classification gives a clear and exact understanding of location and size of fistula/dehiscence. Palatal function has been included as one of the important determinants for devising a management plan. Based on this classification, the authors have proposed an algorithm that encompasses clear guidelines for surgical treatment of these fistulae. Methods: Over the past 15 years, the authors' team operated on 2537 palatal fistula patients. The medical records of these patients were reviewed to determine the location, size, and velopharyngeal competence. A new classification and algorithm were developed. Results: Of 2537 patients, 2258 had midline fistulae, 208 had lateral fistulae, and 53 had subtotal fistulae. There were 18 patients with dehiscence. Recurrence developed in 181 patients. Conclusion: The authors believe that this classification and algorithm can help follow a practical approach to manage palatal fistulae and dehiscence.
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U2 - 10.1097/PRS.0000000000005169
DO - 10.1097/PRS.0000000000005169
M3 - Article
C2 - 30431540
AN - SCOPUS:85059226117
SN - 0032-1052
VL - 143
SP - 140E-151E
JO - Plastic and Reconstructive Surgery
JF - Plastic and Reconstructive Surgery
IS - 1
ER -