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Revista odontológica mexicana
versión impresa ISSN 1870-199X
Rev. Odont. Mex vol.10 no.3 Ciudad de México sep. 2006
https://doi.org/10.22201/fo.1870199xp.2006.10.3.15901
Caso clínico
Cierre de fístulas palatinas amplias mediante colgajos de lengua en pacientes con secuelas de paladar hendido
Palate fistula closure using tongue flaps in patients with cleft palate
* Residente de la Especialidad Cirugía Maxilofacial de la División de Estudios de Posgrado e Investigación, Facultad de Odontología, UNAM.
§ Jefe de la Especialidad Cirugía Maxilofacial de la División de Estudios de Posgrado e Investigación, Facultad de Odontología, UNAM.
II Profesor de la Especialidad Cirugía Maxilofacial de la División de Estudios de Posgrado e Investigación, Facultad de Odontología, UNAM.
¶ Profesor de la Especialidad Cirugía Maxilofacial de la División de Estudios de Posgrado e Investigación, Facultad de Odontología, UNAM. Hospital Atizapán de Zaragoza, ISSEM.
Una fístula oronasal es una de las secuelas más comunes de la reparación quirúrgica del paladar hendido. El propósito de este artículo es presentar la experiencia en el uso de colgajos de lengua para el cierre de fístulas palatinas anteriores amplias con intentos previos de cierre sin éxito o fístulas mayores de 1 cm luego de la palatoplastia primaria, en pacientes con secuelas de paladar hendido. Todos los pacientes fueron intervenidos bajo anestesia general. Se realizaron colgajos de lengua delgados de base anterior, con cierre en dos planos. Los colgajos fueron lіberados entre la 3ra y 4ta semana. De 35 pacientes con edades entre 7 y 44 años se obtuvo cierre satisfactorio de fístulas en 27 casos, cuatro presentaron dehiscencia parcial, dos dehiscencia total, uno necrosis parcial y en otro caso el paciente desgarró intencionalmente el pedículo. Los resultados obtenidos confirman lo reportado por otros autores al presentar a los colgajos de lengua como una opción segura y efectiva para el cierre de fístulas palatinas amplias, luego de la palatoplastia primaria o en casos donde los intentos de cierre han fracasado previamente.
Palabras clave: Colgajo de lengua; fístula palatina; paladar hendido
An oronasal fistule is the most common sequel after the surgical closure of cleft palate. The purpose of this paper is to report the experience with the use of tongue flaps for the closure of large anterior palatal fistulas with previous attempts of closing without success or fistulas larger than 1 cm after the primary palatoplas-ty, in patients with cleft palate sequelae. The surgical procedures were performed under general anesthesia. Thin tongue flaps with anterior base were carried out with two plane closure . The pedicle was cut between the 3rd and 4th week. Of 35 patients, satisfactory closing of the fistulas was obtained in 27 cases, four presented partial dehiscence, two total dehiscence, one partial necrosis and in another case the patient tore the pedicle intentionally. The results confirm what was reported by other authors in regard to the tongue flaps like a sure and effective option for closing a wide palatal fistulas after the primary palatoplasty or in cases where closing intents have previously failed.
Key words: Tongue flap; palatal fistula; cleft palate
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