بررسي ميزان بروز فيستول در بيماران تحت عمل ترميم شكاف كام در بيمارستان بوعلي ساري 83-1376

Evaluation of fistula rate in patients who underwent repair of cleft palate, Booali general hospital, Sari, 1996-2003

Background and purpose : Cleft palate is a common facial anomaly that is shown by free communication between mouse and nose and involves whole or part of palate apparatus. It comprises 2/3 of facial anomalies and causes difficulties in nutrition, speech, growth of teeth and hearing. Several procedures have been described for treatment of this anomaly. Post operation complications include: bleeding, infection and fistula. The latter being the most important of all. The main objectives of repairing cleft palate are fine nutrition, proper speech and avoidance of middle ear complications which may cause hearing loss. It is clear that fistula after cleft palate surgery may obstruct these objectives. The aim of this study is to evaluate the fistula rate in patients who underwent repair of cleft plate. Materials and methods : This is a review study on the medical reeords of 50 cleft palate patients reffered to pediatric surgery clinic of Booali Hospital in Sari from March 1996 to May 2003. Demographic characteristics, type of cleft palate, associated anomalies, technique of surgery and complications after surgery such as fistula were recorded from the files. Mean, standard diviation, mode, frequency and chi-square statistical tests were used for describing and analyzing the data. Results : 50% of cases were girls and 50% were boys. The mean age of patients was 18.84 9.82. Extent of clefting was described according to the Veau classification. The distribution was 6%, 62%, 18% and 14% in Veau class 1, 2, 3 and 4. Fistula was observed in 4% of the patients and fistula and other complications such as infections, hematoma or wound dehiscence were not noted in the rest of patients. No significant differences between patients with and without fistula were identified with respect to Veau classification, technique of surgery, patient sex and age at platoplasty. Conclusion : Fistula is an important complication in cleft palate repair that needs reoperation. The rate of fistula was different in different studies. The fistula rate in this study was 4% which is low compared with others reports (0-62%). This may indicate the high standard of surgery at Booali Hospital.