Acellular Dermal Matrix as an Adjunct Material in Cleft Le Fort I Osteotomies. Issue 1 (January 2017)

• Record Type: Journal Article
• Authors: Susarla, Srinivas M.; MacIsaac, Zoe M.; Swanson, Edward; Davidson, Edward; Kumar, Anand
• Is Part Of: Journal of craniofacial surgery. Volume 28:Issue 1(2017)
• Publication Date: 2017-01
• Subjects: Cleft lip and palate -- cleft orthognathic surgery -- oronasal fistula; Facial bones -- Surgery -- Periodicals; Skull -- Surgery -- Periodicals; Face -- Surgery -- Periodicals; Surgery, Plastic -- Periodicals; 617.52
• DOI: 10.1097/SCS.0000000000003308
• Languages: English
• ISSNs: 1049-2275

Abstract

Abstract : Purpose: To evaluate the use of acellular dermal matrix in the management of nasal lining deficiency at the time of Le Fort I osteotomy. Methods: This was a retrospective cohort study of patients with residual/recurrent oronasal fistulae who underwent Le Fort I osteotomy. In instances where there was an inadequate volume of nasal mucosa for tension-free closure or for defects >1 cm in width, the acellular dermal matrix was used for augmentation. Demographic and cleft-related factors were recorded. Complications (recurrent fistula, infection, seroma, and wound dehiscence) were recorded. Results: Over the 3-year period, the authors used acellular dermal matrix to augment nasal lining in 8 subjects. The sample's mean age was 18.7 ± 3.1 years; 5 subjects were male. Six patients had bilateral cleft defects. The mean follow-up time was 20.2 ± 3.2 years. There were no episodes of infection, seroma, wound dehiscence, or recurrent fistula. Conclusion: Acellular dermal matrix is a useful adjunct for managing nasal lining deficiency at the time of Le Fort I osteotomy. There were no episodes of bone graft extrusion, infection, tooth loss, or bone graft loss. The Enemark scores improved significantly across both subsets ( P <0.001). There was 1 recurrent fistula in the allograft bone alone group. Residual alveolar clefts and oronasal fistulae can be successfully managed at the time of Le Fort I osteotomy using allograft bone and acellular dermal matrix.