Acellular dermal matrix as an adjunct material in cleft le Fort i osteotomies

Srinivas M. Susarla, Zoe M. MacIsaac, Edward Swanson, Edward H. Davidson, Anand Kumar

Research output: Contribution to journalArticle

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 >1cmin 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.

Original languageEnglish (US)
Pages (from-to)225-226
Number of pages2
JournalJournal of Craniofacial Surgery
Volume28
Issue number1
DOIs
StatePublished - Jan 1 2017
Externally publishedYes

Fingerprint

Acellular Dermis
Le Fort Osteotomy
Fistula
Nose
Seroma
Bone and Bones
Wound Infection
Allografts
Transplants
Tooth Loss
Nasal Mucosa
Cohort Studies
Retrospective Studies
Demography
Infection

Keywords

  • Cleft lip and palate
  • Cleft orthognathic surgery
  • Oronasal fistula

ASJC Scopus subject areas

  • Surgery
  • Otorhinolaryngology

Cite this

Acellular dermal matrix as an adjunct material in cleft le Fort i osteotomies. / Susarla, Srinivas M.; MacIsaac, Zoe M.; Swanson, Edward; Davidson, Edward H.; Kumar, Anand.

In: Journal of Craniofacial Surgery, Vol. 28, No. 1, 01.01.2017, p. 225-226.

Research output: Contribution to journalArticle

Susarla, Srinivas M. ; MacIsaac, Zoe M. ; Swanson, Edward ; Davidson, Edward H. ; Kumar, Anand. / Acellular dermal matrix as an adjunct material in cleft le Fort i osteotomies. In: Journal of Craniofacial Surgery. 2017 ; Vol. 28, No. 1. pp. 225-226.
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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 >1cmin 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.",
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