STUDY ON WOUND HEALING AFTER Sommerlad TECHNIQUE REPAIR OF ISOLATED CLEFT PALATE_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

 LUYong ¹ , SHIBing ² , WANGZhiyong ¹ , ZHANXin ¹

1. Department of Oral and Maxillofacial Surgery, the Affiliated Stomatology Hospital, Medical College of Nanjing University, Nanjing Jiangsu, 210008, P. R. China;
2. Department of Cleft and Palate Surgery, State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University;

Corresponding author：

LUYong, Email: cleft_surgery@sina.com

Keywords：

Isolated cleft palate; Sommerlad technique repair; Wound healing

DOI：

10.7507/1002-1892.20140192

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Objective To study the inhibitory effect of Sommerlad technique on the growth of the maxilla by comparing the wound healing between Sommerlad and Von Langenbeck techniques in repair of isolated cleft palate. Methods A retrospective cohort study was conducted on 54 patients with isolated cleft palate who received palatoplasty with levator veli palatini retropositioning according to Sommerlad between June 2005 and August 2011 as trial group;89 cleft patients received Von Langenbeck technique repair between June 2003 and September 2006 as control group.There was no significant difference in gender and age between 2 groups (P>0.05).The operation time,intraoperative blood loss,body temperature,and fever were recorded and compared;the wound healing was observed,and the palatal mucosa was graded according to Karsten standard. Results The operation time of trial group [(72.2±5.5) minutes] was significantly longer than that of control group [(58.1±6.8) minutes] (t=4.494,P=0.000);the intraoperative blood loss of trial group [(18.6±6.5) mL] was significantly less than that of control group [(34.2±10.2) mL] (t=2.447,P=0.000).Within postoperative 48 hours,the highest body temperature was 36.6-37.6℃(mean,36.9℃) in trial group,and was 36.8-38.2℃(mean,37.3℃) in control group;fever occurred in 5 patients (9.3%) of trial group and 21 patients (23.6%) of control group,showing significant difference (χ²=4.640,P=0.030).The patients were followed up 3-18 months (mean,9 months) in the trial group,and 3-6 years (mean,4 years) in the control group.Scar was rated as level 0,level 1,and level 2 in 38,13,and 3 cases of trial group,and in 6,35,and 48 cases of control group,showing significant difference (Z=-7.785,P=0.000). Conclusion The isolated cleft palate repair using Sommerlad technique has the advantages of less injury and less scar tissue,indicating no inhibitory effect on the growth of the maxilla.

Citation： LUYong, SHIBing, WANGZhiyong, ZHANXin. STUDY ON WOUND HEALING AFTER Sommerlad TECHNIQUE REPAIR OF ISOLATED CLEFT PALATE. Chinese Journal of Reparative and Reconstructive Surgery, 2014, 28(7): 869-872. doi: 10.7507/1002-1892.20140192 Copy

1.	Karsten A,Larson M,Larson O.Dental occlusion after Veau-Wardill-Kilner versus minimal incision technique repair of isolated clefts of the hard and soft palate.Cleft Palate Craniofac J,2003,40(5):504-510.
2.	Gundlach KK,Bardach J,Filippow D,et al.Two-stage palatoplasty,is it still a valuable treatment protocol for patients with a cleft of lip,alveolus,and palate.J Craniomaxillofac Surg,2013,41(1):62-70.
3.	Yang IY,Liao YF.The effect of 1-stage versus 2-stage palate repair on facial growth in patients with cleft lip and palate:a review.Int J Oral Maxillofac Surg,2010,39(10):945-950.
4.	Barutca SA,Aksan T,Usçetin I,et al.Effects of palatine bone denudation repair with periosteal graft on maxillary growth:an experimental study in rats.J Craniomaxillofac Surg,2014,42(1):e1-7.
5.	石冰,宋庆高,黄旭,等.组织工程化口腔黏膜移植修复裸露硬腭对上颌骨生长发育影响的研究.华西口腔医学杂志,2003,21(4):255-258.
6.	鲁勇,石冰,郑谦.Sommerlad 腭帆提肌重建术后松弛切口情况的研究.华西口腔医学杂志,2009,27(4):425-429.
7.	Lu Y,Shi B,Zheng Q,et al.Incidence of palatal fistula after palatoplasty with levator veli palatini retropositioning according to Sommerlad.Br J Oral Maxillofac Surg,2010,48(8):637-640.
8.	Antonelli PJ,Jorge JC,Feniman MR,et al.Otologic and audiologic outcomes with the Furlow and von Langenbeck with intravelar veloplasty palatoplasties in unilateral cleft lip and palate.Cleft Palate Craniofac J,2011,48(4):412-418.
9.	Yang Y,Wang Y,Wu Y,et al.What operative or anatomic factors affect dental arch development in the cleft patient? J Oral Maxillofac Surg,2013,71(5):929-937.
10.	Liao YF,Prasad NK,Chiu YT,et al.Cleft size at the time of palate repair in complete unilateral cleft lip and palate as an indicator of maxillary growth.Int J Oral Maxillofac Surg,2010,39(10):956-961.
11.	Ye B,Ruan C,Hu J,et al.A comparative study on dental-arch morphology in adult unoperated and operated cleft palate patients.J Craniofac Surg,2010,21(3):811-815.
12.	Lee JC,Slack GC,Walker R,et al.Maxillary hypoplasia in the cleft patient:contribution of orthodontic dental space closure to orthognathic surgery.Plast Reconstr Surg,2014,133(2):355-361.
13.	Iwasaki H,Kudo M,Yamamoto Y.Influences of palatoplasty by the push-back procedure on craniofacial morphology and growth.J Craniomaxillofac Surg,2012,40(8):638-646.
14.	Williams WN,Seagle MB,Pegoraro-Krook MI,et al.Prospective clinical trial comparing outcome measures between Furlow and von Langenbeck Palatoplasties for UCLP.Ann Plast Surg,2011,66(2):154-163.
15.	Xu X,Zheng Q,Lu D,et al.Timing of palate repair affecting growth in complete unilateral cleft lip and palate.J Craniomaxillofac Surg,2012,40(8):e358-362.
16.	鲁勇,石冰,王志勇,等.Sommerlad腭帆提肌重建术修复腭裂后腭咽结构特征的分析.华西口腔医学杂志,2013,31(5):472-475.
17.	鲁勇,石冰,郑谦.软腭肌解剖与重建对软腭组织结构与功能影响的实验研究.实用口腔医学杂志,2010,16(2):185-189.
18.	Rousseau P,Metzger M,Frucht S,et al.Effect of lip closure on early maxillary growth in patients with cleft lip and palate.JAMA Facial Plast Surg,2013,15(5):369-373.

1. Karsten A,Larson M,Larson O.Dental occlusion after Veau-Wardill-Kilner versus minimal incision technique repair of isolated clefts of the hard and soft palate.Cleft Palate Craniofac J,2003,40(5):504-510.
2. Gundlach KK,Bardach J,Filippow D,et al.Two-stage palatoplasty,is it still a valuable treatment protocol for patients with a cleft of lip,alveolus,and palate.J Craniomaxillofac Surg,2013,41(1):62-70.
3. Yang IY,Liao YF.The effect of 1-stage versus 2-stage palate repair on facial growth in patients with cleft lip and palate:a review.Int J Oral Maxillofac Surg,2010,39(10):945-950.
4. Barutca SA,Aksan T,Usçetin I,et al.Effects of palatine bone denudation repair with periosteal graft on maxillary growth:an experimental study in rats.J Craniomaxillofac Surg,2014,42(1):e1-7.
5. 石冰,宋庆高,黄旭,等.组织工程化口腔黏膜移植修复裸露硬腭对上颌骨生长发育影响的研究.华西口腔医学杂志,2003,21(4):255-258.
6. 鲁勇,石冰,郑谦.Sommerlad 腭帆提肌重建术后松弛切口情况的研究.华西口腔医学杂志,2009,27(4):425-429.
7. Lu Y,Shi B,Zheng Q,et al.Incidence of palatal fistula after palatoplasty with levator veli palatini retropositioning according to Sommerlad.Br J Oral Maxillofac Surg,2010,48(8):637-640.
8. Antonelli PJ,Jorge JC,Feniman MR,et al.Otologic and audiologic outcomes with the Furlow and von Langenbeck with intravelar veloplasty palatoplasties in unilateral cleft lip and palate.Cleft Palate Craniofac J,2011,48(4):412-418.
9. Yang Y,Wang Y,Wu Y,et al.What operative or anatomic factors affect dental arch development in the cleft patient? J Oral Maxillofac Surg,2013,71(5):929-937.
10. Liao YF,Prasad NK,Chiu YT,et al.Cleft size at the time of palate repair in complete unilateral cleft lip and palate as an indicator of maxillary growth.Int J Oral Maxillofac Surg,2010,39(10):956-961.
11. Ye B,Ruan C,Hu J,et al.A comparative study on dental-arch morphology in adult unoperated and operated cleft palate patients.J Craniofac Surg,2010,21(3):811-815.
12. Lee JC,Slack GC,Walker R,et al.Maxillary hypoplasia in the cleft patient:contribution of orthodontic dental space closure to orthognathic surgery.Plast Reconstr Surg,2014,133(2):355-361.
13. Iwasaki H,Kudo M,Yamamoto Y.Influences of palatoplasty by the push-back procedure on craniofacial morphology and growth.J Craniomaxillofac Surg,2012,40(8):638-646.
14. Williams WN,Seagle MB,Pegoraro-Krook MI,et al.Prospective clinical trial comparing outcome measures between Furlow and von Langenbeck Palatoplasties for UCLP.Ann Plast Surg,2011,66(2):154-163.
15. Xu X,Zheng Q,Lu D,et al.Timing of palate repair affecting growth in complete unilateral cleft lip and palate.J Craniomaxillofac Surg,2012,40(8):e358-362.
16. 鲁勇,石冰,王志勇,等.Sommerlad腭帆提肌重建术修复腭裂后腭咽结构特征的分析.华西口腔医学杂志,2013,31(5):472-475.
17. 鲁勇,石冰,郑谦.软腭肌解剖与重建对软腭组织结构与功能影响的实验研究.实用口腔医学杂志,2010,16(2):185-189.
18. Rousseau P,Metzger M,Frucht S,et al.Effect of lip closure on early maxillary growth in patients with cleft lip and palate.JAMA Facial Plast Surg,2013,15(5):369-373.

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STUDY ON WOUND HEALING AFTER Sommerlad TECHNIQUE REPAIR OF ISOLATED CLEFT PALATE

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