A Toolbox of Surgical Techniques for Palatal Fistula Repair.
A Toolbox of Surgical Techniques for Palatal Fistula Repair.
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腭瘘修补术的手术技巧探讨。
DOI：
10.1177/1055665620949321
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发表时间：
2021-03
期刊：
影响因子：
--
通讯作者：
Sitzman TJ
中科院分区：
文献类型：
--
作者：
Rothermel AT;Lundberg JN;Samson TD;Tse RW;Allori AC;Bezuhly M;Beals SP;Sitzman TJ
提供一份口鼻瘘修复技术的清单，以及专家评论哪些技术适合每种瘘类型。研究采用了四阶段的方法来就瘘管修复的手术技术达成共识：(1)在唇裂外科医生中对口鼻瘘病例进行面对面的讨论，(2)利用面对面病例讨论的记录制定瘘管管理方案，(3)通过对其他唇裂外科医生进行基于网络的调查来评估初步方案，(4)利用调查反馈对管理方案进行修订。六名唇腭裂外科医生参加了现场病例讨论。另外11名外科医生参与了网络调查。参与者有不同的培训经历，在20家不同的医院完成了住院医师和研究金。瘘管理的方案被开发，由瘘的位置组织。该模式对每个位置的所有可行方法进行了编目。对于涉及软腭的瘘管，该方案强调了评估腭咽功能不全（VPI）和将VPI管理纳入瘘管修复的重要性。对于涉及硬腭的瘘管，本方案分别列举了每个区域鼻衬修复和口腔衬修复的可用技术。该方案还列出了舌和唇牙槽瘘的多种方法，包括时间、正畸准备和同时进行牙槽骨移植的变化。本研究采用共识方法创建了一个全面的可用瘘管修复技术清单，并在不同的外科医生群体中确定优先技术。
To provide an inventory of oronasal fistula repair techniques alongside expert commentary on which techniques are appropriate for each fistula type. A four-stage approach was used to develop a consensus on surgical techniques available for fistula repair: (1) in-person discussion of oronasal fistula cases among cleft surgeons, (2) development of a schema for fistula management using transcripts of the in-person case discussion, (3) evaluation of the preliminary schema via a web-based survey of additional cleft surgeons, and (4) revision of the management schema using survey responses. Six cleft surgeons participated in the in-person case discussion. Eleven additional surgeons participated in the web-based survey. Participants had diverse training experiences, having completed residency and fellowship at 20 different hospitals. A schema for fistula management was developed, organized by fistula location. The schema catalogues all viable approaches for each location. For fistulae involving the soft palate, the schema stresses the importance of evaluating for velopharyngeal insufficiency (VPI) and incorporating VPI management into fistula repair. For fistulae involving the hard palate, the schema separately enumerates the techniques available for nasal lining repair and for oral lining repair in each region. The schema also catalogues the diversity of approaches to lingual- and labio-alveolar fistula, including variation in timing, orthodontic preparation, and simultaneous alveolar bone grafting. This study employed consensus methods to create a comprehensive inventory of available fistula repair techniques and to identify preferential techniques among a diverse group of surgeons.
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影响因子：
0.9
作者：
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