Pakistan Comprehensive Fistula Classification: A Novel Scheme and Algorithm for Management of Palatal Fistula/Dehiscence
Pakistan Comprehensive Fistula Classification: A Novel Scheme and Algorithm for Management of Palatal Fistula/Dehiscence
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DOI：
10.1097/prs.0000000000005169
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发表时间：
2019-01-01
影响因子：
3.6
通讯作者：
Laub, Donald Rudolph
中科院分区：
文献类型：
--
作者：
Fayyaz, Ghulam Qadir;Gill, Nauman Ahmad;Laub, Donald Rudolph
背景：在文献中很难找到一个基于管理的腭瘘分类。已经有一些尝试对各种各样的瘘进行分类，这些瘘不能全面地描述瘘的细节并指导其管理。作者已经遇到了各种各样的瘘，不能根据任何现行的分类系统进行分类。所提出的分类给出了瘘/裂的位置和大小的清晰和准确的理解。腭功能已被列入制定管理计划的重要决定因素之一。基于这种分类，作者提出了一种算法，该算法包含了这些瘘的外科治疗的明确指南。方法：15年来，对2537例腭瘘患者进行手术治疗。我们回顾了这些患者的医疗记录，以确定其位置、大小和腭咽功能。提出了一种新的分类方法和算法。结果：2537例患者中，中线瘘2258例，外侧瘘208例，次全瘘53例。裂隙18例。181例患者出现复发。结论：作者认为该分类和算法为腭裂瘘的治疗提供了一种实用的方法。
Background: It is not easy to find a management-based classification of palatal fistula in the literature. A few attempts have been made to classify the wide variety of fistulae that do not describe the fistula details comprehensively and guide toward its management. The authors have come across a wide variety of fistulae that could not be classified according to any of the prevailing classification systems. The presented classification gives a clear and exact understanding of location and size of fistula/dehiscence. Palatal function has been included as one of the important determinants for devising a management plan. Based on this classification, the authors have proposed an algorithm that encompasses clear guidelines for surgical treatment of these fistulae.Methods: Over the past 15 years, the authors' team operated on 2537 palatal fistula patients. The medical records of these patients were reviewed to determine the location, size, and velopharyngeal competence. A new classification and algorithm were developed.Results: Of 2537 patients, 2258 had midline fistulae, 208 had lateral fistulae, and 53 had subtotal fistulae. There were 18 patients with dehiscence. Recurrence developed in 181 patients.Conclusion: The authors believe that this classification and algorithm can help follow a practical approach to manage palatal fistulae and dehiscence.