Evaluation of using collagen membrane as interpositional material in closure of palatal fistula in cleft patients

Abstract

Background Palatal fistula after palatal surgery in cleft patients is an annoying problem for both patients and maxillofacial surgeons. The occurrence of fistula is determined by the severity of the underlying defect, the repair technique utilized and the stress applied to the wound. Fistula recurrence rates range from 0% to 58%. Depending on the size, recurrence rate, and surgeon skill, various procedures for palatal fistula closure are documented, ranging from local mucoperiosteal flaps to free flaps. Colla-D is a pure collagen membrane developed to facilitate directed tissue regeneration and aid in the closure of palatal fistulas. Patients and methods A prospective randomized noncontrolled clinical research was conducted on 12 patients with palatal fistulas in the hard palate of cleft patients aged 6 to 20 years. Collagen membrane (Colla-D type BS) is utilized as an interposition material between the oral and nasal layers in cleft patients to aid in the closure of palatal fistulas. Results Collagen membrane was integrated with successful fistula closure in nine (75%) individuals, but palatal closure failure was detected early postoperatively in three (25%) patients. In seven patients, the oral mucosal layer dehisced, exposing the membrane, which was gradually covered by creeping oral mucosa in 4 of 7 patients over a period of 2 to 4 weeks postoperatively. All patients improved in nasalance and even failed cases improved slightly due to a decrease in fistula size, with a mean progress of 33.92% and a standard deviation of 7.28. Conclusions Colla-D collagen membrane is a safe and effective adjunct for the closure of palatal fistulas located in hard palate.