ASSESSING ORONASAL FISTULA RATES: MINIPLATE AS EXTERNAL FIXATOR VS ANTERIOR NASAL SPINE PLATING FOR PALATAL FRACTURES

Authors

  • Ain-us-Saba Oral and Maxillofacial Surgery, Islamabad Medical and Dental College, Islamabad -Pakistan
  • Muhammad Umar Farooq Oral and Maxillofacial Surgery, Pakistan Institute of Medical Sciences, Islamabad -Pakistan
  • Fouzia Aslam HBS Dental College and Hospital Lehtrar Road Islamabad-Pakistan
  • Hamza Hassan Mirza Oral and Maxillofacial Surgery, Islamabad Medical and Dental College, Islamabad -Pakistan
  • Abdul Manan Shahid Oral and Maxillofacial Surgery, Islamabad Medical and Dental College, Islamabad -Pakistan
  • Muhammad Asad Javed Akbar Niazi Teaching Hospital, Islamabad-Pakistan

DOI:

https://doi.org/10.55519/JAMC-02-12367

Keywords:

Palate, Palatal Fractures, Sagittal Fracture, Locking Plates

Abstract

Background: Palate, a midface bone, shapes the face and supports buttresses. Palatine process of maxilla and horizontal plate of palatine bone constitute it. Palatal bone is thicker anteriorly and laterally than posteriorly and centrally. Palatal fractures occur with maxillary fractures. Palatal-maxillary fractures occur 8–46.4% of the time.2,5 Palatal fractures can cause palatal ecchymosis in closed fractures and upper lip, palatal mucosa, incisor tooth loss, or occlusal disruption in displaced fractures. The objective was to determine the surgical outcome of palatal fractures with locking plates as external fixator vs. alveolar plating in terms of frequency of oronasal fistula formation. Methods: A Randomized control trial was carried out in Department of Oral and Maxillofacial surgery, Pakistan Institute of Medical Sciences, Islamabad. between 14th July, 2017 to 14th July, 2018. Lottery split patients into groups A and B. Data was collected on designed questionnaire and was entered and analyzed using SPSS v22. Chi-square was applied to check the association. Results: A total of 130 patients were enrolled in the trial based on the predefined inclusion criteria.  The average age of participants in the research was 41.16 years with a standard deviation of 10.44. Of the total participants, 88 (67.7%) were male and 42 (32.3%) were female, as per the inclusion criteria. The occurrence rate of oronasal fistula development in both groups, namely palatal fractures treated with locking plates as an external fixator vs alveolar plating, was 1 (1.5%) and 7 (10.8%) respectively. This difference was found to be statistically significant with a p-value of 0.029. Conclusion: Osteosynthesis using 2.0 mm locking plates as external fixator had a lower rate of oronasal fistula than alveolar plating. Future investigations at numerous configurations are needed to determine which approach is best. such that a regular strategy will reduce infection, fistula development, and necrosis afterwards

References

Pollock RA. The search for the ideal fixation of the palatal fractures: innovative experience with a mini locking plate. Craniomaxillofac Trauma Reconstr 2008;1(1):15–24.

Kumaravelu C, Thirukonda GJ, Kannabiran P. A novel adjuvant to treat palatal fractures. J Oral Maxillofac Surg 2011;69(6):152–4.

Cienfuegos R, Sierra E, Ortiz B, Fernandez G. Treatment of palatal fractures by Osteosynthesis with 2.0-mm locking plates as external fixator. Craniomaxillofac Trauma Reconstr 2010;3(4):223–30.

Mehboob B, Khan M, Qiam F. Pattern and management of palatal bone fracture. Pak Oral Dent J 2014;34(1):21–4.

Wang Z, He Y, Liu Y, Huang D, Gu L, Wang D, et al. Treatment of sagittal maxillary fracture by an innovative method of reversing pre-activated maxillary expanders. Int J Clin Exp Med 2016;9(3):6279–86.

Ma D, Guo Y, Yao H, Chen J. Transpalatal screw traction: a simple technique for the management of sagittal fracture of maxilla and palate. Int J Oral Maxillofac Surg 2014;43(12):1465–7.

Moss WJ, Kedarisetty S, Jafari A, Schaerer DE, Husseman JW. A review of hard palate fracture repair technique. J Oral Maxillofac Surg 2015;74(2):328–36.

Rai A. 3 Dimentional plate in management of sagittal palatal fractures: A novel technique. J Maxillofac oral surg 2016;16(4):497–9.

Downloads

Published

2024-06-30