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Commentary
January 2003

Comments on Decellularized Dermal Allograft

Author Affiliations

Department of Otolaryngology
University of Arkansas for Medical Sciences
4301 W Markham
Little Rock, AR 72205

 

Department of Otolaryngology
 University of Arkansas for Medical Sciences
 4301 W Markham
 Little Rock, AR 72205


Arch Facial Plast Surg. 2003;5(1):45. doi:

SECOND ONLY to concerns about velopharyngeal insufficiency is the cleft palate surgeon's fear of postoperative fistula: the failure to construct a tissue barrier between oral and nasal cavities. Drs Clark, Safford, and Israel have contributed another tool in efforts to avoid and/or correct this troubling complication of palatoplasty.

After a cogent discussion of the pathophysiology of fistulas and attempts at closure, the authors present 7 consecutive 2-flap palatoplasties for "wide" cleft palates (>15 mm at the posterior edge of the hard palate) using a decellularized dermal allograft (AlloDerm). They adopted this method after its success in closing a postoperative fistula. During short follow-up periods (2-13 months), there were no fistulas even though 2 patients experienced oral mucosal dehiscence exposing the graft. There was no untoward local reaction (rejection, infection, scarring, or contracture). The authors concluded that "Decellularized allograft dermal matrix was used successfully to close wide defects involving the hard and soft palate."

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