Pakistan comprehensive fistula classification: A novel scheme and algorithm for management of palatal fistula/Dehiscence

Ghulam Qadir Fayyaz, Nauman Ahmad Gill, Irfan Ishaq, Muhammad Aslam, Ayesha Chaudry, Muhammad Ashraf Ganatra, Obaidullah Obaid, Moazzam Nazeer Tarar, Philip Kuo Ting Chen, Donald Rudolph Laub

Research output: Contribution to journalArticlepeer-review

7 Citations (Scopus)


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.

Original languageEnglish
Pages (from-to)140E-151E
JournalPlastic and Reconstructive Surgery
Issue number1
Publication statusPublished - Jan 2019

ASJC Scopus subject areas

  • Surgery


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