Background and objectives : Oronasal fistulae (ONF) following cleft palate (CP) repair are challenging and associated with high recurrence rates. The aim of this study was to evaluate effectiveness of acellular dermal matrix in ONF repair associated with CP.

Methods : This is a prospective study where 12 patients with ONF of the hard palate greater than 15 mm in diameter were included. Age ranged from 12 to 25 years. Acellular dermal matrix was firmly secured between repaired oral and nasal mucosal layers. Patients were clinically followed up for at least three months postoperatively to assess total time for complete healing, dehiscence and/or refistulaization.

Results : Acellular dermal matrix was integrated with successfull fistula closure in all except one patient where failure of graft integration was noticed early postoperatively. In several other patients, the oral mucosal layer showed dehiscence, through which the graft was exposed. Graft integration extended from 4 to 12 weeks postoperatively during which patients were instructed to follow soft diet and meticulous oral hygiene measures.

Conclusions : Acellular dermal matrix allografts are safe and effective adjuncts for use in closure of ONF in the hard palate greater than 15 mm in diameter.

Key words: cleft palate; acellular dermal matrix allograft; oronasal fistula