Effect of Collagen Matrix Graft on Palatal Fistula Formation After Cleft Palate Repair

NCT ID: NCT05454670

Last Updated: 2024-10-09

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

48 participants

Study Classification

INTERVENTIONAL

Study Start Date

2022-08-10

Study Completion Date

2024-06-30

Brief Summary

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Palatal fistulas are a major burden to surgeons and patients in the management of cleft palate. Their high rate of occurrence and recurrence makes them particularly challenging even to the highly skilled surgeon. Prevention of postoperative palatal fistula is therefore of paramount importance.

Closure of the nasal mucosa under tension has been proposed as a major cause of palatal fistula formation. However, depending on the presentation of the cleft palate, it may be impossible to achieve surgical closure with minimal tension. Till date, there is no universally acceptable method of preventing palatal fistula formation following cleft palate repair. And although the use of pre-surgical appliances such as Latham appliance and the use of local and distant tissues to achieve two layer closure have been proposed, the use of a superpositional collagen graft may also be used to achieve closure of the nasal mucosa with minimal or no tension during cleft palate repair.

Collagen grafts have the added advantage of being more patient friendly compared to the Latham appliance which requires an initial surgery for appliance insertion before surgical cleft palate repair. They are also less technique sensitive compared to the use of local and distant tissues.

The investigators therefore aim to provide high level scientific evidence of the effectiveness of collagen graft in the prevention of postoperative palatal fistula.

Detailed Description

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Conditions

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Cleft Lip and Cleft Palate Cleft Lip, Cleft Alveolus and Cleft Palate Cleft Palate

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

The study will be a parallel randomized controlled study involving two groups of participants. The test group will include participants with who will undergo cleft palate repair with collagen graft used as superpositional graft between the nasal mucosa/muscle layer and the oral mucosa layer when two-flap palatoplasty is performed while the control group will include participants who undergo two-flap palatoplasty without the use of collagen graft
Primary Study Purpose

PREVENTION

Blinding Strategy

TRIPLE

Participants Caregivers Outcome Assessors
This study will be a double-blind randomized controlled study. After random allocation, the participants (parents/ patients) will be unaware of the study group they belong to. Also, the surgeon assessing postoperative outcomes will not perform the surgery and will be unaware of the study group of the participant being examined. Since the collagen graft will be placed between the nasal/ muscular layers and the oral layer, it is expected that after apposition of the oral layer, no collagen matrix will be visible intraorally to reveal the study group of participants.

Study Groups

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Test group

The intervention will be primary cleft palate repair using resorbable collagen matrix graft as superpositional graft during approximation of the nasal mucosa and muscular layer in cleft palate repair. The collagen graft with be inserted between the nasal mucosa/ muscular layer and the oral mucosa layer during two-flap palatoplasty.

Group Type EXPERIMENTAL

Two-flap palatoplasty

Intervention Type PROCEDURE

Two-flap palatoplasty used to correct cleft palate defect. The cleft palate is closed by separation of the nasal and the oral mucosa layers. Then approximation of the nasal mucosa layer, muscle layer is secured in the posterior palate and then the oral mucosa layer is secured

Control group

The intervention will be primary cleft palate repair using two-flap palatoplasty technique without collagen graft

Group Type ACTIVE_COMPARATOR

Two-flap palatoplasty

Intervention Type PROCEDURE

Two-flap palatoplasty used to correct cleft palate defect. The cleft palate is closed by separation of the nasal and the oral mucosa layers. Then approximation of the nasal mucosa layer, muscle layer is secured in the posterior palate and then the oral mucosa layer is secured

Interventions

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Two-flap palatoplasty

Two-flap palatoplasty used to correct cleft palate defect. The cleft palate is closed by separation of the nasal and the oral mucosa layers. Then approximation of the nasal mucosa layer, muscle layer is secured in the posterior palate and then the oral mucosa layer is secured

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* Non-syndromic cleft palate
* Must be between nine months to two years
* Must have not previously had cleft palate surgery
* Must consent to participate in the study

Exclusion Criteria

* All blood dyscrasias
* All connective tissue dysfunctions
Minimum Eligible Age

12 Months

Maximum Eligible Age

6 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University of Lagos, Nigeria

OTHER

Sponsor Role collaborator

Lagos State University

OTHER

Sponsor Role lead

Responsible Party

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Egbunah Uchenna Patrick

Senior Registrar

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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Lagos University Teaching Hospital

Lagos, , Nigeria

Site Status

Countries

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Nigeria

Other Identifiers

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ADM/DST/HREC/VOL.XVII/763

Identifier Type: -

Identifier Source: org_study_id

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