Related Experiment Video
Updated: Mar 9, 2026
Coronoid-Temporalis Pedicled Flap for Orbital Floor Defect Reconstruction
Published on: December 5, 2025
Acellular Dermal Matrix as an Adjunct Material in Cleft Le Fort I Osteotomies
Srinivas M Susarla1, Zoe M MacIsaac, Edward Swanson
1*Craniofacial Center, Seattle Children's Hospital, Seattle, WA †Department of Plastic Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA ‡Department of Plastic Surgery, Johns Hopkins University School of Medicine, Baltimore, MD.
Purpose:
To evaluate the use of acellular dermal matrix in the management of nasal lining deficiency at the time of Le Fort I osteotomy.
Methods:
This was a retrospective cohort study of patients with residual/recurrent oronasal fistulae who underwent Le Fort I osteotomy. In instances where there was an inadequate volume of nasal mucosa for tension-free closure or for defects >1 cm in width, the acellular dermal matrix was used for augmentation. Demographic and cleft-related factors were recorded. Complications (recurrent fistula, infection, seroma, and wound dehiscence) were recorded.
Results:
Over the 3-year period, the authors used acellular dermal matrix to augment nasal lining in 8 subjects. The sample's mean age was 18.7 ± 3.1 years; 5 subjects were male. Six patients had bilateral cleft defects. The mean follow-up time was 20.2 ± 3.2 years. There were no episodes of infection, seroma, wound dehiscence, or recurrent fistula.
Conclusion:
Acellular dermal matrix is a useful adjunct for managing nasal liningdeficiency at the time of Le Fort I osteotomy. There were no episodes of bone graft extrusion, infection, tooth loss, or bone graft loss. The Enemark scores improved significantly across both subsets (P <0.001). There was 1 recurrent fistula in the allograft bone alone group.Residual alveolar clefts and oronasal fistulae can be successfully managed at the time of Le Fort I osteotomy using allograft bone and acellular dermal matrix.
