Vol. 2 No. 1 (2019): Current Issue
Case Report

Allogeneic Microvascular Tissue Graft Restores Healing Capacity in Recalcitrant Cleft Palate Fistula: A Case Report:

Marek Dobke, M.D.
Professor of Surgery (Plastic), University of California San Diego, California, United States
Joel S. Berger, D.D.S., M.D.
Director of the San Diego Center for Oral and Maxillofacial Surgery, Clinical (Voluntary) Associate Professor of Surgery (Plastic), University of California San Diego, California, United States
Published July 23, 2019
Keywords
  • Cleft palate fistula,
  • Microvascular tissue,
  • Perivascular,
  • Pericytes,
  • Tissue regeneration,
  • Wound healing
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Abstract

The closure of an anterior palatal fistula in a 23-year old female born with a severe class IV complete unilateral cleft lip and palate by means of local administration of an allogeneic microvascular tissue product (mVASC®) is reported. The patient had undergone 30 surgical procedures since 6 months of age, and had developed a recalcitrant oro-nasal fistula. Avascular and fibrous soft tissue surrounding the fistula was injected with mVASC in two series of injections several months apart as an office procedure.  Anergic and fibrous tissue appeared to be more vascular and thicker within a few weeks, and the fistula healed within eight weeks following the resumption of semi-weekly mVASC injections after 20 years of failed multimodal attempts. Therapeutic potential of factors derived from perivascular tissue applicable to impaired healing is discussed in the context of presented case.