The Black Hole: Prevention and Correction of Fistulas Following Cleft Palate Repair

This webinar was originally accepted as a Teaching Course for ACPA's 77th Annual Meeting.

Fistula following cleft palate repair is one of the most significant long-term complications of cleft palate care, as persistent nasal air-escape impairs speech and persistent oronasal regurgitation impacts dental, Eustachian, and nasal hygiene. Re-operation to close a fistula has considerable burden on children and the additional scar limits velar movements and impairs facial growth. The chances of successful palatal closure diminish with each additional surgical attempt and, as such, successful primary cleft palate repair or reconstruction of an existing fistula is of paramount importance to long-term outcome and quality of life.

This session will involve a combination of presentations, case examples, and panel discussion of difficult cases.

Prevention: We will start with detailed surgical anatomy and its application to surgical dissection. We will describe technical maneuvers that can assist with closure and highlight potential pitfalls that can result in complications. We will discuss potential "lifeboats" that can be used during repair. We will emphasize technical nuances that may help to avoid complications

Correction: Fistulas can occur in various locations and in various magnitudes. We will describe surgical options and approaches to closure of a fistula if one has occurred. We will use cases that illustrate potential scenarios. Case discussion: A significant portion of this session will be dedicated to presentation of cases and detailed interdisciplinary discussion. Participation by all will be greatly encouraged.



Continuing Education

Attendees must register, attend and evaluate each webinar to receive continuing education credit. This on-demand course will be eligible through March 31, 2022. 

  • ACCME: ACPA designates this educational activity for a maximum of 1.0 AMA PRA Category 1 Credits™.  Physicians should only claim credits commensurate with the extent of their participation in the activity. The American Cleft Palate-Craniofacial Association is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

Nursing: This nursing continuing professional development activity was approved by the North Carolina Nurses Association, an accredited approver by the American Nurses Credentialing Center’s Commission on Accreditation.

To receive 1.0 contact hours:

  • Learners must attend 80% or more of the webinar.
  • Learners must complete and submit an evaluation form.

Neither the speakers nor members of the planning committee have any conflicts of interest related to the content of this activity.  Individual disclosures may be found in the “Topics” tab under their name.


Original Seminar Date: October 6, 2020

On-Demand Release Date: October 7, 2020

On-Demand Expiration Date: March 31, 2022

Seminar Objectives
  • Each learner will be able to identify detailed anatomy of the hard and soft palate, especially as it pertains to clefts.
  • Each learner will be able to use maneuvers and approaches that can reduce the risk of post-operative complication.
  • Each learner will improve their ability to close a fistula that has developed following cleft palate repair.
Seminar Information
Expiration Date:
March 31, 2022 11:55 PM
1 hour
ACPA Life Member Price:
Transitional Member Price:
Student Non-member Price:
Student Member Price:
Member Price:
ACPA Retired Price:
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The Black Hole: Prevention and Correction of Fistulas Following Cleft Palate Repair
Speaker Information
John Grant MD  [ view bio ]
Sylvie Render MS  [ view bio ]
Raymond Tse MD, FRS(C)  [ view bio ]
Individual topic purchase: Selected
AMA PRA Category 1 Credit(s)™: 1.00
Accreditation Council for Continuing Medical Education (non-MD/DO)
AMA PRA Category 1 Credit(s)™: 1.00
Nursing Contact Hours: 1.00
This seminar is no longer available for purchase.