bone graft and advancement?

May 19, 2005

Hi! I'm new to this group - but I have a surgery date planned for

June 9th in NYC with Dr. Court Cutting. I'm 27 yrs old and was born

with a unilateral cleft lip and palate. Unfortunately I did not

receive a bone graft earlier - and the soft tissue repair of my palate

began to open up a few years ago. Now I have an oral-nasal fistula -

which was my original concern for going to the doctor since food gets

trapped up there and causes infection. Imagine my surprise when I

went into the office for the first time and he concentrated on my

maxillary deficiency! Now I'm scheduled to have three procedures done

at the same time. First a segmental advancement - to help close the

bone deficiency created by the cleft palate. Then a LeFortI of my

upper jaw - only 5-8mm - which they say shouldn't be that bad. Then a

bone graft to fill in the gap. The only concern is that with all the

other procedures, the bone graft may not have a good enough blood

supply to survive - so I may have to have another one. Has anyone

been through a similar situation?

He also told me that for healing of the bone graft I shouldn't use a

straw or change the pressure between my mouth and nose (for fear that

I would create a new whole in the graft). What I realize now is that

I'm constantly " sucking " through the fistula to get rid of food or

snot (sorry it's gross) because I dislike when it gets stuffed up. Is

it possible that I will do this after surgery without thinking? Could

this ruin the bone graft? And will it constantly feel like something

is just " stuffed " in there? I'm also afraid that I've begun to use

the fistula as an alternative breathing source. My left nostril has a

lot of scar tissue and only work about 10%. I typically breathe

through my mouth and subsequently the fistula. Am I going to feel

like I'm not getting enough air?

He also plans to take the bone graft from my hip - but he is able to

use a " long needle " techique which is supposed to be less invasive and

speed healing. I heard the old way was usually the most painful part

of recovery. Does anyone have any experience?

I would be most appreciative of any support or personal stories to

help ease my mind. Even though I've had numerous surgeries before -

as this one approaches my anxiety level has begun to soar. They also

removed a tooth near the cleft area - so I'm currently walking around

the city toothless - not very Sara . I just can't wait

for it to be over. *sigh*

Thanks in advance!

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