Successful Premaxillary Reconstruction and Oronasal Fistula Closure in a Patient With VATER Syndrome With Bilateral Cleft and Missing Premaxilla.
Cleft Palate Craniofac JDec 29, 2025 (epub)
Jayson Workman, Antonio Atte, Patrick Wong et al.
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Case in brief
A patient with VATER syndrome and bilateral cleft lip and palate had undergone premaxillary removal during cleft lip repair, leaving a large maxillary defect and an oronasal fistula. Reconstruction with a non-vascularized bone graft was successful: at 13-month follow-up, the graft had consolidated and the fistula had closed.
What made this case unusual
The combination of VATER syndrome, bilateral clefting, and prior premaxillary removal created an extensive maxillary defect with an oronasal fistula—an uncommon reconstructive setting.
Diagnostic / clinical pearl
A non-vascularized bone graft can achieve consolidation and fistula closure in an extensive maxillary defect, as demonstrated in this case.