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Revision Surgery of the Cleft Palate.

Shirley Hu1, Jared Levinson2, Joseph J Rousso1,3

  • 1Department of Otolaryngology-Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, New York.

Seminars in Plastic Surgery
|May 12, 2020
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Summary

Cleft palate repair often needs revision surgery due to oronasal fistulas and velopharyngeal insufficiency. Preventing surgical complications is crucial for reducing the need for secondary cleft palate procedures.

Keywords:
cleft palatepalatal fistulasrevision cleft surgeryvelopharyngeal insufficiency

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Area of Science:

  • Plastic Surgery
  • Otolaryngology
  • Craniofacial Surgery

Background:

  • Cleft palate repairs frequently necessitate secondary surgeries or revisions.
  • Symptomatic oronasal fistulas and velopharyngeal insufficiency are primary drivers for these repeat procedures.
  • Postoperative complications like wound dehiscence, infection, and hematomas increase the likelihood of revision surgery.

Purpose of the Study:

  • To review the common causes of secondary cleft palate surgeries.
  • To highlight the importance of preventing postoperative complications.
  • To discuss the management and surgical options for fistulas and velopharyngeal insufficiency.

Main Methods:

  • Literature review of studies on cleft palate repair outcomes.
  • Analysis of factors contributing to secondary surgeries.
  • Examination of techniques aimed at reducing revision rates.

Main Results:

  • Oronasal fistulas and velopharyngeal insufficiency are the most frequent indications for revision.
  • Surgical complications significantly impact the need for secondary interventions.
  • Various techniques exist to minimize the incidence of revision surgeries.

Conclusions:

  • Preventing postoperative complications is essential in primary cleft palate repair.
  • Management strategies for fistulas and velopharyngeal insufficiency are diverse.
  • Optimizing primary repair techniques can decrease the need for subsequent surgeries.