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Early Cleft Palate Repair by a Modified Technique Without Relaxing Incisions
Karim Ahmed Sakran1,2,3, Jiayi Yin1,2, Renjie Yang1,4
1State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China.
Insights
This modified palatoplasty technique (MPT) shows excellent wound healing and normal speech outcomes in cleft palate repair. The technique is effective for various cleft severities, with low fistula rates.
Area of Science:
- Oral and Maxillofacial Surgery
- Pediatric Surgery
- Plastic Surgery
Background:
- Cleft palate repair is a complex surgical challenge.
- Optimizing surgical techniques is crucial for improving patient outcomes.
- Modified palatoplasty techniques aim to enhance wound healing and speech function.
Purpose of the Study:
- To evaluate the postoperative outcomes of a modified palatoplasty technique (MPT).
- To identify factors influencing wound healing and velopharyngeal function (VPF) after MPT.
- To assess the efficacy of MPT in non-syndromic cleft palate repair.
Main Methods:
- Retrospective cohort study of 143 patients with non-syndromic cleft palate.
- Patients underwent MPT before one year of age.
- Outcomes included wound healing and VPF; influencing factors were analyzed.
Main Results:
- 96.5% of patients achieved complete wound healing; 3.5% developed fistulas.
- 90.2% demonstrated normal VPF; 9.8% had velopharyngeal insufficiency.
- Cleft width and pharyngeal depth significantly impacted wound healing (P=.015, P=.049).
Conclusions:
- The modified palatoplasty technique yields low fistula rates and good speech outcomes.
- MPT is suitable for early repair of cleft palates across different severities.
- The technique demonstrates potential for widespread clinical adoption.
Objective:
This study sought to evaluate a modified palatoplasty technique (MPT) concerning the postoperative outcomes and associated influencing factors.
Design:
A retrospective cohort study.
Participants And Setting:
One hundred forty-three consecutive patients with non-syndromic cleft palate, who received MPT before one year of age within an oral and maxillofacial surgery department of a university-affiliated tertiary hospital between 2011-2017, were reviewed.
Main Measures:
The postoperative wound healing and velopharyngeal function (VPF) were the primary outcome measures. The sex, age at surgery, cleft type, cleft width, palatal width, soft palate length, pharyngeal cavity depth, and operation duration were preselected as influencing factors. Univariate and multivariate analyses were conducted.
Results:
The mean age at surgery was 9 ± 1.31 months (5-11), and the average cleft width was 9.03 ± 2.41 mm (4-15). The rate of incomplete cleft palate was 84.6% while the complete cleft palate was 15.4%. Complete wound healing was reported in 96.5% while the others (3.5%) had persistent oronasal fistula. About 90.2% of cases have shown normal velopharyngeal function whereas the others (9.8%) had sustained velopharyngeal insufficiency. The wound healing appeared to be significantly impacted by cleft width and pharyngeal cavity depth (P = .015 and 0.049, respectively). However, none of the factors had a significant association with VPF.
Conclusions:
The present modified palatoplasty technique has obtained a low fistula rate and appropriate speech outcome. Therefore, this MPT could be promoted for early repairing cleft palate of different severities.
