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Minimizing Palato/velar Fistulas: A New Anatomic Perspective on Unilateral Cleft Lip and Palate
Gül Schmidt1, Elena Hofmann1,2, Friedrich Mrosk1
1From the Department of Oral and Maxillofacial Surgery, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.
Background:
Unilateral cleft lip and palates present unique anatomy at the palato-velar-vomerine junction. This region can be the widest and most challenging part of the cleft, where functional fistulas may occur. In 2017, an approach concentrating on the nasal part was implemented, which rendered the repair of this transition zone less challenging. This study detailed this surgical modification, which allows easy and effective palate repair and thereby reduces fistula rates.
Methods:
This study included 71 patients with unilateral cleft lip and palates who underwent 1-stage palatal repair using the same technique at the age of less than 1 year between 2017 and 2019 and were followed up until 2022. The surgical technique involved the incorporation of the unconnected vomer at the palato-velar-vomerine junction. Anatomical and speech assessments were performed during the annual follow-up period.
Results:
None of the patients developed fistulas. The rate of hypernasality was 11.9%.
Conclusions:
This study described a reliable technique to reduce fistula formation at the palato/velar junction during unilateral cleft lip and palate repair.
