Primary veloplasty or primary palatoplasty: some preliminary findings

Area of Science:

• Craniofacial surgery
• Pediatric plastic surgery
• Cleft palate repair

Background:

• Staged palatal closure involves separate soft and hard palate repairs.
• Previous methods aimed to reduce lateral crossbite in cleft palate patients.

Purpose of the Study:

• To evaluate the outcomes of staged palatal closure.
• To introduce and describe an alternative, improved palatal closure technique.

Main Methods:

• A cohort of 30 children underwent staged palatal closure (soft palate at 9 months, hard palate at 5 years).
• Patients were followed for 7 years to assess crossbite and speech.
• A novel technique involving specific flap insertions and layer closures was developed.

Main Results:

• Staged closure reduced lateral crossbite incidence in unilateral and bilateral cases.
• Speech results were less satisfactory compared to total palatal closure.
• Two fistulae occurred at the hard-soft palate junction, attributed to surgical difficulty.

Conclusions:

• Staged palatal closure is not recommended due to speech deficits and fistula risks.
• The described alternative technique offers minimal scarring, particularly in the retrotuberosity area, potentially benefiting facial growth.