Palatal Fistulas: Rare with the Two-Flap Palatoplasty Repair

Abstract

The purpose of this study was to examine the palatal fistula rate after repair with the two-flap palatoplasty technique. This is a retrospective review of 119 consecutive cleft-palate repairs performed over a 5-year interval by a single surgeon. The two-flap palatoplasty technique was used to provide tension-free, multilayer repairs. The age of these children at the time of repair ranged from 7 to 84 months (mode, 9 months). The initial follow-up visit occurred 2 to 12 weeks after the repair operation (mean, 4 weeks). The postoperative follow-up duration ranged from 7 to 48 months. This review of 119 cleft-palate repairs revealed a fistula rate of 3.4 percent (four fistulas in 119 repairs). This experience demonstrates the lowest reported palatal fistula complication rate with use of the two-flap palatoplasty technique.

Important points for primary cleft palate repair for speech derived from speech outcome after three different types of palatoplasty

“…Many authors have also demonstrated that one-stage early closure results in significantly better speech outcome than the two-stage operation with delayed hard palate closure [9,14,[21][22][23]25,26]. Our data support this suggestion.…”

Cleft lip and palate treatment of 530 children over a decade in a single centre

“…Percentage of fistulas is relative low in our study but in consistence with other cohorts of children treated with the two flap palatoplasty technique [11,12]. The same applies for velopharyngeal insufficiency (VPI) that is severe enough to require a surgical treatment.…”

V–Y two-layer repair for oronasal fistula of hard palate

“…Causes of fistula formation after cleft palate repair may be the type of cleft, type of repair, wound tension, single-layer repair, infection and dead space deep to the mucoperiosteal flap [4,5]. Complete dehiscence is uncommon, unless the neurovascular bundle is divided.…”