Clinical outcomes of primary palatoplasty in preschool-aged cleft palate children in Srinagarind Hospital and comparison with other standard cleft centers.

BACKGROUND: The purpose of this study was to evaluate the clinical outcomes regarding the rate of hypernasality and oronasal fistula formation in patients with cleft palate who underwvent primaly palatoplasty at our center and under our management protocol. MATERIAL AND METHOD: A Cross-sectional study of 40 consecutive non-syndromnic cleft palates with/or without cleft lips, born between February 2007 and December 2008, who underwent primaty palatoplasty at Srinagarind Hospital, Thailand. Demographic data that were recorded inclutdes: patients with cleft types, age atpalatoplasty, operating surgeons and surgical techniques. RESULTS: 40 consecutive patients. There were 23 boys and 17 girls. Three patients had associated disease; one patient had amniotic band syndrome and clubfeet, two patients had G-6-PD deficiency. Mean age at time of evaluation was 5.7 years (5.0-6.9 years). Mean age atpalatoplasty was 14.1 months (9-64 months). There were three plastic surgeons and plastic surreiy residents. The predominiant cleft lip type was Veau 3 (52.5%) followed by Veau 4 (27.5%) and Veau 1 (20%). Twvo-flap palatoplasty was used in all patients. The rate of hypernasality was 37.5% (15 out of 40 patients). Mild hypernasality was 25% and moderate hypernasality was 12.5%. Oronasalfistula occurred in 10 patients, fistula rate was 25%. Oronasal fistula closure was relformed on nine patients (90%). Two patients (5%) had residual oronasal fistula at the time of the study. There were no statistically significant differences in the cleft types, age at palatoplasty and operating surgeons in hypernality rates and oronas alfistula fomation. CONCLUSION: The rate of hypernasality and oronas alfistu laformation was comparable to resultsfirom other standard cleft.