Yun Shan Phua1, Tristan de Chalain. 1. University of Auckland Faculty of Medical and Health Sciences, South Auckland Clinical School, Middlemore Hospital, Auckland, New Zealand.
Abstract
OBJECTIVE: We present an audit of primary cleft palate surgery at our unit, including rates of oronasal fistula development, speech outcomes, and rates of velopharyngeal insufficiency requiring secondary surgery. DESIGN: A retrospective study of patients with all cleft palate types, born between January 1990 and December 2004, who underwent primary palatoplasty at Middlemore Hospital, Auckland, New Zealand. PATIENTS: The study included 211 patients, collectively operated on by five different surgeons. RESULTS: The overall rate of true fistula development was 12.8% over a mean follow-up period of 4 years 10 months. The incidence of true fistulae that required surgical repair was 8.1%. Fistula rates were higher for more severe degrees of clefting but were not affected by gender or type of surgical repair. Overall, 31.8% of the study population had some degree of hypernasality following primary palatoplasty. Secondary surgery for velopharyngeal insufficiency was required in 13.3% of patients. Following surgical correction of velopharyngeal insufficiency, no patients were reported to have appreciable hypernasality and 21.7% were reported to have mild hypernasality, a result comparable to previously published audits. The requirement for secondary surgery was higher in patients with more severe clefts. CONCLUSION: Our results are comparable to other recent studies. We believe that highly coordinated cleft care helps ensure such outcomes. These data provide a benchmark against which we can measure future performance in our attempts to improve outcomes of cleft repair.
OBJECTIVE: We present an audit of primary cleft palate surgery at our unit, including rates of oronasal fistula development, speech outcomes, and rates of velopharyngeal insufficiency requiring secondary surgery. DESIGN: A retrospective study of patients with all cleft palate types, born between January 1990 and December 2004, who underwent primary palatoplasty at Middlemore Hospital, Auckland, New Zealand. PATIENTS: The study included 211 patients, collectively operated on by five different surgeons. RESULTS: The overall rate of true fistula development was 12.8% over a mean follow-up period of 4 years 10 months. The incidence of true fistulae that required surgical repair was 8.1%. Fistula rates were higher for more severe degrees of clefting but were not affected by gender or type of surgical repair. Overall, 31.8% of the study population had some degree of hypernasality following primary palatoplasty. Secondary surgery for velopharyngeal insufficiency was required in 13.3% of patients. Following surgical correction of velopharyngeal insufficiency, no patients were reported to have appreciable hypernasality and 21.7% were reported to have mild hypernasality, a result comparable to previously published audits. The requirement for secondary surgery was higher in patients with more severe clefts. CONCLUSION: Our results are comparable to other recent studies. We believe that highly coordinated cleft care helps ensure such outcomes. These data provide a benchmark against which we can measure future performance in our attempts to improve outcomes of cleft repair.
Authors: Josine C C Widdershoven; Nicole E Spruijt; Wim G M Spliet; Corstiaan C Breugem; Moshe Kon; Aebele B Mink van der Molen Journal: PLoS One Date: 2011-06-28 Impact factor: 3.240
Authors: Paola L Carvajal Monroy; Sander Grefte; Anne M Kuijpers-Jagtman; Maria P A C Helmich; Dietmar J O Ulrich; Johannes W Von den Hoff; Frank A D T G Wagener Journal: PLoS One Date: 2013-03-15 Impact factor: 3.240
Authors: Vanessa Torrecillas; Sarah Hatch Pollard; Hilary McCrary; Helene M Taylor; Alexandra Palmer; Jeremy Meier; Harlan Muntz; Jonathan R Skirko Journal: Cleft Palate Craniofac J Date: 2020-10-05