Clinical Outcomes of Primary Palatoplasty in Preschool- Aged Cleft Palate Children in Srinagarind Hospital and Comparison with Other Standard Cleft Centers
Nadda Kaewkumsan MD*, Bowornsilp Chowchuen MD, MBA*, Benjamas Prathanee BSc, MA, PhD**
Affiliation : * Division of Plastic Surgery , Department of Surgery, Khon Kaen University, Khon Kaen, Thailand ** Department of Otolaryngology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
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 underwent primary palatoplasty at our center and under our
management protocol.
Material and Medthod: A Cross-sectional study of 40 consecutive non-syndromic cleft palates with/or without cleft lips, born
between February 2007 and December 2008, who underwent primary palatoplasty at Srinagarind Hospital, Thailand.
Demographic data that were recorded includes: patients with cleft types, age at palatoplasty, 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 at palatoplasty was 14.1 months (9-64 months). There were three plastic surgeons and plastic surgery
residents. The predominant cleft lip type was Veau 3 (52.5%) followed by Veau 4 (27.5%) and Veau 1 (20%). Two-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%. Oronasal fistula occurred in 10 patients, fistula rate was 25%. Oronasal
fistula closure was performed 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 oronasal fistula formation.
Conclusion : The rate of hypernasality and oronasal fistula formation was comparable to results from other standard cleft
centers in cleft palate patients who underwent primary palatoplasty during previous rounds of our management protocol.
Keywords : Cleft palate, Palatoplasty, Oronasal fistula, Hypernasality
