Evaluation of postoperative outcomes in palatoplasty with three soft palate cleft repairs

K A Sakran; H Huang; E Al-Moraissi; S A Elayah; H Younis; Y Li; B Shi

doi:10.1016/j.ijom.2024.01.012

Evaluation of postoperative outcomes in palatoplasty with three soft palate cleft repairs

Int J Oral Maxillofac Surg. 2024 Feb 7:S0901-5027(24)00030-4. doi: 10.1016/j.ijom.2024.01.012. Online ahead of print.

Authors

K A Sakran¹, H Huang², E Al-Moraissi³, S A Elayah¹, H Younis², Y Li⁴, B Shi²

Affiliations

¹ Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China; Department of Oral and Maxillofacial Surgery, College of Dentistry, Ibb University, Ibb, Yemen.
² Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China.
³ Department of Oral and Maxillofacial Surgery, College of Dentistry, Thamar University, Thamar, Yemen.
⁴ Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China. Electronic address: luciaya@163.com.

PMID: 38331640
DOI: 10.1016/j.ijom.2024.01.012

Abstract

The aim of this study was to compare the postoperative clinical and functional outcomes of palatoplasty with three soft palate cleft repairs and analyse the factors potentially impacting these outcomes. A retrospective analysis was conducted on a consecutive series of 337 patients who underwent primary cleft palate repair by palatoplasty modified with either Furlow Z-plasty (P-FZP, n = 77), intravelar veloplasty (P-IVV, n = 110), or combined intravelar veloplasty-Furlow Z-plasty (P-IVV-FZP, n = 150). The postoperative outcomes evaluated included wound healing (complete closure/fistula) and velopharyngeal function. Demographic and surgical data were analysed using both univariate and multivariate analysis. There was no significant difference between the groups with regard to the sex distribution, age at repair, cleft width, cleft type, or follow-up duration. However, relaxing incisions were significantly more common with P-FZP (26.0%) and P-IVV (29.1%) compared to P-IVV-FZP (10%) (P = 0.002 and <0.001, respectively). The complete wound closure rate was significantly higher with P-IVV-FZP (97.3%) compared to P-FZP (88.3%) (P = 0.012) and P-IVV (90%) (P = 0.015). The normal velopharyngeal function rate was comparable for P-IVV-FZP (86.7%) and P-FZP (83.1%), and both rates were significantly better than the rate with P-IVV (73.6%) (P = 0.039 and 0.029, respectively). The cleft type and width were identified as factors influencing postoperative outcomes. In conclusion, it may be appropriate to prioritize the palatoplasty with combined intravelar veloplasty-Furlow Z-plasty whenever feasible.

Keywords: Cleft palate; Clinical study; Oral fistula; Reconstructive surgical procedure; Velopharyngeal insufficiency.