Outcomes of Delayed Primary Palatoplasty | ||||
The Egyptian Journal of Plastic and Reconstructive Surgery | ||||
Article 3, Volume 48, Issue 3, July 2024, Page 191-196 PDF (699.87 K) | ||||
Document Type: Original Article | ||||
DOI: 10.21608/ejprs.2024.365328 | ||||
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Authors | ||||
Mohamed Samir Badawy ![]() ![]() ![]() | ||||
The Department of Plastic, Burn and Maxillofacial Surgery, Faculty of Medicine, Ain Shams University | ||||
Abstract | ||||
Background: Despite advances in health awareness programs and general approval of the ideal time for primary palatal repair before two years of life, we still face many patients with untouched or unrepaired palate. Which put the surgeon in a dilemma especially regarding patients’ expectations for improvement of nasality, regurgitation and speech. Objective: Determining reasons of delayed presenting with cleft palate and the effect of palatoplasty. Patients and Methods: We included all patients’ ≥6 years with untouched cleft palate with or without previous cleft lip < br />repair. Data was collected about age, sex, type of cleft, reasons of delay. All Patients underwent two flap palatoplasty and followed postoperatively for complications, improvement of hypernasality and nasal regurgitation. Results: A total of 24 patients with delayed presentation of untreated cleft palate between the years 2011 and 2021 were included in this study. The most common reason for delayed presentation was lacking nearby service (37.5%). The most common presentation was unilateral cleft lip and palate with repaired lip (37.5%). The intra-operative blood loss which need blood transfusion was (8.3%). Also the post-operative complication like bleeding, airway compromise, wound disruption and fistula rate were (49.9%). Nasal regurgitation was improved in 58.3% after palatoplasty only but in 33.3% of patients another intervention needed. Improvement of hypernasality was extremely linked to the patient’s age. Conclusion: We recommend intervention for lately presenting patients with cleft palate even for adult’s despite being accustomed for regurgitation and nasality as the benefits are much more than the drawbacks | ||||
Keywords | ||||
Unrepaired; Cleft Palate; Adult; Late Presentation | ||||
References | ||||
Aziz S.R. and Rhee S.T.: Redai, Cleft surgery in rural Bangladesh: Reflections and experiences. J. Oral Maxillofac. Surg., 67: 1581-1588, 2009. 2- Southby L., Harding S., Phillips V., Wren Y. and Joinson C.: Speech input processing in children born with cleft palate: A systematic literature review with narrative synthesis. International Journal of Language & Communication Disorders, 56: 668-693, 2021. 3- Schwarz R. and Khadka S.B.: Reasons for late presentation of cleft deformity in Nepal. Cleft Palate Craniofac J., 41: 199-201, 2004. 4- Sell D.A. and Grunwell P.: Speech results following late palatal surgery in previously unoperated Sri Lankan adolescents with cleft palates. Cleft Palate J., 27: 162-168, 1990. 5- Carroll D.J., Padgitt N.R., Liu M., Lander T.A., Tibesar R.J. and Sidman J.D.: The effect of cleft palate repair technique on hearing outcomes in children. Int. J. Pediatr. Otorhinolaryngol., 77: 1518-1522, 2013. 6- Pelchat D., Bisson J., Richard N., Perreault M. and Bouchard J.M.: Longitudinal effects of an early family intervention programme on the adaption of parents of children with a disability. Int. J. Nurs. Stud., 36: 465-477, 1999. 7- Bardach J.: Two-flap palatoplasty: Bardach’s technique. Oper. Tech. Plast. Reconstr. Surg., 2: 211-4, 1995. 8- Rohrich R.J., Love E.J., Byrd H.S. and Johns D.F.: Optimal timing of cleft palate closure. Plast. Reconstr. Surg., 21: 106-413, discussion 423-5, quiz 422, 2000. 9- Adeyemo W.L., Ogunlewe M.O., Desalu I., Ladeinde A.L., Mofikoya B.O., Adeyemi M.O., Adepoju A.A. and Hassan O.O.: Cleft deformities in adults and children aged over six years in Nigeria: Reasons for late presentation and management challenges. Clin. Cosmet Investig. Dent, Nov. 30 (1): 63-9, 2009. | ||||
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