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CC BY-NC 4.0 · Arch Plast Surg 2022; 49(01): 43-49
DOI: 10.5999/aps.2021.01396
Pediatric/Craniomaxillofacial/Head&Neck
Original Article

Incidence of fistula after primary cleft palate repair: a 25-year assessment of one surgeon’s experience

Min Suk Park 
Department of Plastic and Reconstructive Surgery, Pusan National University School of Medicine, Busan, Korea
,
Hyung Joon Seo 
Department of Plastic and Reconstructive Surgery, Pusan National University School of Medicine, Busan, Korea
Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
,
Yong Chan Bae 
Department of Plastic and Reconstructive Surgery, Pusan National University School of Medicine, Busan, Korea
Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
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Background Cleft lip and cleft palate are the most frequent congenital craniofacial deformities, with an incidence of approximately 1 per 700 people. Postoperative palatal fistula is one of the most significant long-term complications. This study investigated the incidence of postoperative palatal fistula and its predictive factors based on 25 years of experience at our hospital.

Methods We retrospectively reviewed 636 consecutive palatal repairs performed between January 1996 and October 2020 by a single surgeon. Data from patients’ medical records regarding cleft palate repair were analyzed. The preoperative extent of the cleft was evaluated using the Veau classification system, and the cleft palate repair technique was chosen according to the extent of the cleft. SPSS version 25.0 was used for all statistical analyses, and exploratory univariate associations were investigated using the t-test.

Results Fistulas occurred in 20 of the 636 patients; thus, the incidence of palatal fistula was 3.1%. The most common fistula location was the hard palate (9/20, 45%), followed by the junction of the hard and soft palate (6/20, 30%) and the soft palate (5/20, 25%). The cleft palate repair technique significantly predicted the incidence of palatal fistula following cleft palate repair (P=0.042). Fistula incidence was significantly higher in patients who underwent surgery using the Furlow double-opposing Z-plasty technique (12.1%) than in cases where the Busan modification (3.0%) or two-flap technique (2.0%) was used.

Conclusions The overall incidence of palatal fistulas was 3.1% in this study. Moreover, the technique of cleft palate repair predicted fistula incidence.

Keywords

Cleft palate - Palate surgery - Oral fistula - Risk factor


Publication History

Received: 04 July 2021

Accepted: 18 October 2021

Article published online:
02 June 2022

© 2022. The Korean Society of Plastic and Reconstructive Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonCommercial License, permitting unrestricted noncommercial use, distribution, and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes. (https://creativecommons.org/licenses/by-nc/4.0/)

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