Comparison of the Fistula Risk Associated With Rotation Palatoplasty and Conventional Palatoplasty for Cleft Palate Repair

Abstract

The aims of the cleft palate repair techniques are to reduce the velopharyngeal insufficiency risk and oronasal fistula development to minimal levels without affecting the maxillofacial development. In this article, we present a retrospective study comparing the conventional palatoplasty techniques with the new technique of rotation palatoplasty for the risk of development of oronasal fistula. Materials and Methods: Of the 100 patients who were operated on because of cleft palate between the years 2002 and 2008, 12 patients had Furlow palatoplasty, and 88 patients received the Veau-Wardill-Kilner (V-Y pushback) operation (group C). A total of 67 patients who were operated on between 2008 and 2011 had rotation palatoplasty (group R). Results: One hundred patients were men, and 67 were women. Among all the patient groups, 22.8% were classified as Veau 1, 24.6% were classified as Veau 2, 37.1% were classified as Veau 3, and 15.6% were classified as Veau 4. The rate of fistula was found to be 17.7% in all patients. Fistula development was found in 6% of the patients in group R (4/67) and in 18% of the patients in group C (18/100). The difference between group R and group C regarding the number of patients who developed fistula was statistically significant (P = 0.011). Conclusions: The Veau classification of the cleft palate affects the risk of fistula development, and the risk for fistula after rotation palatoplasty is lower than that associated with the V-Y pushback technique.