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Velopharyngeal insufficiency and palatal fistula following cleft palate repair: an 11-year review.
Michael Zeidman, B.S.
Dr. James A. Lehman, Jr., M.D.
Akron Children's Hospital
2012-01-30
Presenter: Michael Zeidman
Affidavit:
Director Name:
Author Category: Student
Presentation Category: Clinical
Abstract Category: Craniomaxillofacial
How does this presentation meet the established conference educational objectives?
This presentation directly pertains to objective #2. It addresses incidence of post-op complications following cleft palate repair, and correlates this data with pre-op conditions.
How will your presentation be used by practicing physicians in the audience?
Knowing the incidence of complications following cleft palate repair, and factors that make complication more likely, can influence a surgeon's decision making pre and post-operatively, and heighten suspicion of complications in a particular subset of patients.
The most frequent congenital anomalies of the face are cleft lip and cleft palate. Common complications of cleft palate repair include velopharyngeal insufficiency (VPI) and palatal fistula, with varying rates of incidence found in the literature. These complications can affect a child's speech and ability to eat, and often require follow-up procedures. The intention of our study was to evaluate the incidence of VPI and fistula over 11 years of cleft palate repair performed by a single surgeon. Our goal was to assess possible correlation between VPI and fistula incidence with cleft palate type (Veau Class), age at palatoplasty, and syndromic versus nonsyndromic patients. Syndromic patients included those with Pierre Robin, DiGeorge, Stickler, and Van der Woude syndromes. Charts of 169 children with cleft palate who had palatoplasty by the senior writer from 2000 – 2010 were reviewed. The mean age at palatoplasty was 12.6 +/- 0.8 months (range, 7.37 – 46.9 months). The incidence of VPI was 29.6%, and the incidence of fistula was 19.5%. A significant association existed between Veau class and fistula (P = 0.007). Neither age at palatoplasty nor presence of a syndrome had any association with VPI or fistula occurrence.
