<< Back to the abstract archive
Incidence of Cleft Palate Fistulas: An 18-Year Experience
Amani F. Hemphill, M.D., James A. Lehman, Jr., M.D., Michael Subichin
Summa Health System
2010-03-28
Presenter: Amani F. Hemphill, M.D.
Affidavit:
Director Name:
Author Category: Resident/Fellow
Presentation Category: Clinical
Abstract Category: Craniomaxillofacial
This retrospective chart review examined the outcomes of 157 patients who underwent palatoplasties over an 18-year period. The purpose of this study was to determine the incidence and potential risk factors for the development of cleft palate fistulas. Variables analyzed included cleft type, gender, age at the time of palate repair, and the presence of an associated syndrome. Of the 157 patients, 75 (48%) had a unilateral cleft lip and palate, 25 (16%) had a bilateral cleft lip and palate, and 57 (36%) had an isolated cleft palate. The sample contained 94 males and 63 females, the average age at the time of definitive palate repair was approximately 11 months, and 14 (9%) patients had a congenital syndrome. Thirty-four patients developed fistulas (21%). Of these, 13 had unilateral clefts of the lip and palate, 10 had bilateral clefts of the lip and palate, and 11 had an isolated cleft palate. There were no statistically significant differences with respect to age at time of palate repair and gender. There was a significantly higher rate of velopharyngeal insufficiency (p < 0.0001) among patients with fistulas. The presence of a congenital syndrome was also associated with a statistically significant higher rate of fistula development (p < 0.05). When the incidence of fistulas in patients with bilateral clefts was analyzed in comparison to other cleft types, there was a statistically significant relationship to fistula development (p < 0.02). These data represent a benchmark for the evaluation of our future outcomes.
