A retrospective study of palatoplasty surgeries: successes, complications, and reoperations

Methods: The study consisted of retrospective review of 152 cleft palate patients treated by one surgeon at the University of Oklahoma Health Sciences Center from August 1996 to June 2006. Incidence of palatal fistula formation and VPI after primary palatoplasty surgery was analyzed. Clinically significant fistulae were defined as those requiring surgical repair. The success rates of secondary palatoplasties for fistula repair and of pharyngeal flaps VPI correction were also analyzed.

Results: Primary palatoplasties were performed on 124 patients and the remaining 28 received care for complications of primary palatoplasties performed by other surgeons. Twenty six pharyngeal flap surgeries and seventeen fistula repair palatoplasties were performed. We found a 32.3% (n=124) rate of clinically significant palatal fistula formation after primary palatoplasty after following the subjects for a mean period of 1.52 years. Closure of fistulae with secondary palatoplasties had a success rate of 70.6% (n=17). We found a 13% rate (n=46) of definitively diagnosed VPI after primary palatoplasty. Correction of VPI (n=25) with a pharyngeal flap yielded full resolution of the VPI 45.5% of the time and partial resolution of the VPI 45.5% of the time after following the subjects for a mean period of 2.16 years.

Conclusions: The rates of complications after primary surgery and success of repair surgeries found in this study were similar to those reported in the medical literature. These results suggest that oral surgeons and other surgeons have similar success rates and incidence of complications after primary and repair surgeries.