Techniques and outcome of repair of cleft of the secondary palate at University of Port Harcourt Teaching Hospital

Abstract

Background: The technique adopted in the repair of cleft of the secondary palate must not just be based on the choice of the surgeon but on several factors which include the width of the cleft, length of palate and age of the patient. The aim of the article was to document our 4-year experience of the techniques and outcome of repair of these defects in a tertiary center in the south-south zone of Nigeria.
PatientsMethod: Site of palatal involvement was documented; cleft width was measured with linear callipers and categorized as 2cm or less and above 2cm. The lengths of the soft palate were measured with callipers under general anaesthesia, length less than 4cm was classified as insufficient.
Results: Out of 88 patients that were managed, 44(50%) were males and 44(50%) were females. Age range was 4 months to 46 years; Mean (±SD), 8 (8.75) years. Twenty-five (28.4%) were two years and below and 28(31.8%) were 14 years and above. Clefts of widths greater than 2cm were repaired with Bardach’s technique. Von-Langenbeck was used for most defects of 2cm or less. In all, there was healing without fistula in 77(86.3%) cases and functional outcome was satisfactory in 72(81.7%) cases.
Conclusion: The decision for any of the techniques must be based on relevant factors. Therefore, when the width of the cleft is more than 2cm and length of the soft palate is less than 4cm, it is appropriate to raise wide and easily mobilized flaps.

Keywords: Velopharyngeal incompetence, speech, oro-nasal fistula