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Frequency of pharyngoplasty after primary repair of cleft palate.
J Can Dent Assoc 2002; 68(11):688-92JC

Abstract

BACKGROUND

The frequency of pharyngoplasty after initial repair of cleft palate is a direct measure of the success or failure of the primary palatal repair with respect to velopharyngeal function. The optimal timing and surgical technique for the repair of cleft palate remain subjects of debate.

PURPOSE

To assess the outcome of various techniques for primary palatal repair, specifically the frequency of secondary pharyngoplasty, and to determine the significance, if any, of certain variables to this outcome.

METHODS

A pool of 114 patients with cleft lip and palate was compiled from a retrospective analysis of medical records for more than 300 consecutive patients treated over a 15-year period (1980-1995). The review included only patients who had been treated by the same surgeon or by his resident. A 1-stage palatal repair was performed on all patients, in which the hard and the soft palate were closed simultaneously. The following data were collected: patient's sex, patient's date of birth, type of cleft, technique used for initial repair, age at initial repair and date of secondary pharyngoplasty surgery, if performed.

RESULTS

The overall frequency of subsequent pharyngoplasty was 25% (28 patients). The rate of secondary surgery was significantly higher for boys (21/63 or 33%) than for girls (7/51 or 14%). There were also significant differences in the rate of secondary pharyngoplasty according to type of cleft: 50% (6/12) for patients with bilateral cleft lip and palate, 44% (7/16) for those with hard and soft cleft palate, 21% (8/38) for those with unilateral cleft lip and palate, 20% (3/15) for those with submucous cleft palate and 12% (4/33) for those with soft cleft palate. Surgical technique for the primary repair (V-Y pushback or von Langenbeck procedure) was not a significant factor in determining the rate of subsequent pharyngoplasty, nor was age at primary repair, although those who underwent primary repair at age 12-14 months were least likely to require pharyngoplasty.

CONCLUSION

In this study the frequency of velopharyngeal insufficiency after 1-stage palatoplasty was consistent with previously reported results. Of interest would be a comparison of 1-stage and 2-stage approaches to primary palate repair in young patients.

Authors+Show Affiliations

Winnipeg Health Sciences Centre and Division of Oral and Maxillofacial Surgery, Faculty of Dentistry, University of Manitoba, Winnipeg, Manitoba, Canada.No affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

12513937

Citation

Bicknell, Sean, et al. "Frequency of Pharyngoplasty After Primary Repair of Cleft Palate." Journal (Canadian Dental Association), vol. 68, no. 11, 2002, pp. 688-92.
Bicknell S, McFadden LR, Curran JB. Frequency of pharyngoplasty after primary repair of cleft palate. J Can Dent Assoc. 2002;68(11):688-92.
Bicknell, S., McFadden, L. R., & Curran, J. B. (2002). Frequency of pharyngoplasty after primary repair of cleft palate. Journal (Canadian Dental Association), 68(11), pp. 688-92.
Bicknell S, McFadden LR, Curran JB. Frequency of Pharyngoplasty After Primary Repair of Cleft Palate. J Can Dent Assoc. 2002;68(11):688-92. PubMed PMID: 12513937.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Frequency of pharyngoplasty after primary repair of cleft palate. AU - Bicknell,Sean, AU - McFadden,Leland R, AU - Curran,John B, PY - 2003/1/7/pubmed PY - 2003/1/16/medline PY - 2003/1/7/entrez SP - 688 EP - 92 JF - Journal (Canadian Dental Association) JO - J Can Dent Assoc VL - 68 IS - 11 N2 - BACKGROUND: The frequency of pharyngoplasty after initial repair of cleft palate is a direct measure of the success or failure of the primary palatal repair with respect to velopharyngeal function. The optimal timing and surgical technique for the repair of cleft palate remain subjects of debate. PURPOSE: To assess the outcome of various techniques for primary palatal repair, specifically the frequency of secondary pharyngoplasty, and to determine the significance, if any, of certain variables to this outcome. METHODS: A pool of 114 patients with cleft lip and palate was compiled from a retrospective analysis of medical records for more than 300 consecutive patients treated over a 15-year period (1980-1995). The review included only patients who had been treated by the same surgeon or by his resident. A 1-stage palatal repair was performed on all patients, in which the hard and the soft palate were closed simultaneously. The following data were collected: patient's sex, patient's date of birth, type of cleft, technique used for initial repair, age at initial repair and date of secondary pharyngoplasty surgery, if performed. RESULTS: The overall frequency of subsequent pharyngoplasty was 25% (28 patients). The rate of secondary surgery was significantly higher for boys (21/63 or 33%) than for girls (7/51 or 14%). There were also significant differences in the rate of secondary pharyngoplasty according to type of cleft: 50% (6/12) for patients with bilateral cleft lip and palate, 44% (7/16) for those with hard and soft cleft palate, 21% (8/38) for those with unilateral cleft lip and palate, 20% (3/15) for those with submucous cleft palate and 12% (4/33) for those with soft cleft palate. Surgical technique for the primary repair (V-Y pushback or von Langenbeck procedure) was not a significant factor in determining the rate of subsequent pharyngoplasty, nor was age at primary repair, although those who underwent primary repair at age 12-14 months were least likely to require pharyngoplasty. CONCLUSION: In this study the frequency of velopharyngeal insufficiency after 1-stage palatoplasty was consistent with previously reported results. Of interest would be a comparison of 1-stage and 2-stage approaches to primary palate repair in young patients. SN - 1488-2159 UR - https://www.unboundmedicine.com/medline/citation/12513937/Frequency_of_pharyngoplasty_after_primary_repair_of_cleft_palate_ L2 - http://www.cda-adc.ca/jcda/vol-68/issue-11/688.html DB - PRIME DP - Unbound Medicine ER -