Abstract
Cleft lip and palate is the most frequent birth anomaly, with increasing reported rates of complications, such as palate fistulae. Current studies concerning the occurrence rate of cleft lip and palate (CLP) report 2 to 10 cases in 10,000 births. The purpose of this study was to investigate the existence of factors that could predict the occurrence of fistulae after cleft lip and palate surgery. A retrospective study was performed by collecting and analyzing data from all patients who were operated for cleft lip and/or palate in the Maxillo-Facial Department of the Emergency Clinical County Hospital of Cluj-Napoca, Romania, between 2010 and 2020. We investigated the existing evidence for possible links between the number of fistulae observed after the primary palatoplasty and the age at which the primary palatoplasty was performed, the sex of the patient, the type of cleft, the timing of the surgical corrections, and the presence of comorbidities. A total of 137 cases were included for analysis. A significant link between the number of fistulae and the type of cleft was found (with fistulae occurring more frequently after the surgical correction of CLP—p < 0.001). No evidence was found for the existence of significant links between the number of fistulae and the patient’s sex, the timing of surgery, or the presence of comorbidities. This study concluded that the incidence of palatal fistulae appears to be influenced by the type of cleft (CLP), but not by the sex of the patient, the timing of surgery, or the presence of comorbidities.
Highlights
Orofacial clefts (OFCs) are the most common congenital malformations of the craniofacial region and can occur solely or can be associated with additional abnormalities or genetic syndromes [1,2].The prevalence in Europe, based on the International Perinatal Database of TypicalOral Clefts (IPDTOC), is 9.92 in 10,000 births for OFCs, with cleft lip seen in 3.28 per10,000 births and cleft lip and palate (CLP) in 6.64 per 10,000 births [1].When referring to clefts involving the palate, such as cleft lip and/or palate (CL/P) or cleft palate only (CP), the success of the treatment is quantified considering the postoperative development of palatal fistulae, velopharyngeal insufficiency, phonation disorders, and alterations in the mid-face growth pattern
Among the investigated possible prognostic factors, the coexistence of other clefts along with a CP was the only factor comorbidities, and type of cleft), the coexistence of other clefts along with a CP was the found to be prognostically linked to the occurrence of palatal fistulae and to the need to only factor found to be prognostically linked to the occurrence of palatal fistulae and to perform one or several secondary surgical fistula repairs
Based on the results of this single-center experience over 10 years, the current study suggests that the number of secondary palatal fistulae is linked to the type of cleft, being more frequent in cases of CLP, compared to CP alone
Summary
Orofacial clefts (OFCs) are the most common congenital malformations of the craniofacial region and can occur solely or can be associated with additional abnormalities or genetic syndromes [1,2].The prevalence in Europe, based on the International Perinatal Database of TypicalOral Clefts (IPDTOC), is 9.92 in 10,000 births for OFCs, with cleft lip seen in 3.28 per10,000 births and cleft lip and palate (CLP) in 6.64 per 10,000 births [1].When referring to clefts involving the palate, such as cleft lip and/or palate (CL/P) or cleft palate only (CP), the success of the treatment is quantified considering the postoperative development of palatal fistulae, velopharyngeal insufficiency, phonation disorders, and alterations in the mid-face growth pattern. Orofacial clefts (OFCs) are the most common congenital malformations of the craniofacial region and can occur solely or can be associated with additional abnormalities or genetic syndromes [1,2]. Oral Clefts (IPDTOC), is 9.92 in 10,000 births for OFCs, with cleft lip seen in 3.28 per. 10,000 births and cleft lip and palate (CLP) in 6.64 per 10,000 births [1]. When referring to clefts involving the palate, such as cleft lip and/or palate (CL/P) or cleft palate only (CP), the success of the treatment is quantified considering the postoperative development of palatal fistulae, velopharyngeal insufficiency, phonation disorders, and alterations in the mid-face growth pattern. The main objective of palatoplasty is creating the optimal anatomical conditions for normal speech development, assisted by logopedics, and for the appropriate growth of the mid-face [1].
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