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Comparison of the Fistula Risk Associated With Rotation Palatoplasty and Conventional Palatoplasty for Cleft Palate Repair

Kahraman, Ahmet MD*; Yuce, Serdar MD; Kocak, Omer Faruk MD; Canbaz, Yasin MD; Guner, Sukriye Ilkay PhD; Atik, Bekir MD§; Isik, Daghan MD

The Journal of Craniofacial Surgery: September 2014 - Volume 25 - Issue 5 - p 1728–1733
doi: 10.1097/SCS.0000000000000967
Original Articles
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Objectives The aims of the cleft palate repair techniques are to reduce the velopharyngeal insufficiency risk and oronasal fistula development to minimal levels without affecting the maxillofacial development. In this article, we present a retrospective study comparing the conventional palatoplasty techniques with the new technique of rotation palatoplasty for the risk of development of oronasal fistula.

Materials and Methods Of the 100 patients who were operated on because of cleft palate between the years 2002 and 2008, 12 patients had Furlow palatoplasty, and 88 patients received the Veau-Wardill-Kilner (V–Y pushback) operation (group C). A total of 67 patients who were operated on between 2008 and 2011 had rotation palatoplasty (group R).

Results One hundred patients were men, and 67 were women. Among all the patient groups, 22.8% were classified as Veau 1, 24.6% were classified as Veau 2, 37.1% were classified as Veau 3, and 15.6% were classified as Veau 4. The rate of fistula was found to be 17.7% in all patients. Fistula development was found in 6% of the patients in group R (4/67) and in 18% of the patients in group C (18/100). The difference between group R and group C regarding the number of patients who developed fistula was statistically significant (P = 0.011).

Conclusions The Veau classification of the cleft palate affects the risk of fistula development, and the risk for fistula after rotation palatoplasty is lower than that associated with the V–Y pushback technique.

From the *Department of Plastic, Reconstructive and Aesthetic Surgery, Medicine School of Mustafa Kemal University; Departments of †Plastic, Reconstructive and Aesthetic Surgery and ‡Surgical Nursing, Medicine School of Yuzuncu Yil University, Van; §Department of Plastic, Reconstructive and Aesthetic Surgery, Medicine School of Medeniyet University, Istanbul; and ∥Department of Plastic, Reconstructive and Aesthetic Surgery, Medicine School of Katip Celebi University, Izmir, Turkey.

Received October 13, 2013.

Accepted for publication March 13, 2014.

Address correspondence and reprint requests to Serdar Yüce, MD, Tip Fakültesi, Plastik, Rekonstrüktif ve Estetik, Yüzüncü Yil Üniversitesi, Cerrahi AD, 65100 Van, Turkey; E-mail: yuceserdar23@yahoo.com

The authors report no conflicts of interest.

© 2014 by Mutaz B. Habal, MD.