Outcomes of Delayed Primary Palatoplasty

Abstract

Background: Despite advances in health awareness programsand general approval of the ideal time for primary palatalrepair before two years of life, we still face many patientswith untouched or unrepaired palate. Which put the surgeonin a dilemma especially regarding patients’ expectations forimprovement of nasality, regurgitation and speech.Objective: Determining reasons of delayed presentingwith cleft palate and the effect of palatoplasty.Patients and Methods: We included all patients’ ≥6 yearswith untouched cleft palate with or without previous cleft lip < br />repair. Data was collected about age, sex, type of cleft, reasonsof delay. All Patients underwent two flap palatoplasty andfollowed postoperatively for complications, improvement ofhypernasality and nasal regurgitation.Results: A total of 24 patients with delayed presentation ofuntreated cleft palate between the years 2011 and 2021 wereincluded in this study. The most common reason for delayedpresentation was lacking nearby service (37.5%). The mostcommon presentation was unilateral cleft lip and palate withrepaired lip (37.5%). The intra-operative blood loss whichneed blood transfusion was (8.3%). Also the post-operativecomplication like bleeding, airway compromise, wound disruptionand fistula rate were (49.9%). Nasal regurgitation wasimproved in 58.3% after palatoplasty only but in 33.3% of patientsanother intervention needed. Improvement of hypernasalitywas extremely linked to the patient’s age.Conclusion: We recommend intervention for lately presentingpatients with cleft palate even for adult’s despite beingaccustomed for regurgitation and nasality as the benefits aremuch more than the drawbacks