Prevalence of Palatal Fistula in Cleft Palate Repair

Abstract

Background: Cleft palate is a common birth defect. Its incidence is 0.33 in 1000 live births. There is a correlation of family history with cleft lip and palate; present in about 33% to 36% cases. Early complications of cleft palate repair include fistula formation, complete dehiscence, bleeding and palatal flap necrosis. The reported incidence rate of palatal fistula is 29.8%. The study aims to identify the prevalence of fistula formation in complete cleft palate repair.

Methodology: It was a prospective, cohort study aimed to see the occurrence of palatal fistula in cleft palate patients. The study was performed in the Plastic Surgery Department at Patel Hospital, Karachi. All patients fulfilling the inclusion criteria were included in the study. The two-flap palatoplasty was used (Bardach’s technique) to repair the cleft palate. Patients were examined weekly and at 4 weeks postoperatively in the outpatient department to assess fistula formation.

Results: 116 patients with complete cleft palate were included and operated. Later, followed for occurrence of palatal fistula. The mean age was 23.6±20.4 months. During follow up 18 patients developed palatal fistula (15.5 %). The highest fistula rates were observed in older age groups (30.8%) in >36 months.

Conclusion: The frequency of palatal fistula in our study is 15.5 %; showing less fistulae occurrence before the age of 18 months as compared to that of after 18 months.

Keywords: Orofacial congenital anomaly, Cleft palate, Palatal fistula, Bardach technique, Pittsburgh classification