Surgical outcomes and challenges in primary palatoplasty among adults: A retrospective cohort study of 395 patients

Document Type

Article

Department

Medical College Pakistan; Surgery

Abstract

Objective: To evaluate surgical outcomes and challenges associated with primary palatoplasty in adults.
Design: Retrospective cohort study
Setting: Lahore, Pakistan, from 2015 to 2024.
Patients/Participants: A total of 395 adult patients (≥18 years) with unrepaired overt cleft palate ± cleft lip undergoing primary palatoplasty (mean age = 21.6 years, 55.6% male, 44.4% female).
Interventions: Primary palatoplasty was performed using von Langenbeck, Bardach 2-flap, or midline incision-only techniques. Modifications for wide clefts and adjunctive pharyngeal flaps were used when indicated.
Main Outcome Measures: Postoperative fistula formation and speech outcomes
Results: Bilateral incomplete cleft palate (Veau II) was the most common phenotype (35.9%) encountered. Postoperative fistula formation occurred in 16.9% of patients, most commonly at the hard-soft palate junction. Increasing age was independently associated with fistula formation (adjusted odds ratio 1.05; 95% confidence interval (CI) 1.001-1.09; P = 0.04). Composite speech scores improved significantly from 14.6 ± 0.75 to 12.3 ± 1.41 (95% CI 2.15-2.45; P < 0.001), representing modest speech improvement.
Conclusion: Primary palatoplasty in adults remains technically challenging but can provide modest improvements in speech outcomes and functional communication.

Comments

Volume, issue, and pagination are not provided by the author/publisher.

Publication (Name of Journal)

The Cleft Palate Craniofacial Journal

DOI

10.1177/10556656261489252

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