Functional results of patients with cleft palate between 1993 and 2006 in Moravia I – Epidemiology and surgical results

Česká verzia

Authors: Z. Dvořák ^1,2; T. Mrázek ²; J. Vokurková ^3,4; T. Výška ²; J. Veselý ^1,2
Authors place of work: Lékařská fakulta Masarykovy Univerzity, Brno ¹; Klinika plastické a estetické chirurgie FN U sv. Anny, Brno ²; Oddělení dětské plastické chirurgie KDCHOT, FN Brno ³; Klinika popálenin a plastické chirurgie, FN Brno ⁴
Published in the journal: Čes-slov Pediat 2019; 74 (6): 315-327.
Category: Original Papers

Summary

Objective: To evaluate the results of palatal reconstruction in children with cleft palate based on the therapeutic results of the multidisciplinary team of the Cleft center at the Department of Plastic and Aesthetic Surgery of St. Anna’s Faculty Hospital in Brno (KPECH) focusing on epidemiological data and results of surgical control.

Methods: The basic set consisted of 919 cleft patients operated from January 1, 1993 to December 31, 2006 at KPECH, 20 children had an atypical cleft, 899 children had a typical cleft. An epidemiological analysis of the set has been carried out. The 688 children of the set were operated with a cleft palate. Timing, type of surgery, surgical and postoperative complications were monitored. The function of the velopharyngeal closure was evaluated in 561 of these patients.

Results: Female gender for cleft palate (55.7%) and male gender in other cleft types (67.4–69.5%) as well as the predisposition of left-sided clefts have been confirmed. The palatal reconstruction was performed most often between 10–15 months of life (median 13 months). From surgical methods, the Furlow’s method was used in 288 children, two-flap palatoplasty with intravelar veloplasty (IVV) in 268 children and without IVV in 133 patients. Early complications occurred in ¼ of patients (most commonly serious rhinitis and postoperative febrile), palatal perforations were observed in 6.7% of patients. The 16.2% of patients were reoperated for velofaryngeal dysfunction.

Conclusion: From the epidemiological point of view, the patient population has all characteristics of the Central European population of cleft patients. Based on the results of surgical examinations, Furlow’s method had the best results in patients with the isolated cleft palate, and two-flap palatoplasty with IVV had the best results in patients with the cleft lip and palate.

Keywords:

cleft lip – cleft palate – orofacial cleft – velofaryngeal insufficiency – reconstructive surgery

Zdroje

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