Mongolian Journal of Obstetrics, Gynaecology and Pediatrics  2021;30(2):2173-2179

Velopharyngeal function: a comparison result of primary palatoplasty by various techniques

Erdenetsogt J 1 ; Ayanga G 2 ; Munkhdul A 3 ; Khentii L 2

Affiliations

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Keywords

cleft palate; velopharyngeal insufficiency; primary palatoplasty; nasopharyngeoscopy

Country

Mongolia

Language

Mongolian

Abstract

Velopharyngeal function: a comparison result of primary palatoplasty by various techniques:Introduction: The main purpose of primary cleft palate repair is to reconstruct anatomical structure with minimal impairment of maxillary growth and normalize velopharyngeal function and feeding process. One of the most common complications after the primary cleft palate repair is velopharyngeal insufficiency, which leads to the subsequent surgery. The velopharyngeal function assessment characterizes speech development in children. Researches noted that velopharyngeal insufficiency causes in 5-86% after primary cleft palate repair. Therefore, it is essential to choose an adequate primary surgical method for each particular type of cleft palate. To compare velopharyngeal function using nasopharyngoscopy after primary CP repair Materials and methods: The patients who with congenital cleft palate and, underwent primary cleft palate repair in the Department of Maxillofacial surgery of the National Centre for Maternal and Child Health and had velopharyngeal function assessment were recruited to the study. Patients with wound dehiscence and oronasal fistula postoperatively were excluded from the study. Cleft palate was classified according to the Veau system and Golding-Kushner scale of nasopharyngoscopy was used to assess patient’s velopharyngeal function in order to associate with cleft types and the primary palatoplasty techniques. Pearson’s chi-squared analysis and Fisher exact test were used for statistical analysis. Results: A total of 335 patients were included in the study. The mean age at primary palate repair was 22.9±13.6 months. There were 56, 42, 177, and 60 patients with Veau-I type, Veau-II type, Veau-III type and Veau- IV type respectively, whereas for primary palatoplasty 65 patients underwent Furlow technique, 148 patients – Mongolian technique, 108 patients – Two flap technique, 34 patients – Von Langenbeck technique. Nasopharyngoscopy assessment of adequate velopharyngeal function was as followed as by “Furlow” technique in 89.4% cases, ”Mongolian” technique in 62.2% cases but by “Two flap” technique only in 48.1% and Von Langenbeck technique in 47.1% cases. Conclusions: The Furlow and Mongolian techniques were superior for maintaining velopharyngeal function after primary palatoplasty.