Exploring the Relationship Between Palatal Cleft Type and Width With the Use of Relieving Incisions in Primary Repair
- Resource Type
- Authors
- Shaheel Chummun; Ali R M Cobb; Amy Davies; Scott Deacon; Alex J Davies; Yvonne Wren
- Source
- Davies, A, Davies, A, Wren, Y, Deacon, S, Cobb, A R M & Chummun, S 2022, ' Exploring the Relationship Between Palatal Cleft Type and Width With the Use of Relieving Incisions in Primary Repair ', Cleft Palate-Craniofacial Journal, vol. 59, no. 5, pp. 659-668 . https://doi.org/10.1177/10556656211019616
- Subject
- Velopharyngeal Insufficiency
medicine.medical_treatment
Reconstructive Surgical Procedures/methods
Dentistry
Cohort Studies
03 medical and health sciences
Primary repair
0302 clinical medicine
Postoperative Complications
medicine
Humans
Oral mucosa
030223 otorhinolaryngology
Retrospective Studies
Velopharyngeal Insufficiency/surgery
business.industry
Infant
030206 dentistry
Plastic Surgery Procedures
Cleft Palate/surgery
Cleft Palate
medicine.anatomical_structure
Palatoplasty
Treatment Outcome
Otorhinolaryngology
Postoperative Complications/surgery
Cleft palate repair
Oral Surgery
business
- Language
- ISSN
- 1545-1569
Objective: The mainstay of palatal repair in the United Kingdom is the intravelar veloplasty (IVVP). It is not always possible to align the oral mucosa in the midline to achieve tension-free repair. The addition of lateral relieving incisions may aid transposition of the oral mucosa to allow closure. The aim of this study was to explore cleft features that may predispose to a requirement for relieving incisions in order to allow palate closure. Design: We performed a national multiinstitutional retrospective study using data from the UK Cleft Collective cohort study. Patients: The study sample consisted of 474 patients who had undergone IVVP at the time of palatal closure across all 16 of the UK cleft units. Results: We found strong evidence for the requirement for relieving incisions in patients with an increased degree of clefting per the Veau classification ( P < .001), increasing palatal soft-edge width ( P < .001) and moderate evidence of an associated use in patients with Pierre Robin sequence ( P = .015). Insufficient data were available to explore the relationship between intertuberosity distance and the presence of fistula formation with the use of relieving incisions. Conclusions: The results of this study identify cleft features that increase the likelihood for requiring lateral relieving incisions to allow palatal closure. The degree to which the addition of relieving incisions to IVVP affects maxillary growth and speech outcomes is unknown. Further study is required to answer this important question.