{Reference Type}: Journal Article
{Title}: Review of Current Techniques of Cleft Palate Repair Concerning Palatal Innervation: A Preliminary Assumption.
{Author}: Askar SM;Labib Alnakib N;Quriba AS;Sweed AH;El Shora M;
{Journal}: Cleft Palate Craniofac J
{Volume}: 0
{Issue}: 0
{Year}: 2024 Jul 21
{Factor}: 1.915
{DOI}: 10.1177/10556656241264644
{Abstract}: OBJECTIVE: To highlight the possible surgical steps that could affect the neural supply of soft palate and velopharyngeal sphincter during Furlow palatoplasty and posteriorly-based myo-mucosal buccal flaps in patients with persistent velopharyngeal insufficiency after primary cleft palate repair.
METHODS: Institution-based retrospective study.
METHODS: Academic Medical Center.
METHODS: Non-syndromic patients with persistent hypernasality (after primary cleft palate repair) who had Furlow palatoplasty or posteriorly-based buccal myo-mucosal flaps and were followed up for at least 60 months after the secondary surgery.
METHODS: All patients were examined using a fiberoptic endoscopy, the movement of components of the velopharyngeal sphincter: soft palate, and lateral pharyngeal walls were traced on the monitor and given a score from 0-4. The pattern of VPS closure was reported whether coronal, circular, or sagittal for each case.
METHODS: Patients' characteristics, auditory perceptual assessment, the severity of hypernasality, intraoperative lengthening of the palate, and operative complications were recorded.
RESULTS: At postoperative (at least 60 months) evaluation of the patients statistically non-significant differences were reported when comparing the pre-versus post-operative auditory perceptual assessment following both procedures (P value ≥0.05). A greater tendency towards improvement was noticed with BF but was non-significant.
CONCLUSIONS: The nerve supply of the palate could be jeopardized by many techniques of primary or secondary repair of the cleft palate leaving behind a deceiving intact but weak poor-functioning palate. All efforts should be made to provide more neural-preservation techniques in primary/secondary repair of the cleft palate. Further wide-scale research is essential to have final clear conclusions.