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CC BY 4.0 · Arch Plast Surg 2024; 51(03): 284-289
DOI: 10.1055/a-2263-7857
Pediatric/Craniomaxillofacial/Head & Neck
Original Article

Incidence of Velopharyngeal Insufficiency after Primary Cleft Palate Repair: A 27-Year Assessment of One Surgeon's Experience

Chan Woo Jung 
1   Department of Plastic and Reconstructive Surgery, School of Medicine, Busan National University, Busan, Korea
,
Hyung Joon Seo 
1   Department of Plastic and Reconstructive Surgery, School of Medicine, Busan National University, Busan, Korea
2   Biomedical Research Institute, Busan National University Hospital, Busan, Korea
,
Ye Seul Choi 
3   Department of Rehabilitation Medicine, Busan National University Hospital, Busan, Korea
,
Yong Chan Bae 
1   Department of Plastic and Reconstructive Surgery, School of Medicine, Busan National University, Busan, Korea
2   Biomedical Research Institute, Busan National University Hospital, Busan, Korea
› Author Affiliations Funding This work was supported by a 2-year Research Grant from Pusan National University.
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Abstract

Background Velopharyngeal insufficiency (VPI) is a major complication of cleft palate repair. The purpose of this study was to evaluate the incidence and predictive factors of VPI after cleft palate repair based on 27 years of one surgeon's experience.

Methods Medical records were retrospectively reviewed for 652 patients who underwent cleft palate repair between 1995 and 2021. After exclusion of those with other syndromes or developmental disorders, the study included 374 patients with sufficient follow-up until the age of 4 years, when language evaluation was possible. VPI status was categorized through subjective and objective tests into normal, VPI, and borderline. We analyzed potential differences in VPI incidence by multiple factors. Factors with significance were analyzed to confirm the relationships between subvariables.

Results Of the 374 patients, 311 (83.2%) exhibited normal pronunciation, 51 (13.6%) had VPI, and 12 (3.2%) were borderline. Primary cleft palate repair performed after 18 months was associated with a higher incidence of VPI than repair conducted before 18 months (p = 0.005). The incidence of VPI was higher in cases of submucous cleft palate than in the other types based on the Veau classification (p = 0.011). However, in the multivariable analysis, only the submucous type showed statistically significant results (p = 0.026).

Conclusion A total of 374 people underwent primary cleft palate repair, and 13.6% of those with VPI required secondary therapy. The incidence of VPI was relatively high among patients with primary cleft palate repair after 18 months and patients with submucous cleft palate.

Keywords

cleft palate - velopharyngeal insufficiency - risk factor

Authors' Contributions

Y.C.B. was responsible for conceptualization. C.W.J. was responsible for writing—original draft. H.J.S. was responsible for writing—review and editing. Y.S.C. was responsible for resources.


Ethical Approval

The study was approved by the Institutional Review Board of Pusan National University Hospital (IRB No. H-2210-018-120).


Patient Consent

There are no images or data requiring patient consent.


Note

This work was presented at The 12th Research & Reconstruction Forum.




Publication History

Received: 10 February 2023

Accepted: 30 January 2024

Accepted Manuscript online:
07 February 2024

Article published online:
09 May 2024

© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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