A single surgeon's experience with the Delaire palatoplasty

The purpose of this review was to evaluate the clinical outcomes regarding velopharyngeal insufficiency and fistulization in patients with cleft palat e who underwent primary repair with the one-stage Delaire palatoplasty. All patients who had a primary Delaire-type palatoplasty performed by the seni or surgeon over a 10-year period (1988 to 1998) were studied. During this p eriod, each consecutive patient with an open palatal cleft underwent the sa me type of repair by the same surgeon. Speech quality and velopharyngeal co mpetence as determined by a single speech pathologist were recorded. A tota l of 95 patients were included in this series. The average length of follow -up was 31 months (range, 1 to 118 months). Average age at time of surgery was 13.3 months (range, 6 to 180 months). Thirty-one patients (32.6 percent ) had significant associated anomalies. The average length of hospital stay was 1.9 days (range, 1 to 8 days) with a trend in recent) ears toward disc harge on postoperative day 1. There were no intraoperative complications, e ither surgical or anesthetic. Three patients (3.2 percent) developed palata l fistula; none of them required repair. Sis patients (6.3 per cent) had ve lopharyngeal incompetence. In patients with more than 1 year of follow-up, the incidence of velopharyngeal incompetence was 9.2 percent (6 of 65). The incidence of fistula after the Delaire palatoplasty was lower than usually reported. The incidence of velopharyngeal incompetence requiring pharyngop lasty was equal to or lower than that seen after other types of palatoplast y, suggesting superior soft-palate muscle function attributable to approxim ation of the musculus uvulae. The Delaire palatoplasty results in a functio nal palate with low risk for fistula formation and velopharyngeal incompete nce.