The outcome of the main surgical techniques of palatoplasty

Abstract

The management of a patient with cleft palate is complex. Patients with cleft palate should be managed by a multidisciplinary team.The team approach has decreased the number of operations needed to obtain better outcomes as the surgeon has gained knowledge from the other specialists involved in cleft care. Currently, there is no universal agreement on the suitable treatment strategy to follow. Normal speech is the main objective around which, the therapeutic plan should be constructed. The increased application of methods that incorporate reconstruction of the levator palatini muscle has produced much more predictable speech results. Jeopardizing facial growth should be minimalized, but not at the cost of speech impairment since the resultant facial distortion can be satisfactorily managed by surgery, while speech impairment can often be irreparable. It is important to recognize that a critical review of the literature still does not provide clear answers to the important questions regarding comparative outcome results for cleft palate repair, consequently there is no simple answer when thinking about the ideal technique of palate repair, because the research results are part of a big controversy between the centers. There is a necessity for well-controlled, prospective research to confirm the reliability of the claimed superior outcomes from different procedures. Cleft palate remains a significant and interesting challenge for current and future plastic surgeons.