Assessment of velopharyngeal insufficiency and oronasal fistula after primary surgery of cleft palate

Background: Cleft palates are the most common congenital craniofacial anomalies in children, and their treatment is challenging in terms of outcomes. The objective of the study was to determine the incidence of velopharyngeal insufficiency (VPI), and of the oronasal fistula after a veloplasty. Methods: By a retrospective study, over a period of 2 years, going from January 2017 to December 2018, carried out in the department of ENT and head and neck surgery of the August 20 hospital in Casablanca, Morocco. The inclusion criteria were all patients operated on for a cleft palate. The main results were the incidence of VPI, and of the oronasal fistula after a primary repair of the palate. Results: Out of a total of 21 cases, the average age was 4 years, and the sex ratio was 0.61, the average postoperative follow-up duration was 1 year and 9 months. VPI was found in 13 patients (62%), it was mild in 3 patients (14%), moderate in 6 patients (28%), and severe in 4 patients (19%), the frequency of VPI increased significantly with increasing age (p=0.05). The oronasal fistula was found in 5 (23.8%) patients, this fistula was more frequent when the patient benefited from the operation at an early age. Conclusions: Age is the most important factor in the management of cleft palates.