Medical Journal of Indonesia Vol. 31 No. 4 2022 FKUI
Surgical Techniques to Reduce Oronasal Fistula Risk in Wide Cleft Palate Repair: A Systematic Review

Medical Journal of Indonesia Vol. 31 No. 4 2022 FKUI
Surgical Techniques to Reduce Oronasal Fistula Risk in Wide Cleft Palate Repair: A Systematic Review

cleft palate, fistula, surgery, technique

BACKGROUND Wide cleft palate is a common congenital anomaly, particularly in
developing countries with limited access to plastic surgeons and specialized cleft
centers. It can be severe and may contribute to the development of oronasal fistula,
which can occur in up to 78% of cases. Despite numerous surgical techniques for wide
cleft repair, the best method remains unclear. This study aimed to identify surgical
techniques for wide cleft palate repair to minimize the occurrence of oronasal fistula.
METHODS Literature searching was conducted using multiple online databases
including PubMed, Scopus, and Cochrane Library. The keywords used were “cleft
palate”, ” surgery”, “technique”, “palatoplasty”, and “wide”. Inclusion and exclusion
criteria were applied to select relevant studies, and the quality was assessed.
RESULTS A total of 12 studies discussed surgical techniques to repair the primary wide
cleft palate and their outcome on oronasal fistula formation. The surgical techniques
included modified Furlow palatoplasty, two-flap palatoplasty, and modified Bardach’s

two-flap palatoplasty. The incidence of oronasal fistula was 9.6% (n = 28/291) in one-
stage Furlow palatoplasty and 12.0% (n = 24/200) in the modified one-stage two-flap

palatoplasty.
CONCLUSIONS Two-flap palatoplasty and Furlow palatoplasty (and their modifications)
were the safe surgical techniques for wide cleft repair with a low occurrence of oronasal
fistula.

Prasetyanugraheni Kreshanti, Patricia Marcellina Sadikin, Margareth Ingrid Anggraeni, Jasmine Athiyya Wibowo, Kristaninta Bangun

https://doi.org/10.13181/mji.oa.236347

March 24, 2023

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