Preservation palatoplasty: anatomically sparing approach to cleft palate repair and its advantages

Objective. To implement the principles of minimally invasive surgery in palatoplasty for development of a novel technique. Material and methods. This study included 78 pediatric patients with congenital cleft lip and/or palate divided into two groups according to surgical technique: preservation palatoplasty (n=43) and Ivanov-Ageeva palatoplasty (n=35). Surgery time, intraoperative blood loss, early and late postoperative complications were evaluated. Results. Mean surgery time was significantly shorter in the preservation palatoplasty group (155.8±8.3 vs. 171.4±11.6 min, p<0.05). Postoperative recovery was also more favorable. Fluid intake on the day of surgery was higher (700±60.3 ml vs. 443±80.8 ml, p<0.001), while complications were less frequent, including tongue edema (1 case vs. 4 cases, p<0.05), respiratory disorders (1 case vs. 8 cases, p<0.01), and fistula (0 vs. 3 cases, p<0.05). Conclusion. Preservation palatoplasty allows for closure of various clefts while minimizing tissue trauma. Extension of palatal aponeurosis and periosteum of sphenoid medial plate reduce surgical invasiveness and shorten postoperative recovery.