Prevalence, cause, and location of palatal fistula in operated complete unilateral cleft lip and palate: retrospective study.

Objective: To evaluate the prevalence of fistulas after palate repair and analyze their location and association with possible causal factors.

Design: Retrospective analysis of patient records and evaluation of preoperative initial photographs.

Setting: Tertiary craniofacial center.

Participants: Five hundred eighty-nine individuals with complete unilateral cleft lip and palate that underwent palate repair at the age of 12 to 36 months by the von Langenbeck technique, in a single stage, by the plastic surgery team of the hospital, from January 2003 to July 2007.

Interventions: The cleft width was visually classified by a single examiner as narrow, regular, or wide. The following regions of the palate were considered for the location: anterior, medium, transition (between hard and soft palate), and soft palate.

Main Outcome Measures: Descriptive statistics and analysis of association between the occurrence of fistula and the different parameters were evaluated.

Results: Palatal fistulas were observed in 27% of the sample, with a greater proportion at the anterior region (37.11%). The chi-square statistical test revealed statistically significant association (P ≤ .05) between the fistulas and initial cleft width (P = .0003), intraoperative problems (P = .0037), and postoperative problems (P = .00002).

Conclusions: The prevalence of palatal fistula was similar to mean values reported in the literature. Analysis of causal factors showed a positive association between palatal fistulas with wide and regular initial cleft width and intraoperative and postoperative problems. The anterior region presented the greatest occurrence of fistulas.