Surgical treatment of total cleft palate from the perspective of postoperative complications

Introduction. Cleft palates are the most common malformations among congenital malformations. According to existing classifications, the most common complications according to the bibliographic data are total palatal clefts. Due to the insufficiency of both bone and soft tissue in the anterior part of the hard palate, complications in the form of oronasal fistulas frequently occur in the postoperative period. Objective of the study. Optimization of surgical treatment to reduce complications of anterior oronasal fistula origin in total and total transfixing cleft palates. Methodology. 20 medical files of patients with oronasal fistulas were examined. Their number and causative factors of oronasal fistulas were found. Results. As a result of the analysis of the medical records of children with clefts of the face, we found that 40% of children present with cleft palates. Of the total clefts, 15% are total and transfixing palatal clefts. In all children, bone tissue insufficiency was found in the anterior part of the hard palate. These forms of cleft palate showed the highest complication rate of oronasal fistulas. Which represents the location of fistulas in the anterior region of the hard palate. In the primary treatment of cleft palate, a modification of the classical method was proposed, which consists in the creation of a bipediculated Langhenbeck flap. The method involves preserving the continuity of the Langhenbeck flap in the anterior part. The wide detachment of the mucoperiosteal layer is performed on the anterior part of the hard coat, in the areas with preserved bone tissue integrity. Results. The proposed method created favorable conditions for the prevention of anterior oronasal fistulas. All 20 children operated according to this method did not present oronasal fistulas. Conclusion. In conclusion, we can state that preserving the integrity of the Langhenbeck flap in the anterior part of the hard palate prevents the formation of oronasal fistulas.