Clinical Outcomes after Cleft Palate Repair at a Major Referral Hospital in Addis Ababa, Ethiopia

Abstract

Background: The two most common complications after primary palatoplasty are oronasal fistula and velopharyngeal insufficiency (VPI). To the best of our knowledge, there have been no studies examining postpalatoplasty speech outcomes in Ethiopia. Methods: A hospital-based retrospective cross sectional study design was used. A total of 149 patient records were reviewed, and 103 patients fulfilled all the inclusion criteria. These 103 cleft lip and palate patients who had undergone cleft palate repair at Yekatit 12 Hospital Medical College and who had undergone long-term speech assessment with the speech therapy department from January 2019 to December 2021 were included in this study. The bivariate/multivariate logistic regression was used to compare between different groups of patients, with the level of significance set at a P value of less than 0.05. Results: Moderate and severe hypernasality was seen in 45.7% of patients. Age at time of palatal surgery has significant association with incidence of hypernasality (P = 0.01). The type of cleft, sex of the patient, and type of surgery had no significant association with incidence of hypernasality. Oronasal fistula was seen in 25% of patients, with Pittsburgh type VI being the most common (40%). Conclusions: There is a high rate of VPI and oronasal fistula in this cohort of patients who underwent palatoplasty at Yekatit 12 Hospital. One of the factors for higher complication rate was older age at time of surgery. Therefore, patient education and strengthening the cleft care with training are paramount to ensure better results.