J Korean Assoc Oral Maxillofac Surg.  2021 Feb;47(1):47-50. 10.5125/jkaoms.2021.47.1.47.

Primary repair of untreated cleft palate in an elderly patient: a case report

• Lee JS
• Lee JY
• Kim YD
• Song JM
• Choi WH

• KMID: 2513429
• DOI: http://doi.org/10.5125/jkaoms.2021.47.1.47

Abstract

Untreated adult or elderly cleft lip and palate patients are rarely seen, but studies on delayed primary palatal closure have been performed in the less developed Asian and African countries, where access to medical care is difficult. A 64-year-old woman visited our clinic with untreated cleft palate with a 40×20-mm-wide defect in the medial palate. Two-flap palatoplasty under general anesthesia was performed to close the cleft palate. After 1 month, the result was favorable without any complications including oronasal fistula. Cleft palate primary repair in an elderly patient is rare and has some surgical problems that are associated with a wide range of defects, but good results can be obtained if surgery is performed well with appropriate considerations.

Keyword

Cleft palate; Aged; Surgical procedure

Figure

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  Fig. 1 Clinical features. Cleft nasal deformity due to sequelae of the cleft lip and palate. A, B. Intraoral features. C, D. Extraoral features. A 40×20-mm-wide defect in the medial palate caused velopharyngeal insufficiency during speech; cleft palate speech, including hypernasality, was observed. Interestingly, the patient previously underwent augmentation rhinoplasty by a local plastic surgeon to improve the appearance of her nose.

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  Fig. 2 Intraoperative features. A. Nasal side closure. B. Palatal side closure. An additional back-cut incision on the posterior region of the flap facilitates primary closure.

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  Fig. 3 Postoperative clinical features. A. Intraoral features one month later. B. Intraoral features one year later. C, D. Nasal features after cleft nose deformity correction with auricular cartilage one year postoperative. After one month, the result was favorable without any complications, including oronasal fistula. Three months after palatoplasty, nasal deformity correction with auricular cartilage graft was performed. The patient has been under observation since then and is currently undergoing prosthetic treatment.

Reference

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