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Publication - Dr Andrew Wills

    Closer to the truth on national fistula prevalence after unilateral complete cleft lip and palate repair? The Cleft Care UK study

    Citation

    Yang, A, Richard, BM, Wills, A, Mahmoud, O, Sandy, J & Ness, AR, 2019, ‘Closer to the truth on national fistula prevalence after unilateral complete cleft lip and palate repair? The Cleft Care UK study’. Cleft Palate-Craniofacial Journal.

    Abstract

    Objectives:
    To 1) determine the prevalence of non-perialveolar palatal fistula up to age five following repair of unilateral cleft lip and palate (UCLP) in the United Kingdom (UK); 2) examine the association of palatoplasty techniques with fistula occurrence, and 3) describe the frequency of fistula repairs and their success.

    Design:
    Cross-sectional study

    Setting:
    All 11 centralized regional cleft centers in the UK.

    Participants:
    268 children born between 2005-2007 recruited by Cleft Care UK (CCUK), a nationwide cross-sectional study of all five-year-old children born with non-syndromic UCLP.

    Main outcome measure:
    Non-perialveolar palatal fistula prevalence up to age five.

    Results:
    Fistulas were found in 72 children (31.3%, 95% CI: 25.4 to 37.7%), and had no significant association with palate repair sequences. Twenty-four fistulas were repaired by age five, twelve of which had data showing 10 (83.3%) successful repairs.

    Conclusion:
    The prevalence of non-perialveolar fistulas following primary palatoplasty of UCLP in the UK was higher than previously reported. This information should be part of the preoperative discussion with families. Prospective collection of the presence of fistulas will be necessary before we can associate the occurrence of fistulas with a surgeon, institution, surgical technique or protocol of care.

    Full details in the University publications repository