Objectives: To evaluate the effect of Platelet rich plasma (PRP) applied during primary repair of complete cleft palate and comparing the results with those obtained without PRP application.
Design: A prospective randomized study.
Setting: All patients attending at pediatric surgery and otolaryngology departments, Al-Azhar University hospitals, Cairo, Egypt.
Patients: Forty patients divided into two equal groups. All patients underwent 2- flap technique palatoplasty. Group A; 20 patients had PRP injection (3-5ml injected in each layer) during palatoplasty, while group B; 20 patients without PRP application. All patients were followed up in the out-patient clinic for 13 (12-17) months.
Results: Forty patients presented with complete cleft palate, 25 males and 15 females, with a mean age of 18 months (12-24 months). All patients undergone 2-flap palatoplasty with no intra-operative complications. In group A, no cases of postoperative fistula (0%) after palatal surgery, while fistula occurred in 4 cases (20%) of patients in group B. The fistula occurrence in group A was lower than that in group B (p=0.08) with no statistically significant difference.
Conclusions: PRP application is feasible and effective technique. Fistula formation after primary palatoplasty is decreased with PRP application.
Cleft palate; Platelet Rich Plasma; palatoplasty; Palatal fistula
Cleft palate is the most common congenital anomaly in the oral and maxillofacial region. The incidence of cleft palate with or without cleft lip is 3.4-22.9 per 10,000 births . Cleft palate surgery is aiming to close the defect and to improve the velopharyngeal function . The development of complications depends on several factors as; extent of cleft, timing of repair, type of surgical repair and surgeon’s experience . Fistulas were reported to occur between 0 and 77.8% of patients after primary palatoplasty . The widespread use of PRP in the healing process of varied tissue types resides in the fact that platelets represent an easily accessible reservoir of critical GFs and other signaling molecules, including leukocyte-derived catabolic cytokines and fibrinogen, which may govern and regulate the tissue-healing process . The PRP was used in repairing defects caused by dental extraction or tumor resection as well as for alveoloplasty in dental and maxillofacial surgery . Accelerated healing, decreased risk of infection, less postoperative discomfort, and faster recovery were reported in all these applications. The aim of the present study was to evaluate the effect of PRP application in primary cleft palate repair using a new modified technique of PRP application and comparing results with another group of patients, using the same technique of surgery without application of PRP. The fistula has been selected because it is the most dangerous and most common complication following cleft palate repair.