Use of Autologous Platelet-Rich Plasma in Complete Cleft Palate Repair

Objectives/Hypothesis: Evaluate the effect of topical application of autologous platelet-rich plasma ( PRP) in primary repair of complete cleft palate and then compare the result with another group of patients using the same surgical technique, without application of PRP with regard to the incidence of oronasal fistula, velopharyngeal closure, and grade of nasality. Study Design: Case control study. Methods: This study was carried on 44 children with complete cleft palate with age range from 12 to 23 months. The children were divided into two age-and gender-matched groups: All children were subjected to the same technique of V-Y pushback repair of the complete cleft palate. In group A ( 22 children), the PRP prepared from the patient was topically applied between the nasal and oral mucosa layer during palatoplasty, whereas in group B ( 22 children) the PRP was not applied. Results: All cases were recovered smoothly without problems. In group A, no oronasal fistula was reported, whereas in group B three patients ( 13.6%) had postoperative fistulae and two patients ( 9.1%) needed revision palatoplasty. At 6 months postoperative assessment, group A ( with PRP application) showed significantly better grade of nasality ( P = 0.024) and better endoscopic velopharyngeal closure ( P = 0.016) than group B. Conclusion: Usage of autologous PRP in complete cleft palate repair is simple; effective; can decrease the incidence of oronasal fistula; and also significantly improves the grade of nasality and velopharyngeal closure, which decreases the need of further surgical intervention in cleft palate patients.