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Asociación Mexicana de Cirugía Bucal y Maxilofacial, Colegio Mexicano de Cirugía Bucal y Maxilofacial, A.C.

2026, Number 1

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Rev Mex Cir Bucal Maxilofac 2026; 22 (1)

Functional palatal closure in cleft palate: surgical and anatomical-functional determinants. Analysis of the available evidence

Castilla CH, Dolores GIA, Salgado CF

Language: Spanish
References: 31
Page: 12-20
PDF size: 520.46 Kb.


ABSTRACT

Introduction: cleft palate is a congenital malformation associated with speech, swallowing, and middle ear ventilation disorders. Despite advances in palatoplasty, velopharyngeal insufficiency remains one of the main functional sequelae. In this context, functional palatal closure has gained relevance as a surgical objective beyond anatomical repair. Objective: to analyze the available evidence on surgical and anatomical-functional determinants associated with functional palatal closure in pediatric patients with non-syndromic cleft palate, with emphasis on timing of palatoplasty, surgical technique, and its velopharyngeal and auditory implications. Material and methods: a structured narrative review was conducted in PubMed, Scopus, and ScienceDirect, including publications from 2000 to 2024 on surgical timing, palatoplasty technique, velopharyngeal function, and auditory outcomes in pediatric patients with non-syndromic cleft palate. Results: fifteen studies were analyzed. Palatoplasty performed before nine months of age was associated with a lower incidence of velopharyngeal insufficiency than surgery performed after the first year of life. Techniques involving active muscular reconstruction of the soft palate, particularly the Furlow technique, showed better functional outcomes than Bardach or von Langenbeck. Greater velar length was associated with improved velopharyngeal competence. Evidence regarding auditory outcomes was less consistent, although it suggests a possible benefit from adequate muscular reconstruction. Conclusions: functional palatal closure depends on the interaction between surgical timing, repair technique, and anatomical-functional restoration of the velar musculature.


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