Palatoplasty: Evolution and Controversies

Treatment of cleft palate has evolved over a long period oftime. Various techniques of cleft palate repair that are practicedtoday are the results of principles learned through many yearsof modifications. The challenge in the art of modern palatoplastyis no longer successful closure of the cleft palate but anoptimal speech outcome without compromising maxillofacialgrowth. Throughout these periods of evolution in the treatmentof cleft palate, the effectiveness of various treatment protocolshas been challenged by controversies concerning speech andmaxillofacial growth. This article reviews the history of cleftpalate surgery from its humble beginnings to modern-daypalatoplasty, and describes various palatoplasty techniques andcommonly used modifications. Current controversial issues onthe timing of cleft palate repair, and the effects on speech andmaxillofacial growth are also discussed.