Background: The timing and technique for palatoplasty is very controversial, recent literature advocates for early repair, between six and eighteen months of age. It is using three kinds of techniques of palatoplasty mainly, two flap technique, Furlow double opposing z-plasty, and two-step palatoplasty. Oro-nasal fistula formation is an one of most documented postoperative complication, and it’s rate is reported between 6–42.3% in the literature. In Mongolia patients often present in older than recommended age for palatoplasty, it provides surgeons with the challenge of managing wider defects, which have higher rates of fistula formation and wound dehiscence. These complications forced us to modify palatoplasty techniques for improved outcomes.

Objective: The objective is to compare the efficacy of three established palatoplasty techniques with our new modified Mongolian technique.

Methods: A retrospective review of all palatoplasty cases, between January 1992 and November 2008, in Mongolia was performed. Exclusion criteria included those suffering from an acute or chronic respiratory illness at presentation or in the recovery period. We compared three established techniques with our modified technique. Outcome measures were duration of surgery, length of hospital stay and complication rate.

Results: Palatoplasty was performed on 436 patients. The modified palatoplasty technique had reduced surgical time ( p value < 0.01), hospital stay ( p value < 0.01), and a 96% complication free wound recovery.

Conclusions: Most of patients (87%) had palatoplasty older than the recommended age. We have shown the modified palatoplasty technique is a significantly more efficient surgical procedure and has a lower complication rate.

Conflict of interest: None declared.