Purpose statement: Fistula formation after cleft palate repair is still a significant problem especially in very wide clefts and in reoperated palates. Adjunctive procedures were devised to attempt to reduce the incidence of post-operative palate fistulas.

Methods and materials: The study reviews all consecutive cases of cleft palate repair by one surgeon in the last two years using an interposed acellular dermal matrix allograft between the nasal and oral mucosal layers. The matrix was placed from the incisive foramen area to beyond the junction of the hard and soft palates. Palate repairs were done with a modified push-back palatoplasty with intravelar veloplasty technique. The patients were evaluated post operatively and assessed for healing and complications.

Results and conclusions: Of the 20 patients who underwent the procedure, none had wound healing problems. No patient developed palatal fistulas.

The use of acellular dermal matrix allograft during cleft palate repair may reduce the incidence of fistula formation.