Operating microscope use increased operative time in cleft palate repair for infants under two years

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Journal of cranio-maxillo-facial surgery : official publication of the European Association for Cranio-Maxillo-Facial Surgery Published May 1, 2026 Medically reviewed May 5, 2026 Study authors: Demiröz Anıl, Yalçın Can E, Aydın Servet Y, Ercan Alp, Karatan Berrak, Arslan Hakan, Aydın Yağmur PubMed ↗ DOI ↗ By Dr. Sofia Müller, MD · Lifespan & Whole-Person Care

Key Takeaway

Note that operating microscope use increased operative time but maintained similar complication rates in cleft palate repair.

This prospective, quasi-randomized controlled study included 40 patients under the age of two years with isolated nonsyndromic secondary incomplete cleft palate. The intervention involved operating microscope use, compared against surgical loupe use. The setting and publication type were not reported.

Operative time was significantly longer in the microscope group compared to the loupe group, with means of 76.75 ± 3.7 min versus 60.91 ± 1.05 min. Intraoperative visualization scores were significantly higher in the microscope group according to the surgical team, anesthesiologist, scrub nurse, and residents. The specific scores were not reported.

Complication rates were similar among groups. Safety data, including adverse events, serious adverse events, discontinuations, and tolerability, were not reported. Follow-up duration was not reported. Minor limitations were noted, and funding or conflicts were not reported.

The study suggests that advantages may justify routine use of the operating microscope in cleft palate repair. However, the quasi-randomized design and lack of reported p-values or confidence intervals prevent definitive causal conclusions.

Study Details

Study typeRct

Sample sizen = 40

EvidenceLevel 2

PublishedMay 2026

PMID41889042

View Original Abstract ↓

The use of an operating microscope in cleft palate repair offers improved visualization, enhanced illumination, and ergonomic advantages. However, its clinical adoption remains limited. This study compares surgical efficiency, intraoperative visualization, and complication rates between microscope and surgical loupe use. A prospective, quasi-randomized controlled study was conducted on 40 patients under the age of two years with isolated nonsyndromic secondary incomplete cleft palate. Patients were allocated to either surgical loupe magnification or operating microscope use in an alternating sequence, ensuring balanced distribution between groups. Operative time, intraoperative visualization scores from the surgical team, and postoperative complications were recorded. The mean operative time was significantly longer in the microscope group (76.75 ± 3.7 min) compared to the loupe group (60.91 ± 1.05 min), though this difference decreased over the study period. Visualization scores given by the anesthesiologist and scrub nurse were significantly higher in the microscope, while residents also rated the microscope group higher, though not statistically significant. Complication rates were similar among groups. The operating microscope Improves intraoperative visualization, enhances surgical ergonomics, and provides educational benefits. The initially increased operative time diminishes with experience, indicative of a learning curve. Despite minor limitations, its advantages may justify its routine use in cleft palate repair.