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Correction of incomplete cleft palate by u-shaped flap palatoplasty.
Afr J Paediatr Surg. 2010 Sep-Dec; 7(3):185-7.AJ

Abstract

OBJECTIVES

During cleft palate repair, velopharyngeal sphincter reconstruction is still a challenge to plastic surgeons. To improve results of surgical treatment of cleft palate and secondary velopharyngeal incompetence, a carefully designed modified procedure for palatoplasty is presented.

MATERIALS AND METHODS

Thirty patients with incomplete cleft palate corrected by this procedure from April 2003 to October 2007 were included. A u-shaped incision was made in the anterior palate to separate bipedicle flap based on the greater palatine arteries of both sides. After complete dissection of the nasal and palatal mucosa, palatal muscles were carefully dissected from the posterior edge of the bones of the hard palate, wherein the well-mobilised flap receded backward spontaneously and elongated the soft palate. After suturing the nasal mucosa in the midline, the dissected palatal muscles of both sides were sutured together in the anterior third of the soft palate. On suturing the nasal mucosa and the palatal muscles, the soft palate became elongated and the oral mucosa was seen receding backward spontaneously to cover the anterior part of the soft palate.

RESULTS

All corrected patients showed good results, with no recurrence, no post-operative fistulae, with accepted speech pattern and no need for further pharyngoplasty. The line of the sutured nasal mucosa and the palatal muscles became covered by the healthy non-sutured oral mucosa and the soft palate became elongated, with narrowing of the vellopharyngeal isthmus after this technique.

CONCLUSION

The designed flap allows covering of sutured nasal mucosa and palatal muscles with a healthy unsutured oral mucosa and elongates the soft palate. Thus, there was no incidence of post-operative fistula and no need for further pharyngoplasties.

Authors+Show Affiliations

Assistant Professor of Pediatric Surgery, Faculty of Medicine, Zagazig University, Egypt. aminsaleh65@yahoo.co.uk

Pub Type(s)

Journal Article

Language

eng

PubMed ID

20859027

Citation

Saleh, Amin. "Correction of Incomplete Cleft Palate By U-shaped Flap Palatoplasty." African Journal of Paediatric Surgery : AJPS, vol. 7, no. 3, 2010, pp. 185-7.
Saleh A. Correction of incomplete cleft palate by u-shaped flap palatoplasty. Afr J Paediatr Surg. 2010;7(3):185-7.
Saleh, A. (2010). Correction of incomplete cleft palate by u-shaped flap palatoplasty. African Journal of Paediatric Surgery : AJPS, 7(3), 185-7. https://doi.org/10.4103/0189-6725.70423
Saleh A. Correction of Incomplete Cleft Palate By U-shaped Flap Palatoplasty. Afr J Paediatr Surg. 2010 Sep-Dec;7(3):185-7. PubMed PMID: 20859027.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Correction of incomplete cleft palate by u-shaped flap palatoplasty. A1 - Saleh,Amin, PY - 2010/9/23/entrez PY - 2010/9/23/pubmed PY - 2010/10/27/medline SP - 185 EP - 7 JF - African journal of paediatric surgery : AJPS JO - Afr J Paediatr Surg VL - 7 IS - 3 N2 - OBJECTIVES: During cleft palate repair, velopharyngeal sphincter reconstruction is still a challenge to plastic surgeons. To improve results of surgical treatment of cleft palate and secondary velopharyngeal incompetence, a carefully designed modified procedure for palatoplasty is presented. MATERIALS AND METHODS: Thirty patients with incomplete cleft palate corrected by this procedure from April 2003 to October 2007 were included. A u-shaped incision was made in the anterior palate to separate bipedicle flap based on the greater palatine arteries of both sides. After complete dissection of the nasal and palatal mucosa, palatal muscles were carefully dissected from the posterior edge of the bones of the hard palate, wherein the well-mobilised flap receded backward spontaneously and elongated the soft palate. After suturing the nasal mucosa in the midline, the dissected palatal muscles of both sides were sutured together in the anterior third of the soft palate. On suturing the nasal mucosa and the palatal muscles, the soft palate became elongated and the oral mucosa was seen receding backward spontaneously to cover the anterior part of the soft palate. RESULTS: All corrected patients showed good results, with no recurrence, no post-operative fistulae, with accepted speech pattern and no need for further pharyngoplasty. The line of the sutured nasal mucosa and the palatal muscles became covered by the healthy non-sutured oral mucosa and the soft palate became elongated, with narrowing of the vellopharyngeal isthmus after this technique. CONCLUSION: The designed flap allows covering of sutured nasal mucosa and palatal muscles with a healthy unsutured oral mucosa and elongates the soft palate. Thus, there was no incidence of post-operative fistula and no need for further pharyngoplasties. SN - 0974-5998 UR - https://www.unboundmedicine.com/medline/citation/20859027/Correction_of_incomplete_cleft_palate_by_u_shaped_flap_palatoplasty_ L2 - http://www.afrjpaedsurg.org/article.asp?issn=0189-6725;year=2010;volume=7;issue=3;spage=185;epage=187;aulast=Saleh DB - PRIME DP - Unbound Medicine ER -