2-Flap Palatoplasty for Troublesome Cleft Palate

Uhm, Ki Il; Kim, Soon Jin; Choi, Hyun Gon; Kim, Sun Hum; Shin, Dong Hyeok

Abstract

PURPOSE: If the primary palatoplasty fails, mobilization of the mucoperiosteal flap will become difficult because of mucoperiosteal scarring. Likewise, cleft palate with wide gap makes it difficult to secure a sufficient mobilization of the periosteal flap. Authors have achieved satisfactory results with the operation of troublesome cleft palate using two-flap palatoplasty with dissection of neurovascular bundle from the mucoperiosteal flap. MATERIAL & METHODS: From January to December of 2005, Authors treated 3 troublesome cleft palates with two-flap palatoplasty with dissection of neurovascular bundle from the mucoperiosteal flap. Authors dissected pedicle wide enough to check it from operation field to make mobilization of flap easier, so that any restriction on mobilization of flap or wide gap of cleft palate can be overcome. Among the three patients, two patients are boys and one patient is a girl. Incomplete cleft palate is one case, and complete cleft palates are two cases. Two patients ware treated with cleft palate in the past. But, there still remained the cleft with marginal scarring. One patient has cleft palate with wide gap.
RESULTS
All of the cleft palates were repaired with one- stage operation. There was no morbidity or complication reported such as flap necrosis, hemorrhage, palatal fistula and delayed wound healing.
CONCLUSION
The excellence of two flap palatoplasty has proved by numerous authors, and it has been widely used as a primary palatoplasty. The two flap palatoplasty by our method is useful for mobilization of the flap. Dissection of neurovascular bundle from the mucoperiosteal flap creates sufficient mobilization, reduces injury on soft tissue, and eliminates tension when the cleft is closed. Also, no other donor site was needed. As two flap palatoplasty boasts many more advantages than those mentioned above, authors applied it to troublesome cleft palate as an alternative to other complicate operation methods to acquire good and positive results.