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- Title
Anatomical Study of Domain Rescue of Palatal Length in Patients With a Wide Cleft Palate: Buccal Flap Reconstruction in Primary Palatoplasty.
- Authors
Morrison, Kerry A.; Park, Jenn; Rochlin, Danielle; Lico, Margaret; Flores, Roberto L.
- Abstract
Background: This study characterizes the potential loss of velar length in patients with a wide cleft and rescue of this loss of domain by local flap reconstruction, providing anatomic evidence in support of primary lengthening of the soft palate during palatoplasty. Methods: A retrospective review was conducted of all patients with a cleft palate at least 10mm in width, who underwent primary palatoplasty with a buccal flap prior to 18 months of age over a 2-year period. All patients underwent primary palatoplasty with horizontal transection of the nasal mucosa, which was performed after nasal mucosa repair, but prior to muscular reconstruction. The resulting palatal lengthening was measured and the mucosal defect was reconstructed with a buccal flap. Results: Of the 22 patients included, 3 (13.6%) had a history of Pierre Robin sequence, and 5 (22.7%) had an associated syndrome. No patients had a Veau I cleft, 7 (31.8%) had a Veau II, 12 (54.5%) had a Veau III, and 3 had (13.6%) a Veau IV cleft. All patients had a right buccal flap during primary palatoplasty. The mean cleft width at the posterior nasal spine was 10.6 ± 2.82mm, and mean lengthening of the velum after horizontal transection of the nasal mucosa closure was 10.5 ± 2.23mm. There were 2 (9.1%) fistulas, 1 (4.5%) wound dehiscence, 1 (4.5%) 30-day readmission, and no bleeding complications. Conclusions: Patients with a wide cleft palate have a potential loss of 1cm velar length. The buccal flap can rescue the loss of domain in palatal length, and potentially improve palatal excursion.
- Subjects
ORAL fistula; SURGICAL flaps; SOFT palate; CLEFT palate; PLASTIC surgery; RETROSPECTIVE studies; PATIENT readmissions; SURGICAL complications; SURGICAL wound dehiscence; TREATMENT effectiveness; NASAL mucosa; DESCRIPTIVE statistics; PIERRE Robin Syndrome; MIDDLE ear ventilation; ORAL mucosa; DISEASE risk factors
- Publication
Cleft Palate Craniofacial Journal, 2024, Vol 61, Issue 1, p103
- ISSN
1055-6656
- Publication type
Article
- DOI
10.1177/10556656221117930