No abstract

A small but significant percentage of patients have inadequate velopharyngeal closure, or secondary velopharyngeal incompetence, following primary palatoplasty. The use of the buccinator musculomucosal (MM) flap has been described for both primary palate repair with lengthening and secondary palate lengthening for the correction of insufficient velopharyngeal closure. The MM flap was first described in 1969 for the primary repair of a wide cleft palate by Mukherji, and it was Bozola et al in 1989 who first formally described it and gave first description of its anatomy. The first report on its use to lengthen the palate in secondary velopharyngeal insufficiency (VPI) was published by Hill et al in 1999. This case report presents a patient who had correction of secondary velopharyngeal incompetence using bilateral buccinator MM flaps used as a sandwich and also gives a brief review of the literature regarding its application in cases of secondary VPI.