Modified Palatoplasty Method (Busan Modification) for Incomplete Type Cleft Palate

Abstract

To achieve ultimate goals of cleft palate repair, levator muscle's appropriate reapproximation is viewed more importantly as of now, rather than simple palatal lengthening. Authors have developed modified version of 2-flap palatoplasty technique for incomplete type cleft palate and conducted follow-up study, including its early complications, speech evaluation, and facial growth measurement. Of the entire patients receiving a surgery from 2002 to 2012, the authors surveyed consecutive 100 cases of nonsyndromic incomplete cleft palate receiving our modified surgeries, and their early postoperative complication occurrence and the progress were monitored. Of them, the authors performed speech evaluation (n = 36) and facial growth measurement (n = 28) for the patients who the authors could follow-up until at least the age of 4.The medical record review has found no single, early postoperative complication requiring immediate treatment. A total of 10 cases showed delayed wound healing, but 7 of them recovered without a special problem and the other 3 showed residual fistula, recording 3% fistula formation rate. Of the 36 pronunciation evaluation cases, average score was 64.2, reaching almost to the full score of 66, but 1 case with the lowest point was found to need a corrective surgery for the clinical velopharyngeal dysfunction. Cephalometric measurement receiving 28 cases showed sella-nasion-A point angle (SNA) of 82.8° ± 3.4°, sella-nasion-B point angle (SNB) of 78.9° ± 3.9°, and a point-nasion-B point angle (ANB) of 3.9° ± 1.9°. In all range of the measurements, no significant statistical difference was found between normal population at that age and the sample group. The authors consecutively performed this modified method (Busan modification) for patients with incomplete cleft palate and consequentially found a lower rate of early postoperative complications. Moreover, relatively excellent long-term results including speech evaluation score and facial growth outcome were proved during 4 years of postoperative follow-up period.

Postoperative Speech Outcomes and Complications in Submucous Cleft Palate Patients

“…All operations were performed by a single surgeon. The most frequent type of surgery was the Busan modification [ 1 ] in both groups, followed by double opposing Z-plasty in the SMCP group and two-flap palatoplasty in the ICP group ( Table 2 ).…”

Incidence of Velopharyngeal Insufficiency after Primary Cleft Palate Repair: A 27-Year Assessment of One Surgeon's Experience

“…In most cases, repair was performed using the modified cleft palate repair method (Busan modification) for Veau classes I and II. 24 However, even in the case of Veau classes I and II, two flap repair was performed if the width of the cleft was wide or extended to the interior. For Veau classes III and IV, the surgeon performed two-flap repair, and a Vomer turnover flap was used to close the anterior nasal mucosa.…”

“…In most cases, repair was performed using the modified cleft palate repair method (Busan modification) for Veau classes I and II. 25 However, even in the case of Veau Class I and II, two flap repair was performed if the width of This article is protected by copyright. All rights reserved.…”

Incidence of fistula after primary cleft palate repair: a 25-year assessment of one surgeon’s experience

“…For submucous cleft palate, cleft repair was performed using Furlow double-opposing Z-plasty [ 4 ]. In most cases of Veau classes I and II, cleft palate repair was performed using the modified cleft palate repair method (Busan modification) [ 16 ]. Cases of Veau classes III and IV were repaired using two-flap repair, and the anterior nasal mucosa was closed using a vomer turnover flap.…”

“…The modified cleft palate repair method (Busan modification) [ 16 ] is a modified two-flap palatoplasty that omits an anterior V-shaped incision. It involves performing a halving incision along the cleft margin and a lateral relaxing incision on both sides along the alveolar margin ( Fig.…”