The evaluation of the use of the buccal myomucosal flap in cleft palate repair—a comparative study

Habib, Medhat E.; Jackson, Ian T.; Thomas, C.

doi:10.1007/s00238-009-0363-2

Cited by 5 publications

(1 citation statement)

References 15 publications

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“…While the addition of myomucosal buccal flaps to palatal repair has previously been described, the characterization of the potential loss of domain in palatal length rescued by buccal flap reconstruction has not been previously reported. [43][44][45][46][47][48][49] We believe this study provides quantifiable, anatomic support for the implementation, in select patients, of this technique to lengthen the soft palate at the time of primary palatoplasty. A recent study on the use of buccal flaps during primary palatoplasty by Jagannathan et al reported that for Veau I clefts and narrower clefts, there was less palatal lengthening exhibited, 46 which further underscores the supporting evidence for performing a unilateral buccal flap only in the setting of a wide cleft, only for Veau II or greater clefts, as we found.…”

Section: Discussionmentioning

confidence: 99%

Anatomical Study of Domain Rescue of Palatal Length in Patients With a Wide Cleft Palate: Buccal Flap Reconstruction in Primary Palatoplasty

Morrison

Park

Rochlin

et al. 2022

The Cleft Palate Craniofacial Journal

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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.

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