The Influence of Different Types of Hard Palate Closure in Two-stage Palatoplasty upon Palatal Growth: Dental Cast Analysis.

Abstract

Abstract.We investigated the influence of different types of hard palate closure in two-stage palatoplasty.In 12 cases the lip and soft palate were closed at the age of 3 to 7 months; these 12 were then divided into two groups. The hard palate was closed at the age of 1 year 5-11 months by the vomer flap with skin graft in the vomer flap (VF) Group (Osada's two-stage palatoplasty), and by push-back procedure of the mucoperiosteal flap in the push-back (PB) Group. Dental casts of the two groups were measured and compared at the ages of 0, 1, 3-4, and after 10 years. 1) In spite of apparent differences in palatal configurations at the age of 3-4 years, no significant differences in palatal size and area were noted between the groups. The cross-sectional areas in the VF Group were significantly larger than those in the PB Group in all the sections. 2) When the two groups were compared for rates of growth from 1 to 3-4 years, no significant differences in palatal size were noted, except in palatal width 1, although palatal growth from 1 to 3-4 years was more consistent and favorable in the VF Group. The rates of growth or change in palatal area and cross sectional-area 2 were significantly larger in the VF Group. 3) In spite of the apparent difference in palatal configuration, after age 10, no significant differences in palatal size, area, and depth were noted except in cross-sectional area 2. (Keio J Med 46 (1): 27-36, March 1997)

Cleft palate repair and variations

“…Bumsted's two-layer closure of palate in very wide cleft palate[30]Widmaier-Perko Palatoplasty[31]Supraperiosteal dissection of flap in the region of hard palate instead of mucoperiosteal flap[32] This dissection has been advocated so as to minimize the maxillary hypoplasia, however, the surgical dissection in the submucosal plane is bloody, difficult and time-consuming.Osada's two-stage palatoplasty[33]Frolova primary palatoplasty technique[34]Anterior mucoperiosteal hinge for nasal lining in partial cleft palate[35]Marginal musculo-mucosal flap[36]…”

Cleft palate repair and variations

“…To mention a few: • Bumsted's two-layer closure of palate in very wide cleft palate [30] • Widmaier-Perko Palatoplasty [31] • Supraperiosteal dissection of flap in the region of hard palate instead of mucoperiosteal flap [32] This dissection has been advocated so as to minimize the maxillary hypoplasia, however, the surgical dissection in the submucosal plane is bloody, difficult and timeconsuming. • Osada's two-stage palatoplasty [33] • Frolova primary palatoplasty technique [34] • Anterior mucoperiosteal hinge for nasal lining in partial cleft palate [35] • Marginal musculo-mucosal flap [36] These are some of the variations and procedures which are being performed by a specific surgeon or in a specific centre. The long-term benefits and wider acceptance are awaited.…”

Transverse Maxillary Development in Complete Cleft Patients: Comparison of 2 Treatment Strategies by Longitudinal and Cross-Sectional Model Analysis

“…The palatal surface of the minor segment remained completely covered by mucoperiosteum in the exposed and the unexposed bone group; thus, it is possible that this cover prevented a collapse of the minor segment (Fudalej et al, 2012). Earlier, Tanino et al (1997) suggested that the palatal periosteum and mucosa adjacent to the alveolar process and the greater palatine neurovascular bundles be preserved and that no raw surface should be left over the palate on both the oral and nasal aspects as this prevents maxillary constriction.…”