Background: Wide cleft palate is a problem faced by
plastic surgeons. Many techniques have been described for
cleft palate repair, but not all of them can be used in cases of
wide cleft palate. The most common post-operative complication
is palatal fistula. Oronasal fistulae causes several
problems such as nasal food regurgitation, bad oral odor,
hypernasal speech. This study was performed to evaluate two
modifications of cleft palate repair techniques aiming to
decrease the rate of post-operative fistulae.
Patients and Methods: In this series of cleft palate patients,
we used the two flap palatoplasty technique combined with
an anterior triangular flap based anteriorly at the cleft margin
which is utilized as a turnover flap to decrease tension at the
anterior nasal mucosal layer especially in wide clefts. Moreover,
in wider clefts modifications such as greater palatine
osteotomy and mobilization of the flap pedicles were used to
provide more anterior and medial mobility of the flaps and
thus decreasing the tension at the suture line in the midline.
Results: The study included 20 patients. Healing of the
flap suture lines was uneventful. No complications were
recorded.
Conclusion: The two modifications of cleft palate repair
help to decrease tension during repair and thus decreasing the
incidence of palatal fistulae.