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The square flap method for cleft palate repair
Jing-Hong Xu1, Hong Chen, Wei-Qiang Tan
1Department of Plastic Surgery, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China.
Insights
This study introduces the square flap method for cleft palate repair, achieving successful outcomes with good velopharyngeal closure and stable speech results. The technique offers tension-free closure and improved soft palate length.
Area of Science:
- Plastic Surgery
- Craniofacial Surgery
- Pediatric Surgery
Background:
- Cleft palate repair is crucial for speech and facial development.
- Existing techniques may have limitations in achieving optimal functional and aesthetic results.
- The square flap method is a novel approach to address these challenges.
Purpose of the Study:
- To introduce and evaluate the efficacy of the square flap method for cleft palate repair.
- To assess the functional outcomes, including velopharyngeal closure and speech.
- To determine the long-term stability of the surgical results.
Main Methods:
- Retrospective analysis of prospectively collected data from 37 patients (21 males, 16 females) with cleft palates.
- Application of the square flap method (one rhombic, four triangular flaps) to the von Langenbeck procedure.
- Postoperative evaluation included nasopharyngeal fiberscopy, radiography, and clinical speech assessment over 6 months to 2 years.
Main Results:
- All flaps demonstrated good viability and healed well without complications like dehiscence or fistula.
- Satisfactory velopharyngeal closure and clinical speech evaluations were achieved in all patients.
- The surgical effects remained stable during the follow-up period.
Conclusions:
- The square flap technique provides effective cleft palate repair with significant advantages.
- Key benefits include tension-free palatal closure, robust muscular reconstruction, and adequate soft palate lengthening.
- This method represents a valuable advancement in cleft palate surgery.
Objective:
To introduce a new surgical technique for repair of cleft palate using the square flap method.
Design And Setting:
A retrospective analysis of prospectively collected data.
Patients And Methods:
The procedure was performed from 1995 to 2004 in 21 males and 16 females with cleft palates of different types; the patients had a median age of 6.0 years and an average age of 9.4 years (range from 22 months to 23 years). In these patients, the square flap method, consisting of one rhombic flap and four triangular flaps, designed on the soft palate across the defect, was applied to the von Langenbeck procedure. After incisions, the flaps were rotated and advanced, and each flap was inserted into the opposite side and then sutured. The patients were followed from 6 months to 2 years, the velopharyngeal closure was examined by nasopharyngeal fiberscope and/ or x-ray radiography, and a clinical speech evaluation was performed.
Results:
In all cases, no problem of flap viability was encountered and all healed well. The postoperative results were satisfactory without any complications such as dehiscence, perforation, palatal fistula, or functional disturbance. The velopharyngeal closure and clinical speech evaluation were satisfactory, and the effects of the operation were stable.
Conclusions:
The technique presented has been effective, with the advantages of palatal closure without tension, good muscular reconstruction, and sufficient lengthening of the soft palate.
