Flaps for cleft lip and palate surgery

The advantages of palate repair by double opposing Z-plasty include excellent access for complete mobilization of the palatal muscles, construction of an overlapping muscle sling, and avoidance of the growth-limiting horseshoe-type scars of the hard palate that result from lateral relaxing incisions or pushback procedures. The excellent speech that results seems to justify use of the procedure. An Abbé flap designed to mimic the normal philtrum placed over an interlacing orbicularis reconstruction that is well supported superiorly can salvage a thin, scarred upper lip and improve its mobility. The lateral gingival flap provides excellent esthetic reconstruction of the cleft alveolus, secure cover over an alveolar bone graft, and ease closure of an anterior oronasal fistula.