Flaps for cleft lip and palate surgery.

Area of Science:

• Plastic Surgery
• Craniofacial Surgery
• Pediatric Surgery

Background:

• Cleft palate repair presents challenges in achieving optimal speech and minimizing growth restriction.
• Previous techniques like pushback procedures can lead to scar contractures affecting hard palate growth.
• Reconstruction of associated lip and alveolar clefts requires specialized flap techniques for functional and aesthetic restoration.

Purpose of the Study:

• To evaluate the advantages of double opposing Z-plasty for palate repair.
• To assess the efficacy of an Abbé flap and lateral gingival flap in concurrent lip and alveolar reconstruction.
• To highlight the functional and aesthetic benefits of these combined surgical techniques.

Main Methods:

• Palate repair utilizing a double opposing Z-plasty technique.
• Reconstruction of the upper lip using an Abbé flap with interlacing orbicularis oris muscle.
• Repair of the alveolar cleft with a lateral gingival flap, incorporating alveolar bone grafting.

Main Results:

• Double opposing Z-plasty provides excellent muscle mobilization and avoids scar contractures, promoting normal palatal growth.
• The technique facilitates the creation of an overlapping muscle sling, contributing to improved speech outcomes.
• The Abbé flap successfully reconstructs the lip, enhancing mobility and aesthetics, while the gingival flap ensures secure alveolar graft coverage and fistula closure.

Conclusions:

• Double opposing Z-plasty is an advantageous technique for cleft palate repair, yielding excellent speech results and preserving palatal growth.
• Combined with Abbé and lateral gingival flaps, it offers comprehensive reconstruction for cleft lip, alveolus, and palate, improving both function and appearance.