Transpalatal approach with pedicled palatal osteo-muco-periosteal flap

Area of Science:

• Oral and Maxillofacial Surgery
• Surgical Innovation
• Anatomy and Physiology

Background:

• Conventional transpalatal approach involves extensive mucoperiosteal elevation and bone removal, leading to complications.
• Reported complications include palatal fistula, scarring, disfiguration, and velopharyngeal incompetence.
• A new palatotomy technique is presented to mitigate these adverse outcomes.

Purpose of the Study:

• To describe and evaluate a novel palatotomy technique.
• To compare the incidence of post-operative complications with the conventional transpalatal approach.
• To assess the safety and efficacy of preserving palatal structures.

Main Methods:

• Retrospective review of 20 patients undergoing conventional transpalatal approach.
• Design of a new technique involving partial mucoperiosteal elevation and osteotomy from the oral side.
• Preservation of ipsilateral palatal mucoperiosteum by sectioning hard palate from the nasal side, creating a pedicled flap.

Main Results:

• All 20 patients (100%) using the conventional technique experienced post-operative complications.
• Eight patients treated with the new technique showed no post-operative complications after a 2-year follow-up.
• The new technique successfully preserved the palatal osteo-mucoperiosteal flap.

Conclusions:

• The palatal osteo-mucoperiosteal flap technique is an effective method for preserving palatal mucoperiosteum and bone.
• This approach facilitates quicker healing and minimizes functional impairment.
• The technique offers a safe and easy alternative to the conventional transpalatal approach.