Two-stage closure of cleft palate (progress report)

In order to achieve palatal closure with the least possible impediment to maxillary growth, the two-stage repair seems to be the best procedure in our hands. The technique and timing of closure of soft and hard palate are described. For soft palate closure a modification of Widmaier's (1959) technique is used. Of the 216 cases operated upon this manner, usually at the age of 18 months (total and partial clefts included), the great majority show a soft palate of sufficient length and good elevation, a definite improvement in comparison with the one-stage procedure used formerly. Hard palate closure is postponed until between 5 and 8 years, the timing of surgery is chosen individually on the assessments of speech and dento-maxillary development.