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Repeat Buccal Flaps Successfully Reduce Hypernasality in a Patient with Cleft Palate.
Jackson Green1, Austin Lignieres1, Chioma G Obinero1
1Division of Plastic Surgery, Department of Surgery, McGovern Medical School at The University of Texas Health Science Center at Houston, Houston, TX, USA.
Summary
Buccal flaps can be successfully reused for secondary palatal lengthening to treat velopharyngeal insufficiency (VPI). This repeat surgery improved hypernasality and reduced posterior gaps in a patient with VPI.
Area of Science:
- Plastic and Reconstructive Surgery
- Speech-Language Pathology
Background:
- Surgical interventions for cleft palate (CP) repair can lead to velopharyngeal insufficiency (VPI).
- VPI can manifest as hypernasality and regurgitation, impacting speech clarity and quality of life.
Observation:
- A patient with a history of bilateral buccal flaps for primary CP repair presented with persistent hypernasality and VPI.
- Speech and imaging assessments confirmed the presence and severity of VPI.
Findings:
- The patient underwent a repeat bilateral buccal flap palatal lengthening procedure.
- Three months post-division of the pedicles, the patient showed significant improvement, with hypernasality reducing from moderate to mild.
- Imaging revealed a decreased posterior gap, indicating improved velopharyngeal function.
Implications:
- This case demonstrates the efficacy of reusing buccal flaps for secondary palatal lengthening in VPI management.
- Buccal flaps represent a viable option for revision surgery in patients with VPI after initial CP repair.
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