A method for lining the superiorly based pharyngeal flap

The development of a mucosal flap as a lining for a superiorly based pharyngeal flap has undergone many modifications. The technique described herein uses tissue from the nasal surface of the soft palate with its base at the uvula. Its ease of construction is based on the adaptive use of modern vascular instruments. Since 1979 a total of 32 pharyngeal flaps have been lined in this manner. The results, as determined by a trained speech pathologist and the use of the oral panendoscope, have been quite good. This method offers a number of advantages, including the ability to line the pharyngeal flap with a shortened soft palate or one that is difficult to mobilize due to scarring, no through-and-through incision into the soft palate, and no exposed raw surfaces that can contribute to recurrence of velopharyngeal incompetence.