How Much Does the Soft Palate Lengthen Using Primary Two-Flap Palatoplasty with a Buccinator Musculomucosal Flap?

ObjectiveWe have reported on the usefulness of lengthening the nasal mucosa in primary two-flap palatoplasty by inserting a unilateral, nasal-side only buccal musculomucosal flap (BMMF) into the nasal mucosa of the soft palate, which improved postoperative outcomes compared with Bardach's two-flap palatoplasty. This study aimed to determine the precise amount of soft palate lengthening with the BMMF procedure.DesignRetrospective cohort study.SettingTertiary, cleft team.PatientsNon-syndromic patients receiving primary cleft palate repair with the BMMF method at Nagano Children's Hospital with the BMMF method. Patients with any syndrome were excluded.InterventionsPalatoplasty between April 2018 and March 2023.Main Outcome MeasuresWe assessed the amount of soft palate lengthening, the change in distance between the soft palate and the posterior pharyngeal wall, the mucosal defect width created by transection of the nasal mucosa, and BMMF width.ResultsFifty-two patients were analyzed. Postoperative soft palate length was significantly longer than preoperative length by a mean of 8.2 ± 3.2 mm (p < 0.05). Accordingly, the postoperative distance between the soft palate and the posterior pharyngeal wall was significantly shorter than preoperatively by a mean of 5.4 ± 2.7 mm (p < 0.05). The ratio of soft palate lengthening was 57 ± 31%.ConclusionThe BMMF method effectively enabled soft palate elongation of 8.2 ± 3.2 mm. The amount of soft palate lengthening with our method was greater than that of the two-flap palatoplasty method reported elsewhere.