Description of the 180° Rotational Mucosal Flap Technique in Patients With Incomplete Cleft Palate: A Study From...

Objectives This study aims to provide a detailed, reproducible description of a 180° rotational mucosal flap technique from the oral to the nasal layer for palatal reconstruction in patients with incomplete cleft palate and to report the early clinical outcomes associated with its use, including total operative time and the occurrence of secondary palatal fistulas during follow-up. Materials and methods A retrospective descriptive case series was conducted at a referral institution in Cali, Colombia, between January 2021 and August 2025. A total of 84 consecutive patients with incomplete cleft palate (Veau classifications I and II) who underwent primary palatorrhaphy using a 180° rotational mucosal flap were evaluated. The surgical approach incorporates a triangular oral mucosal flap with a 45° apex elevated, rotated 180°, and sutured into the nasal mucosal plane to provide a watertight reinforcement at the hard-soft palate junction. Clinical outcomes, operative time, and complications were analyzed through medical records over a 36-week follow-up period. Results The study cohort comprised 63 males (75%) and 21 females (25%). The mean total surgical duration was 60.0 minutes (standard deviation: 5.3 minutes). Ernst relaxation incisions were required in 55 patients (65.4%) to achieve a tension-free closure. During the 36-week follow-up period, complete cleft closure at the hard-soft palate junction was achieved in all cases, with no documented secondary palatal fistulas. Conclusions The 180° rotational mucosal flap technique was reproducible, achieving complete anatomical cleft closure in all patients, with no secondary palatal fistulas observed during the 36-week follow-up period.