Secondary palatal repair by the island flap technique. A follow-up study

The island flap technique was applied to the secondary repair of 57 cleft patients with persisting open nasality and no velopharyngeal closure. A follow-up investigation showed that closure was achieved in about 50%, and the degree of nasality in spontaneous speech diminished in about 70% of the patients. The general quality of speech was postoperatively good in about 50%, but on the other hand fully normal only occasionally. The island flap secondary repair should probably be reserved for selected patients having a tight, short but mobile velum and relatively slight nasality. Failures of this method can still be improved by a traditional upwards based pharyngeal flap.