Successful primary closure of cleft palate is the only prophylaxis against postoperative fistula. Many factors are accused of causing fistula, but the most important factor is the repair under tension. We tried in this work to rotate one of the mucoperiosteal flaps backward (90–180°) to fill the midline gap at the point of maximum tension. The other flap is then transposed medially to fill the anterior gap of the cleft. This work was conducted in the Plastic Surgery Unit in Suez Canal University Hospital from March 2007 to March 2010. Forty-eight patients were operated on using with the modified technique. Fistula occurred in one patient (2.1% of patients). With the simplicity of this procedure and its success rates we recommend this method as an alternative to the standard von Langenbeck cleft palate repair especially with wide cleft palate or when there is much tension when suturing the oral mucosa.
European Journal of Plastic Surgery – Springer Journals
Published: Aug 1, 2011
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