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Use of Rotation Flap in Repair of Cleft Palate and Velopharyngeal Insufficiency

Isik, Daghan MD*; Durucu, Cengiz MD†; Isik, Yasemin MD‡; Atik, Bekir MD*; Kocak, Omer Faruk MD*; Karatas, Erkan MD§; Bekerecioglu, Mehmet MD∥

Journal of Craniofacial Surgery: July 2011 - Volume 22 - Issue 4 - pp 1203-1209
doi: 10.1097/SCS.0b013e31821c0d2e
Original Articles

Although cleft palate anomaly is frequent, the criterion standards in surgical treatment have not been determined yet. There are a few techniques described for cleft palate repair owing to the limited tissue in the palatal mucosa, the rigid structure of the palatal mucosa, and the limited vascularity of the hard palate. In this study, a novel cleft palate repair technique based on separating the soft palate from the hard palate as a musculomucosal flap and using it as a rotation flap has been described. The operation is evaluated individually for each anomaly because variations occur in the surgical technique according to the extension of the cleft toward the teeth in the palate. This operation was performed on a total of 28 patients (17 girls and 11 boys) aged between 1.5 and 16 years and presented to our clinic. Patients were assessed for speech analysis outcomes, tympanogram values, hearing functions, magnitude of palatal lengthening during the operation, and rate of fistulae. Statistically significant differences in values of the speech analysis and the audiometric assessment were determined between before and 6 months after surgery. Complete recovery of otitis was observed 1 month after surgery without another treatment in 9 (42.8%) of 21 patients who were detected to have serous otitis media preoperatively. Tension-free closure, lower risk of fistula, good restoration of velopharyngeal functions, ability to be performed on all types of cleft palate, ability to provide a good intraoperative exposure, and being a single stage seem to be the most important advantages of this technique.

From the *Department of Plastic and Reconstructive Surgery, Medicine School of Yuzuncu Yil University, Van; †Department of ENT, Medicine School of Gaziantep University, Gaziantep; ‡Department of Anesthesiology, Medicine School of Yuzuncu Yil University, Van; §Department of ENT, Private Malatya Park Hospital, Malatya; and ∥Department of Plastic and Reconstructive Surgery, Medicine School of Gaziantep University, Gaziantep, Turkey.

Received August 25, 2010.

Accepted for publication September 14, 2010.

Address correspondence and reprint requests to Daghan Isik, MD, Tip Fakultesi, Plastik Cer. A.D. Maras Cad. Yuzuncu Yil University, 65100, Van, Turkey; E-mail: daghanmd@yahoo.co.uk

The authors report no conflicts of interest.

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© 2011 Mutaz B. Habal, MD