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A Technique for Cleft Palate Repair

Sommerlad, Brian C. M.B., B.S., F.R.C.S.

Plastic & Reconstructive Surgery:
doi: 10.1097/01.PRS.0000085599.84458.D2
Original Articles
Abstract

The author has developed a technique of palate repair that combines minimal hard palate dissection with radical retropositioning of the velar musculature and tensor tenotomy. The repair is performed under the operating microscope. Results are reported for 442 primary palate repairs performed between 1978 and 1992 inclusive, with follow-up of at least 10 years. In 80 percent of these palate repairs, repair was carried out through incisions at the margins of the cleft and without any mucoperiosteal flap elevation or lateral incisions. Secondary velopharyngeal rates have decreased from 10.2 to 4.9 to 4.6 percent in successive 5-year periods within this 15-year period. Evidence from independent assessment of speech results in palate re-repair and submucous cleft palate repair suggests that this more radical muscle dissection improves velar function.

Author Information

London and Essex, United Kingdom

From the Great Ormond Street Hospital for Children and St. Andrew’s Centre for Plastic Surgery, Broomfield Hospital.

Received for publication August 21, 2002;

revised January 9, 2003.

Brian C. Sommerlad, M.B., B.S., F.R.C.S.

The Old Vicarage

17 Lodge Road

Writtle, Chelmsford

Essex, CM1 3HY

United Kingdom

brian@sommerlad.co.uk

©2003American Society of Plastic Surgeons