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Limited Incision With Thorough Elevation Palatoplasty

Technical Evolution for Superior Results in Cleft Repair of the Secondary Palate

Baek, Rong-Min MD, PhD; Koo, Youn-Taek MD; Kim, Baek-kyu MD

doi: 10.1097/SAP.0b013e31829565d8
Head and Neck Surgery
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Background All kinds of palatoplasty emphasize elongating the soft palate and reconstructing the velar musculature without complication. We present the limited incision with thorough elevation (LITE) palatoplasty that leaves the anterior margin of the hard palate intact, achieving a fully movable bipedicled flap for complete closure and an adequate functioning velar muscular sling.

Methods Fifty-six patients consecutively underwent the LITE palatoplasty. The patients were diagnosed with varying degrees of cleft of the secondary palate. The length of the soft palate was measured, preoperatively and postoperatively, to quantify the lengthening effect of the surgical procedure. The LITE palatoplasty lengthens the soft palate by full mobilization of the velar musculature and reconstruction of the muscles. The LITE palatoplasty also completely repairs the hard palate and leaves no raw surfaces, which can be disadvantageous to the maxillary growth.

Results The average length of soft palate was 18.5 ± 3.1 mm preoperatively, and the increased length of the soft palate was 5.06 ± 2.41 mm (27.3 ± 17.4%). There were no complications including fistula formation, hematoma, or wound problems. After 2 years of operation, only 2 patients who had multiple congenital problems showed grade 1 hypernasality in speech assessment.

Conclusions The LITE palatoplasty gives satisfactory results in elongating the soft palate and reconstructing a functional velar sling without leaving any raw surfaces that can be detrimental to healing and facial growth. And there was a better speech outcome without complications.

From the Department of Plastic Surgery, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Gyeonggi, Korea.

Received December 12, 2012, and accepted for publication, after revision, March 27, 2013.

Conflicts of interest and sources of funding: This article is supported by grant 02-2012-063 from the SNUBH Research Fund.

Reprints: Baek-kyu Kim, MD, Department of Plastic and Reconstructive Surgery, Seoul National University Bundang Hospital, Seongnam, Gyeonggi, Korea. E-mail: plasrecon@gmail.com.

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