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Bilateral Buccal Flaps with Double Opposing Z-Plasty for Wider Palatal Clefts

Mann, Robert J. M.D.; Fisher, David M. M.D.

Plastic and Reconstructive Surgery: October 1997 - Volume 100 - Issue 5 - p 1139–1143
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Described is a technique that has evolved from the challenges of closure of larger cleft palate defects and that we are now using in preference over other techniques to repair a wide variety of clefts. Soft-palate closure and muscular sling reconstruction are accomplished using a modified Furlow technique. An associated cleft of the hard palate and the gaps produced by posterior displacement of the reconstructed soft palate are closed by adding tissue, buccal flaps, rather than by closure under tension or leaving residual raw surfaces. Palate lengthening is achieved both by the Z-plasty effect and by the interposition of buccal flaps between the hard and soft palate. Seventy-six palates have been repaired using this procedure. There were three postoperative fistulas. (Plast. Reconstr. Surg. 100: 1139, 1997.)

Grand Rapids, Mich.

From the Michigan State University College of Human Medicine, Cleft Palate Clinics of Butterworth Hospital, Blodgett Memorial Medical Center, and The GRAMEC Plastic Surgery Residency. Received for publication May 8, 1996; revised October 4, 1996.

Portions of this paper have been presented at the following meetings: GRAMEC Research Day, April 20, 1993, Grand Rapids, Michigan; Midwest Plaslic Surgery Association, Chicago, Illinois, June 10, 1993; GRAMEC Research Day, April 10, 1996, Grand Rapids, Michigan; and Michigan Association of Plastic Surgeons, July 16, 1996, Mackinac Island, Michigan.

Dr. Robert J. Mann

Plastic Surgery and Craniofacial Service PC

Michigan Street Center—Suite 304

426 Michigan Avenue NE

Grand Rapids, Mich. 49503

©1997American Society of Plastic Surgeons