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Cleft Lip, Cleft Palate, and Velopharyngeal Insufficiency

Fisher, David M. F.R.C.S.(C.), F.A.C.S.; Sommerlad, Brian C. F.R.C.S., F.R.C.S.Ed.(Hon.)

Plastic and Reconstructive Surgery: October 2011 - Volume 128 - Issue 4 - p 342e–360e
doi: 10.1097/PRS.0b013e3182268e1b
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Learning Objectives: After reading this article, the participant should be able to: 1. Recognize the clinical features associated with unilateral cleft lip, bilateral cleft lip, the cleft lip nasal deformity, cleft palate, and velopharyngeal insufficiency. 2. Describe the most frequently used techniques for repair of cleft lip and palate. 3. Diagnose and treat velopharyngeal insufficiency.

Summary: This article provides an introduction to the anatomical and clinical features of the primary deformities associated with unilateral cleft lip–cleft palate, bilateral cleft lip–cleft palate, and cleft palate. The diagnosis and management of secondary velopharyngeal insufficiency are discussed. The accompanying videos demonstrate the features of the cleft lip nasal deformities and reliable surgical techniques for unilateral cleft lip repair, bilateral cleft lip repair, and radical intravelar veloplasty.


Toronto, Ontario, Canada; and London, United Kingdom

From the Cleft Lip and Palate Program, The Hospital for Sick Children, University of Toronto.

Received for publication December 23, 2010; accepted February 8, 2011.

Disclosure:The authors have no financial interest to declare in relation to the content of this article.

Related Video content is available for this article. The videos can be found under the “Related Videos” section of the full-text article, or, for Ovid users, using the URL citations printed in the article.

David M. Fisher, M.D.; Cleft Lip and Palate Program, The Hospital for Sick Children, University of Toronto, 5424-555 University Avenue, Toronto, Ontario M5G 1X8, Canada,

©2011American Society of Plastic Surgeons