Two-flap palatoplasty: description of the surgical technique and reporting of results at a single center

Ear Nose Throat J. 2012 Mar;91(3):E33-7. doi: 10.1177/014556131209100320.

Abstract

Two-flap palatoplasty is commonly used to treat cleft palate defects, but only a few reports on outcomes have been published in the literature. We conducted a retrospective analysis of 257 cases of cleft palate treated with two-flap palatoplasty at a single center in Greece over a 13-year period. Our outcomes data included surgical complication rates, the results of speech assessments, midface development, and other parameters. We found a low rate of short- and long-term complications that required revision surgery, such as symptomatic fistula (5.4%) and velopharyngeal insufficiency (5.3%). Speech outcomes in relation to intelligibility, hypernasality, and nasal emissions were satisfactory in 70 to 86% of patients. Dental arch relationships, as estimated by the 5-Year-Olds Index, were judged to be either good or excellent in 62% of those evaluated. A considerable proportion of patients (45%) who had otitis media with effusion experienced a spontaneous resolution without the use of tympanostomy tubes 2 to 8 months after their operation. We conclude that two-flap palatoplasty is an effective procedure that warrants further attention. We describe the surgical technique in detail. Our technique includes a modified intravelar veloplasty that incorporates near-total muscle retropositioning.

MeSH terms

  • Adolescent
  • Child
  • Child, Preschool
  • Cleft Palate / surgery*
  • Humans
  • Orthognathic Surgical Procedures / methods*
  • Surgical Flaps*
  • Treatment Outcome