Buccinator Myomucosal Flap for Wide Cleft Palate.

Nam, Seung Min; Tark, Min Seong; Kim, Cheol Hann; Park, Eun Soo; Kang, Sang Gue; Kim, Young Bae

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Original Article

Journal of the Korean Society of Plastic and Reconstructive Surgeons 2007;34(6):748-752.
Published online November 1, 2007.

Buccinator Myomucosal Flap for Wide Cleft Palate.

Seung Min Nam, Min Seong Tark, Cheol Hann Kim, Eun Soo Park, Sang Gue Kang, Young Bae Kim

Department of Plastic and Reconstructive Surgery, College of Medicine, Soonchunhyang University, Seoul, Korea. tarkms @hosp.sch.ac.kr

Abstract

PURPOSE
The goal of palatoplasty is focused on two points. One is to close the palatal defect completely, and the other to create a velopharyngeal system for normal speech. While established methods such as pushback palatoplasty or double opposing Z palatoplasty are used in wide cleft palate repair, sequelae such as maxillary hypoplasia or oronasal fistula may result. Therefore, when palatoplasty with buccinator myomucosal flap is used in the case of wide cleft palates, maxillary hypoplasia and oronasal fistula is reduced and optimal results are obtained. METHODS: From October 2005 to December 2006, four children with wide complete cleft palate underwent unilateral buccinator myomucosal flap and intravelar veloplaty. Mean age at cleft repair was 15 months, and mean cleft size was 2.15cm. The patients underwent intravelar veloplasty and palatoplasty was done using unilateral buccinator myomucosal flap.
RESULTS
The patients, after mean 10 months of follow- up observation, showed no signs of oronasal fistula resulting from flap tension. The shape and color similar to normal oral mucosa was obtained, and velopharyngeal function was acquired.
CONCLUSION
When intravelar veloplasty and palatoplasty with unilateral buccinator myomucosal flap is done on wide cleft palates, postoperative speech function is optimal, velopharyngeal incompetence is effectively corrected, and sequelae resulting from pushback palatoplasty and double opposing Z-plasty, such as maxillary hypoplasia and oronasal fistula, is reduced.

Keywords: Buccinator myomucosal flap; Cleft palate

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