A New Application of the Vomerine Flap for Repair of Unilateral Complete Cleft Hard and Soft Palate: A Proposed Single Stage Technique

Abstract

Background:The study proposes double layer vomer flaps technique for closure of unilateral complete cleft palate and shows the preliminary outcome of that technique after one year.Patients and Methods: Twenty patients with nonsyndromic unilateral complete cleft lip and palate, aged 9-15 months were operated randomly in this study. They were submitted for double layer vomer flaps technique for closure of unilateral complete cleft palate. Follow-up continued for one-year post-operative for each patient. Healing and functional outcomes are assessed objectively and subjectively. Approval of Institutional ethical Committee has been obtained.Results: All patients showed sound healing and functional outcome repair after single stage interference. Only one patient revealed partial uvular disruption. Otherwise, no reported cases revealed complete disruption, marked scarring or fistula either in hard or soft palate.Conclusions: This study proposes a technique for the unilateral complete cleft palate repair in a single stage by using double layer vomer flaps with closure without tension. This technique has a less invasive approach and minimizes the dissection of palatal mucoperiosteal flaps, and no lateral hard palatal incision and subsequently no denuded bones and less blood loss. The technique could have a positive outcome that has very minimal or even no risk of mid-face hypoplasia and its subsequent squeals.