Supraperiosteal Flap Technique versus Mucoperiosteal Flap Technique in Cleft Palate Surgery

Leenstra, Thomas S.; Kohama, Gen–iku; Kuijpers-Jagtman, A.M.; Freihofer, Hans Peter M.

doi:10.1597/1545-1569_1996_033_0501_sftvmf_2.3.co_2

Cited by 12 publications

(6 citation statements)

References 15 publications

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“…[29] Variations There are sporadic reports on variations of palatoplasty techniques. To mention a few: • Bumsted's two-layer closure of palate in very wide cleft palate [30] • Widmaier-Perko Palatoplasty [31] • Supraperiosteal dissection of flap in the region of hard palate instead of mucoperiosteal flap [32] This dissection has been advocated so as to minimize the maxillary hypoplasia, however, the surgical dissection in the submucosal plane is bloody, difficult and timeconsuming. • Osada's two-stage palatoplasty [33] • Frolova primary palatoplasty technique [34] • Anterior mucoperiosteal hinge for nasal lining in partial cleft palate [35] • Marginal musculo-mucosal flap [36] These are some of the variations and procedures which are being performed by a specific surgeon or in a specific centre.…”

Section: Buccal Myomucosal Flapmentioning

confidence: 99%

Cleft palate repair and variations

Agrawal

2009

Indian J Plast Surg

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Cleft palate affects almost every function of the face except vision. Today a child born with cleft palate with or without cleft lip should not be considered as unfortunate, because surgical repair of cleft palate has reached a highly satisfactory level. However for an average cleft surgeon palatoplasty remains an enigma. The surgery differs from centre to centre and surgeon to surgeon. However there is general agreement that palatoplasty (soft palate at least) should be performed between 6-12 months of age. Basically there are three groups of palatoplasty techniques. One is for hard palate repair, second for soft palate repair and the third based on the surgical schedule. Hard palate repair techniques are Veau-Wardill-Kilner V-Y, von Langenbeck, two-flap, Aleveolar extension palatoplasty, vomer flap, raw area free palatoplasty etc. The soft palate techniques are intravelar veloplasty, double opposing Z-plasty, radical muscle dissection, primary pharyngeal flap etc. And the protocol based techniques are Schweckendiek's, Malek's, whole in one, modified schedule with palatoplasty before lip repair etc. One should also know the effect of each technique on maxillofacial growth and speech. The ideal technique of palatoplasty is the one which gives perfect speech without affecting the maxillofacial growth and hearing. The techniques are still evolving because we are yet to design an ideal one. It is always good to know all the techniques and variations so that one can choose whichever gives the best result in one's hands. A large number of techniques are available in literature, and also every surgeon incorporates his own modification to make it a variation. However there are some basic techniques, which are described in details which are used in various centres. Some of the important variations are also described.

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Section: Buccal Myomucosal Flapmentioning

confidence: 99%

Cleft palate repair and variations

Agrawal

2009

Indian J Plast Surg

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“…One method is to use supraperiosteal instead of mucoperiosteal flaps to cover the cleft area; that is, the palatal bone left exposed after surgery is not stripped from its periosteum (54). Compared with scar tissue formation over denuded bone, scars after wounds where the deeper layer of the mucoperiosteum was left in situ were found to differ in structure, composition, and outline (55). Even if the patients were followed up to only 5 years of age, this more beneficial healing after surgery resulted in greater maxillary arch length than in a group of patients in whom palatal bone was left completely denuded at repair.…”

Section: Palatal Surgerymentioning

confidence: 99%

Growth sites and growth mechanisms at risk in cleft lip and palate

Friede

1998

Acta Odontologica Scandinavica

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A newborn with some kind of facial cleft displays certain characteristics of the nose, upper lip, and jaw caused by abnormal influence on specific growth sites and growth mechanisms. Treatment, particularly surgery, attempts to counteract this aberrant development, for both functional and aesthetic reasons. However, not infrequently, therapy impedes future midfacial growth to a greater or lesser degree. To better understand the varying growth influence, this article aims to review certain aspects of growth of the middle third of the face in both normal and cleft subjects. The normal elongation of the maxilla, to give space for the molars, is usually not affected by lip surgery but rather by scar tissue from palatal repair. The displacement of the upper jaw in relation to the vomer is recognized. Early surgery should therefore avoid affecting the growth of the vomero-(pre)maxillary suture if possible. Periosteal growth, necessary for the development of dentoalveolar structures, might be affected by scar tissue from palatal repair. Different ways to reduce the development of palatal scars and their negative effects on growth are discussed.

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“…In the literature, an interpositional layer has been created between the oral and nasal layers in the soft palate region using different alternatives (acellular dermal matrix, hemostatic gelatin sponge, collagen membrane, and platelet-rich plasma) to enhance mucosal healing and reduce fistula formation (Losee et al, 2008; Hudson and Pickett, 2015; El-Anwar et al, 2016; Li et al, 2017; Goh and Chia, 2019; Simpson et al, 2019; Ha et al, 2020; Tanaka et al, 2021). Modifications on palatal dissection (subperiosteal flap technique vs mucoperiosteal flap technique) (Leenstra et al, 1996; Ito et al, 2006) and lateral relaxing incision (only a small incision lateral to the hamulus or no use of lateral incision) (Karsten et al, 2003; Becker and Hansson, 2013; Parikakis et al, 2018; Seo et al, 2019) have also been proposed to attenuate bone denudation-related scar contracture and subsequent maxillary growth interference. Future fistula rate- and maxillary development-focused outcome studies could then compare the described approach based on the use of interpositional buccal fat flaps.…”

Section: Discussionmentioning

confidence: 99%

Reinforcing the Modified Double-Opposing Z-Plasty Approach Using the Pedicled Buccal Fat Flap as an Interpositional Layer for Cleft Palate Repair

Denadai¹,

Chou

2021

The Cleft Palate Craniofacial Journal

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Pedicled buccal fat flaps have been adopted in primary Furlow double-opposing Z-plasty palatoplasty to reduce oronasal fistula formation or to attenuate maxillary growth disturbance. We combined both goals in a single intervention. This study describes a series of 33 modified Furlow small double-opposing Z-plasty palatoplasties reinforced with a middle layer of pedicled buccal fat flaps between the oral and nasal layers for full coverage of the dissected palatal surfaces, with rapid mucosalization of lateral relaxing incisions and no dehiscence or fistula formation.

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Supraperiosteal Flap Technique versus Mucoperiosteal Flap Technique in Cleft Palate Surgery

Abstract: T h o m a s S. L e e n s t r a , D .D .s. G en-ïku K o h a m a , D .D .S ., P h .D. A nne M. K u ijp e r s-J a g t m a n , D .

Cited by 12 publications

References 15 publications

Cleft palate repair and variations

Cleft palate repair and variations

Growth sites and growth mechanisms at risk in cleft lip and palate

Reinforcing the Modified Double-Opposing Z-Plasty Approach Using the Pedicled Buccal Fat Flap as an Interpositional Layer for Cleft Palate Repair

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