Trans‐antral temporalis transfer for the repair of adult cleft palates

Abstract

Temporalis muscle transfer is a versatile technique frequently used for reconstructive procedures in the maxillofacial region. However the thickness of the pedicle may interfere with masticatory function when used anteriorly in the oral cavity. To repair fulllength mid-palatal defects in fully dentate patients the flap can be passed through the maxillary sinus and combined with local repair of the soft palate, thus avoiding any occlusal trauma from the posterior teeth. The operation is a single stage procedure with low morbidity and few complications, and is a useful technique for repairing the large untreated clefts frequently encountered in developing countries. The procedure is used by members of the Australian and New Zealand Association of Oral and Maxillofacial Surgeons Bangladesh Project who have operated in Dhaka teaching hospitals on a regular basis since 1991.

Does Early Repair of Cleft Lip Helps to Reduce the Cleft Alveolar and Palatal Gap in Unilateral Complete Cleft Lip - Palate Patients?

“…But, we could not do surgery at time, as patients were malnourished. The male female ratio (1.5:1) in our study group was similar (1.5:1 to 2.1:1) with other 3,7,14 . Side of cleft is also similar to the literatures where showed more cleft involvement in the left side than the right.…”

“…Even after surgery, they may present with wound disruption or recurrent oronasal fistula formation. Some parents prefer cleft lip repair first irrespective of the age of the child, only for esthetic reasons, and do not come again for cleft palate or oronasal fistula closure 3 . Palatoplasty often needs extensive dissection, specially if the age of the patients is more and there may be more chances of oronasal fistula formation, which is very difficult to repair, and may cause mid-facial growth disturbance 7,12 .…”

“…The incidence of cleft lip or/and cleft palate in Bangladesh is 3.9 per 1000 live births 2 . Incidences of cleft lip-palate and other multifactorial congenital malformation are increasing day by day due to environmental pollution, misuse of drugs by pregnant women, radiation hazards etc 3 . In our country most of the cleft patients come to the doctor only when their parents are aware or when the child had some problem like repeated respiratory tract infection, feeding difficulty, various social problem.…”

“…Even after repair, there may be chances of wound disruption, oronasal fistula formation. Some parents prefer cleft lip repair first irrespective of the age of the child only for aesthetic region and do not come again for cleft palate or oronasal fistula closure due to poverty, transport problem, lack of knowledge 3,9 . Late repair of this defect is complicated by high fistula formation and which may persist for an extended period of time 8 .…”

Efficacy of Temporalis Myofascial Flap in Maxillofacial Reconstruction

“…In a study John F arvier showed that for the repair of the adult cleft palate the transantral transfer of TMF is a single stage procedure with low morbidity and few complication. 4 The present study was designed to find out the efficacy of temporalis myofascial flap for reconstruction of various defects of maxillofacial region after tumour surgery in the department of Oral and Maxillofacial Surgery (OMS), Dhaka Dental College & Hospital (DDCH).…”