Transposed flaps in cleft palate repair

Cuthbert, James

doi:10.1016/s0007-1226(51)80032-8

Cited by 15 publications

(4 citation statements)

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“…1). In the first group, treated between January 1972 and late 1981, the secondary palate was repaired at 6 months of age using the Cuthbert (1951) three-flap modification of the Veau Wardill Kilner V-Y retroposition (CV), whose rationale was considered to be that it lengthened the ''short'' soft palate. In this operation, closure of the nasal layer was achieved by a vomer flap sutured to the nasal layer of the cleft side.…”

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A Comparison of Three Methods of Repairing the Hard Palate

Pigott¹,

Albery²,

Hathorn

et al. 2002

The Cleft Palate-Craniofacial Journal

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Objective To compare growth, speech, and nasal symmetry outcomes of three methods of hard palate repair. Patients Consecutive available records of children born with unilateral bony complete cleft lip and palate over the period 1972 to 1992. Interventions Identical management of lip, nose, alveolus, and soft palate. Hard palate repair by Cuthbert Veau (CV) from 1972 to 1981, von Langenbeck (vL) from 1982 to 1989, or medial Langenbeck (ML) from 1989 to 1991. Outcome Measures For growth: GOSLON yardstick or 5-year model index. For speech: articulation test. Nasal anemometry. For nasal symmetry: Coghlan computer-based assessment. All these measures were developed during the period of data collection but not for this project. Results There was a strong trend toward more favorable anteroposterior maxillary growth with the change from CV to vL to ML techniques. This fell short of statistical significance because of the small sample size. There was a significant reduction in cleft-related articulation faults (p = .01) considered to be related to improved arch form. In the absence of improved rates of velopharyngeal insufficiency or nasal symmetry, increased surgical experience was discounted as a significant contribution to improved growth and articulation outcomes. Conclusions Reduced periosteal undermining and residual exposed palatal shelf from CV to vL to ML improved incisor relationships and articulation.

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A Comparison of Three Methods of Repairing the Hard Palate

Pigott¹,

Albery²,

Hathorn

et al. 2002

The Cleft Palate-Craniofacial Journal

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“…Accordingly, stretching the neurovascular bundle 14,15 and or its lengthening were applied by dissection from the mucoperiosteal flaps [16][17][18] . Some surgeons transected the vessels in cleft palate because they believed that the greater palatine neurovascular bundle is unimportant 19,20 . More recently, some researchers developed a guarded osteotome for out-fracturing of the greater www.wjps.ir palatine foramen with the aim of medializing the greater palatine foramen.…”

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confidence: 99%

Quantitative and Qualitative Assessment of Medial Osteotomy of the Greater Palatine Foramen in Wide Cleft Palate Repair

Fathi¹,

Hoseininejad

Molaei

2022

WJPS

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Background: Repairing of a wide cleft palate faces with several problems, e.g. medialization of palatal flaps, lack of tissue for repair, and fistula formation. We aimed at quantitative and qualitative evaluation of medial osteotomy of the greater palatine foramen for patients with wide cleft palate and its postoperative outcomes.Methods: Eight patients 4 males, 4 females with wide cleft palate and the median age of 1.5 year were operated using medial osteotomy of the greater palatine foramen from 2018-2020. In this technique, the osteotomy was carried in the outlet of vascular pedicle medially and posteriorly. This led to more degrees of freedom for the vascular pedicle and a palatoplasty without tension through mucoperiosteal flap movement toward the medial direction.Results: After osteotomy and repairing for 8 patients (16 flaps), the mean (SD) length of mucoperiosteal flap pedicle was significantly increased from 2.78 mm to 6.09 mm (P<0.001). All patients were successfully repaired with no major complications, and none of them required any secondary repair. Three weeks postoperatively, all patients showed normal feeding, normal nasal resonance of speech with normal palatal mobility. Conclusion:Osteotomy of the greater palatine foramen for the closure of wide palatal clefts showed a good efficiency, quantitatively and qualitatively. The mean length of mucoperiosteal pedicle increased by 3.22 mm (6.44 mm for bilateral) after repairing, which helps to more freely medial movement of the palatal flap and lesser tension across its closure. All patients were successfully improved without any major complications.

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“…He initially used the Cuthbert modification of Veau Wardill Kilner. 5 He then utilised lateral Von Langenbeck releasing incisions 6 , and finally he described the so-called Medial Langenbeck releasing incision. 7 He published improved facial growth outcomes with this medial releasing technique.…”

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confidence: 99%