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Plast Reconstr Surg Glob Open. 2015 May 07;3(4):e373. doi: 10.1097/GOX.0000000000000342. eCollection 2015 Apr.

One-flap Palatoplasty: A Cohort Study to Evaluate a Technique for Unilateral Cleft Palate Repair.

Plastic and reconstructive surgery. Global open

Percy Rossell-Perry, Omar Cotrinal-Rabanal, Evelyn Caceres-Nano

Affiliations

  1. Post Graduate Studies, Faculty of Medicine, San Martin de Porres University, Lima, Peru; Padre Tezza Clinic, Lima, Peru; ARMONIZAR Foundation, Lima, PerĂº; and School of Pedagogic Training of Lima, Lima, Peru.

PMID: 25973351 PMCID: PMC4422204 DOI: 10.1097/GOX.0000000000000342

Abstract

BACKGROUND: The 2-flap palatoplasty technique is actually the approach most commonly used in the United States for cleft palate repair. This is a one-time surgery that enables closure under minimal tension, lowering rates of subsequent fistula development. However, its primary disadvantage is potential detriment to maxillary growth (due to extent of dissection on both sides of the cleft and raw lateral surfaces). Since 2007, a surgical technique using only one mucoperiosteal flap from the noncleft side has been performed by us, reducing the extent of the surgery and its potential nondesirable effects over the palate. The purpose of this study is to evaluate the utility of this technique for unilateral cleft palate repair.

METHODS: This is a retrospective, simple-blinded cohort study between 2 groups of 120 patients each with unilateral cleft palate who were operated on using the 2-flap and 1-flap techniques by the Outreach Surgical Center Program Lima from 2007 to 2012. Data collection was accomplished by physical examination to evaluate the presence or absence of a fistula and to evaluate the presence of hypernasality. Postoperative bleeding was also studied.

RESULTS: We have observed no increase in the rate of fistulas and velopharyngeal insufficiency between these 2 studied groups (P = 0.801 and P = 1.000).

CONCLUSIONS: Use of a 1-flap technique for unilateral cleft palate repair allowed us to achieve results comparable to those of a 2-flap technique in terms of postoperative fistula development and hypernasal speech. Additional studies are required to evaluate the effect of this technique on palatal growth.

References

  1. Cleft Palate Craniofac J. 2007 Jan;44(1):13-22 - PubMed
  2. Plast Reconstr Surg. 2003 Nov;112(6):1542-8 - PubMed
  3. Plast Reconstr Surg. 2009 Sep;124(3):899-906 - PubMed
  4. Plast Reconstr Surg. 2010 May;125(5):1503-10 - PubMed
  5. Cleft Palate Craniofac J. 2009 May;46(3):305-13 - PubMed
  6. Cleft Palate Craniofac J. 2006 May;43(3):272-88 - PubMed
  7. Cleft Palate Craniofac J. 2005 Nov;42(6):594-600 - PubMed
  8. Br J Oral Maxillofac Surg. 2013 Mar;51(2):144-8 - PubMed
  9. Cleft Palate Craniofac J. 2006 Sep;43(5):547-56 - PubMed
  10. Plast Reconstr Surg. 2001 Nov;108(6):1515-8 - PubMed
  11. Plast Reconstr Surg. 1996 Aug;98(2):236-46 - PubMed
  12. Cleft Palate Craniofac J. 2008 Jan;45(1):1-17 - PubMed
  13. Plast Reconstr Surg. 2006 Jul;118(1):193-204 - PubMed
  14. Ann Plast Surg. 2016 Apr;76(4):406-10 - PubMed
  15. Plast Reconstr Surg. 2010 Dec;126(6):2216-21 - PubMed
  16. JAMA Facial Plast Surg. 2014 May-Jun;16(3):206-10 - PubMed
  17. Scand J Plast Reconstr Surg Hand Surg. 2005;39(5):287-9 - PubMed
  18. Cleft Palate Craniofac J. 2010 Nov;47(6):623-30 - PubMed
  19. Br J Oral Maxillofac Surg. 2013 Dec;51(8):851-7 - PubMed
  20. J Plast Surg Hand Surg. 2014 Apr;48(2):132-5 - PubMed
  21. Plast Reconstr Surg. 2008 Jul;122(1):232-9 - PubMed
  22. Plast Reconstr Surg. 1986 Dec;78(6):739-47 - PubMed
  23. Cleft Palate Craniofac J. 2011 May;48(3):244-51 - PubMed
  24. J Craniofac Surg. 1999 Nov;10(6):503-18 - PubMed
  25. Plast Reconstr Surg. 1987 Oct;80(4):518-24 - PubMed
  26. Plast Reconstr Surg. 2013 Dec;132(6):1644-8 - PubMed
  27. Plast Reconstr Surg. 1991 Jun;87(6):1041-7 - PubMed

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