Al Shahat, O., Khalifa, M., Ouf, M., Salem, A., Hamdina, S., Helmy, Y. (2022). A New Application of the Vomerine Flap for Repair of Unilateral Complete Cleft Hard and Soft Palate: A Proposed Single Stage Technique. The Egyptian Journal of Plastic and Reconstructive Surgery, 46(1), 83-88. doi: 10.21608/ejprs.2022.220456
Osama Al Shahat; Mohamed Hosny Khalifa; Mohamed Osama Ouf; Ahmed Mohamed Salem; Sherif Youssif Hamdina; Yasser Helmy. "A New Application of the Vomerine Flap for Repair of Unilateral Complete Cleft Hard and Soft Palate: A Proposed Single Stage Technique". The Egyptian Journal of Plastic and Reconstructive Surgery, 46, 1, 2022, 83-88. doi: 10.21608/ejprs.2022.220456
Al Shahat, O., Khalifa, M., Ouf, M., Salem, A., Hamdina, S., Helmy, Y. (2022). 'A New Application of the Vomerine Flap for Repair of Unilateral Complete Cleft Hard and Soft Palate: A Proposed Single Stage Technique', The Egyptian Journal of Plastic and Reconstructive Surgery, 46(1), pp. 83-88. doi: 10.21608/ejprs.2022.220456
Al Shahat, O., Khalifa, M., Ouf, M., Salem, A., Hamdina, S., Helmy, Y. A New Application of the Vomerine Flap for Repair of Unilateral Complete Cleft Hard and Soft Palate: A Proposed Single Stage Technique. The Egyptian Journal of Plastic and Reconstructive Surgery, 2022; 46(1): 83-88. doi: 10.21608/ejprs.2022.220456
A New Application of the Vomerine Flap for Repair of Unilateral Complete Cleft Hard and Soft Palate: A Proposed Single Stage Technique
The Department of Plastic Surgery and Burn, Faculty of Medicine, Al-Azhar University
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.
1- Deshpande G., Wendby L., Jagtap R. and Schonmeyr B.: The efficacy of vomer flap for closure of hard palate during primary lip repair. J. Plast. Reconstr. Aesthet. Surg., 68: 940e5, 2015. 2- Brattstrom V., Molsted K., Prahl-Andersen B., Semb G. and Shaw W.C.: The Eurocleft study: Intercenter study of treatment outcome in patients with complete cleft lip and palate. Part 2: craniofacial form and nasolabial appearance. Cleft Palate Craniofac. J., 42: 69-77, 2005. 3- Leow A.M. and Lo L.J.: Palatoplasty: Evolution and controversies. Chang Gung Med. J., 31 (4): 335-345, 2008. 4- Grawal K. and Panda K.: Use of Vomer flap in palatoplasty: Revisited. Cleft Palate-Craniofac Journal, 43: 30-37, 2006. 5- Sommerland B.C.: A technique for cleft palate repair. Plast. Reconstr. Surg., 112 (6): 1542-1548, 2003. 6- Rossell-P. Percy and Luque-Tipula Margot: The Lima Surgical Protocol for Cleft Palate Repair. Journal of Craniofacial Surgery, 31 (6): 1533-1538, 2020. 7- Sommerlad B.C.: Sommerlad's Technique of Cleft Palate Repair. Cleft Lip and Palate Primary Repair by Bing Shi and Brian C. Sommerlad Editors, Springer Heidelberg New York Dordrecht London, pp. 265-276, Ch. 14, 2013. 8- Yu-Fang Liao, Ying-Hsin Lee, Ruby Wang, Chiung-Shing Huang, Philip Kuo-Ting Chen, Lun-Jou Lo and Yu-Ray Chen: Vomer flap for hard palate repair is related to favorable maxillary growth in unilateral cleft lip and palate. In Clin. Oral Invest, 2013. 9- Shetye P.R.: Facial growth of adults with unoperated clefts. Clin. Plast. Surg., 31 (2): 361-371, 2004. 10- Salyer K.E., Sng K.W. and Sperry E.E.: Two-flap palatoplasty: 20-year experience and evolution of surgical technique. Plast. Reconstr. Surg., 118 (1): 193-204, 2006. 11- Delaire J. and Precious D.: Avoidance of the use of vomerine mucosa in primary surgical management of velopalatine clefts. Oral Surg. Oral Med. Oral Pathol., 60: 589e97, 1985. 12- Millard D.R.: Alveolar and palatal deformities. Cleft craft: the evolution of its surgery. Volume 3. Boston: Little, Brown and Company, 1980. 13- Maggiulli F., Hay N., Mars M., et al.: Early effect of vomerine flap closure of the hard palate at the time of lip repair on the alveolar gap and other maxillary dimensions.In the cleft palate-Craniofacial Journal, 51 (1): pp. 43- 48, 2014. 14- Friede H.: Growth sites and growth mechanisms at risk in cleft lip and palate. Acta. Odontol. Scand, 56 (6): 346- 351, 1998. 15- Deshpande Gaurav, Wendby Lisa, Jagtap Rasika and Schönmeyr Björn: The efficacy of vomer flap for closure 88 Vol. 46, No. 1 / A New Application of the Vomerine Flap of hard palate during primary lip repair. Journal of plastic, reconstructive & aesthetic surgery: JPRAS, ISSN, 68 (7): 940-5. 16- Miranda Bruna Lima, Júnior Júlio Leite de Araújo, Paiva Marcos Antônio Farias de and More: Management of Oronasal Fistulas in Patients with Cleft Lip and Palate. Journal of Craniofacial Surgery, 31 (6): 1526-1528, 2020.
View on SCiNiTO
Top