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Case Reports
. 2017 Aug 18:17:ic21.
eCollection 2017.

Palatal Lengthening With Double-Opposing Buccal Flaps for Velopharyngeal Insufficiency

Paige C Goote  1 , Nicholas S Adams  1   2 , Robert J Mann  1   2   3
Affiliations
Case Reports

Palatal Lengthening With Double-Opposing Buccal Flaps for Velopharyngeal Insufficiency

Paige C Goote et al. Eplasty. .
No abstract available

Keywords: buccal flap; cleft palate; palate lengthening; speech surgery; velopharyngeal dysfunction.

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Figures

Figure 1
Figure 1
Hard and soft palates of a 5-year-old boy with a history of Furlow double-opposing Z-plasty palatoplasty (dashed line). Note the short palatal length and nonanatomical location of the velum relative to the posterior pharyngeal wall.
Figure 2
Figure 2
(a) The buccal flap is marked just inferior to the opening of the parotid duct (arrow). The pedicle is based at the retromolar trigone (asterisk).
Figure 2
Figure 2
(b) Elevated buccal flap. A majority of buccinator muscle is included within the flap.
Figure 3
Figure 3
After releasing the soft palate from the hard palate, the bilateral buccal flaps are interposed in the resultant space. One flap reconstructs the nasal mucosa and the other is opposed to reconstruct the oral mucosa. The inset buccal flap is seen here from the oral side. Note the soft palate in a more posterior, anatomical position.
Figure 4
Figure 4
Twenty-two months postoperatively. The palate is completely healed with pliable mucosal tissue interposed between the hard and soft palates (dashed line). Note the pedicles of the bilateral buccal flaps near the retromolar trigone. These will be divided and inset at a later procedure.
See this image and copyright information in PMC

References

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    1. Kirschner RE, Baylis AL, Rodriguez ED, Losee JE, Neligan PC. Plastic Surgery: Craniofacial, Head and Neck Surgery Pediatric Plastic Surgery. 3rd ed. Amsterdam, Netherlands: Elsevier Health Sciences; 2012. Velopharyngeal dysfunction; pp. 614–35. Vol 3.
    1. Paniagua LM, Signorini AV, da Costa SS, Collares MVM, Dornelles S. Velopharyngeal dysfunction: a systematic review of major instrumental and auditory-perceptual assessments. Int Arch Otorhinolaryngol. 2013;17(3):251–6. - PMC - PubMed
    1. Fisher DM, Sommerlad BC. Cleft lip, cleft palate, and velopharyngeal insufficiency. Plast Reconstr Surg. 2011;128(4):342e–60e. - PubMed
    1. Gart MS, Gosain AK. Diagnosis and management of velopharyngeal insufficiency following cleft palate repair. J Cleft Lip Palate Craniofac Anomalies. 2014;1(1):4.

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