A Salvage Procedure in Cleft Palate Repair: Suturing Nasal Mucosa Directly to Palatine Process

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doi: 10.1597/06-062
The Cleft Palate-Craniofacial Journal: Vol. 44, No. 3, pp. 233–234.

A Salvage Procedure in Cleft Palate Repair: Suturing Nasal Mucosa Directly to Palatine Process

Gökhan Tunçbilek, M.D.
Ersoy Kona, M.D.
Figen Özgür, M.D.

Dr. Tunçbilek is Associate Professor, Dr. Kona is Resident, and Dr. Özgür is Professor, Department of Plastic and Reconstructive Surgery, Hacettepe University, Faculty of Medicine, Ankara, 06100, Turkey

Submitted April 2006; Accepted September 2006.

Objective: Palatal fistulas are among the complications of cleft palate repair requiring additional surgery. Suturing the nasal mucosa and mucoperiosteal flaps together in a tension-free manner to create a double-layered closure in the hard palate is one of the most important points in prevention of dehiscence and fistula formation. In this report, we describe a salvage procedure to repair nasal mucosa that might be lacerated while being freed from the upper surface of the palatal process.
Method: To restore the nasal lining, an ipsilateral vomer mucoperiosteal flap or the opposite nasal mucosa flap is advanced to the palatine bone and sutured directly to the palatal process in order to guarantee an intact cleft palate repair.
Results: This method is an easy, simple, and time-saving procedure. It should be a useful addition to the armamentarium of every plastic surgeon, especially those working as consultants in training units.

KEY WORDS: cleft palate, fistula