Abstract
Oro-nasal fistula is often found in the alveolar region after cleft lip and palate repair. For this problem, in 1939 V. Veau. reported the method of closure of the cleft of alveolus and anterior palate with vomer flap and palatal flap at the time of lip repair. Thereafter, some people studied or improved this method. However, after closure of the alveolus and anterior cleft palate, much raw surface is exposed on the oral or nasal side, and sometimes a lip deformity results from lip contraction.
Thus we use a vomer flap combined with lip repair for closure of the alveolus and anterior cleft palate, and LPS (Lyophilized Porcine Skin) is applied to the raw surfaces of the oral side.
In repairing alveolar cleft, a mucoperiosteal flap is made at cleft side and a vomer flap at the non-cleft side. These flaps are turned over and sutured to close the nasal floor, alveolar cleft and anterior palate cleft. Then LPS is applied to the raw surface of the oral side and after suturing around, roll gauze is put on and pressed by the tie over method. The roll gauze is removed 4 days after operation, and about 7 days after that, gradual melting of the surface of LPS is observed. Epithelisation of the raw surface is almost completed about 14 days after operation.
1 year after opera t ion, when the palate repair is done, the alveolus and anterior cleft palate are closed completely and the alveolar arch form is good. The results are satisfactory.
