Abstract
The pharyngeal flap operation is useful for the correction of velophryngeal inadequacy, but because of variations in the degree of shrinkage and scar contracture of the central pharyngeal flap, the size of the remaining lateral apertures cannot be predicted. In 1975, Isshiki constructed the superiorly-based “folded pharyngeal flap” without a raw surface. There is minimal shrinkage and scar contracture of the flap. Therefore, the size of the lateral apertures can be predicted. Sixty-six patients with cleft palate, who had been previously operated on unsuccessfully, were treated with Isshiki's operation with several modifications in Kurashiki Central Hospital between 1979 and 1982. The majority of subjects had more effective closure with resultant reduction in nasality.
