CLOSURE OF THE NASAL RAW SURFACE IN PUSHBACK SURGERY WITH BILATERAL MUSCULOMUCOSAL FLAPS FROM CLEFT MARGINS AND ITS EARLY SPEECH EVALUATION

Abstract

In order to cover the raw mucosal surface on the nasal side just posterior to the hard palate in conventional pushback surgery, a new microsurgical approach is presented. Two denervated musculomucosal flaps, one each from the cleft margins of the soft cleft palate, are rotated into the opposite side of the raw surface on the nasal side and sutured under an operating micro-scope (magnification 6 ×). The flaps prevent scar contracture and retrogres-sion of the repositioned levator muscle sling and contribute to better early velopharyngeal function attested by an early postoperative articulation study in 10 cases. These tissues are usually discarded during conventional pushback surgery. Therefore, our method is not expected to have any detrimental effects on the palate in addition to the conventional surgery itself.