BILATERAL BUCCAL FLAPS WITH DOUBLE OPPOSING Z-PLASTY FOR WIDER PALATAL CLEFTS

Described is a technique that has evolved from the challenges of closu re of larger cleft palate defects and that we are now using in prefere nce over other-techniques to repair a wide variety of clefts. Soft-pal ate closure and muscular sling reconstruction are accomplished using a modified Furlow technique. An associated cleft of the I-lard palate a nd the gaps produced by posterior displacement of the reconstructed so ft palate are closed by adding tissue, buccal flaps, rather than by cl osure under tension or leaving residual raw surfaces. Palate lengtheni ng is achieved both by the Z-plasty effect and by the interposition of buccal flaps between the hard and soft palate. Seventy-six palates ha ve been repaired using this procedure. There were three postoperative fistulas.