Cheek Flap for Short Palates

Abstract

An ideal operation for cleft palate is to produce a long mobile soft palate. Short soft palates with wide cleft of palatal processes are a source of concern to plastic surgeons, orthodontists, and speech therapists. Short soft palate is a relative term; length will be short if the nasopharynx is deep even though the actual length of the soft palate is fairly satisfactory. Average length of soft palates in children of one and one half to two years is about 2.5 cm, the range varies from 1.75 to 3 cm. For 35 patients, the distance between the elevated nasal side of the soft palate and the posterior pharyngeal wall has been studied to establish the inadequacy of the soft palate. The distance has been measured from x-ray films showing soft palate and nasopharynx, and has been calculated properly. Of the 35 patients, 15 (42.8%) had distances between the soft palate and the posterior pharyngeal wall of less than 5 mm, 11 (or 31.4%) had distances greater than 5 mm but less than 10 mm, and 9 (or 25.7%) had distances greater than 10 mm. This 25.7% of the cleft palate children and a few of the second group (greater than 5 mm and less than 10 mm) present the problems to be solved. In the Plastic Unit of the Institute, the treatment of the cleft lip and palate is carried on in a very systematic way through a Cleft Palate Clinic which is held twice a month. The clinic is composed of plastic surgeons, orthodontic surgeons, a pediatrician, a speech therapist, and an anesthetist, whenever such a problem is faced. Treatment of these infants is started almost one month after birth. Base splint is fitted for all infants a) to prevent the protrusion of the tongue into the nose, hampering the growth and falling down of the nearly vertical palatal processes which are also very short at the time and b) to maintain the normal arch relations.