Two-Layer Closure of A Wide Palatal Cleft

Abstract

A method of obtaining a complete two-layer closure of an extremely wide cleft of the secondary palate is presented. Extremely wide is defined as a bony palatal shelf less than one—third the width of the cleft defect. The nasal mucoperiosteum of the superior surface of the palatal shelf was incorporated into the oral layer of the closure by the use of turnover flaps based on the oral mucosa at the cleft margin. The nasal layer of the closure was obtained by the use of a long, superiorly based pharyngeal flap. This procedure was successfully utilized in a patient who was unable to wear a speech appliance successfully. This technique of palatoplasty provides a complete two—layer closure of wide palatal clefts when surgical correction is indicated.