Anatomical and Physiological Changes Following Primary Palatoplasty Using "The Buccal Flap Approach".

Document Type

Article

Publication Date

2025

Publication Title

The Cleft palate-craniofacial journal : official publication of the American Cleft Palate-Craniofacial Association

Abstract

Objective: The purpose of this study was to determine the anatomical differences among selected individuals with a cleft palate repaired using "The Buccal Flap Approach" during primary palatoplasty compared to aged-matched participants without cleft palate.

Design: Observational, prospective.SettingTwo regional hospitals.ParticipantsA total of 30 adult males consisting of 15 adults born with cleft palate who received the Double Opposing Z-Plasty plus Buccal Flaps (DOZP  +  BF) repair at the time of primary palatoplasty and no history of secondary speech surgery or orthognathic surgery and 15 adults without a history of cleft palate.InterventionsAll participants underwent MRI to visualize anatomy.Main

Outcome: MeasuresTen velopharyngeal and craniofacial anatomical measures.

Results: No statistically significant differences between groups were observed for velar thickness, velar length, pharyngeal depth, NSBa angle, SNB angle, or levator veli palatini length. Individuals with the DOZP  +  BF presented with a greater effective velar length (p <  .001), greater effective VP ratio (p <  .001), smaller SNA angle (p <  .001), and smaller maximal velar stretch (p <  .001) compared to the control participants.

Conclusions: This study suggests that adult males who received the DOZP  +  BF repair at the time of primary palatoplasty and no history of secondary speech surgery or orthognathic surgery present with a longer effective velar length and larger effective VP ratio in comparison to the non-cleft group. Future research is needed to compare patients with and without favorable outcomes from multiple surgical types to fully understand how surgical techniques alter the anatomy.

Volume

62

Issue

2

First Page

316

Last Page

325

DOI

10.1177/10556656231215141

ISSN

1545-1569

PubMed ID

38037274

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