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Vomopalatoplasty: a novel procedure to reduce velopharyngeal distance in cleft palate repair.

 In Sik Yun  ;  Joo Hong Lee  ;  Be-young Yun Park 
 JOURNAL OF CRANIOFACIAL SURGERY, Vol.21(2) : 526-528, 2010 
Journal Title
Issue Date
Child, Preschool ; Cleft Palate/surgery* ; Female ; Humans ; Infant ; Male ; Mouth Mucosa/transplantation ; Nasal Bone/surgery ; Nasal Mucosa/transplantation ; Osteotomy/methods ; Palate, Hard/surgery ; Palate, Soft/surgery* ; Periosteum/transplantation ; Reconstructive Surgical Procedures/methods* ; Surgical Flaps ; Velopharyngeal Sphincter/surgery* ; Vomer/surgery*
Cleft palate ; palatoplasty ; vomer flap ; vomopalatoplasty
Despite numerous improvements in the palatoplasty procedure, speech dysfunction tends to develop in many patients, requiring another surgery. In addition, vomer flaps have been used in palatoplasty in various shapes and on purposes. Nonetheless, they have been used mostly to cover the defect in wide and complete type of cleft palate. We introduce the vomopalatoplasty procedure that uses a vomer flap to reduce the nasopharyngeal space in incomplete or submucous type of cleft palate patients.The mucoperiosteal flaps on the nasal and oral sides were elevated by the conventional palatoplasty procedure, which subsequently elevated the bilateral vomer flaps to the posterior edge of vomer. Then, the vomer flap was sutured with the mucoperiosteal flap of the nasal side to the anterior half of the soft palate, and thus, the soft palate was fixed in more posterosuperior direction than in conventional palatoplasty. For patients whose junction of vomer and hard palate had to be exposed, a part of the bone at the bifid posterior nasal spine of the hard palate may be removed sometimes.Ostectomy of the bifid posterior nasal spine or the posterior end of the hard palate was performed in 11 patients. Another 12 patients did not need ostectomy. After the surgery, the surgical wounds healed well in all patients without any major complications such as dehiscence or loss of flap.Our vomopalatoplasty is easy to perform, and the procedure could be combined to the conventional palatoplasty procedure. Thus, we consider vomopalatoplasty as a useful procedure that could reduce the nasopharyngeal space in patients with incomplete or submucous type of cleft palate.
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1. College of Medicine (의과대학) > Dept. of Plastic and Reconstructive Surgery (성형외과학교실) > 1. Journal Papers
Yonsei Authors
Park, Beyoung Yun(박병윤)
Yun, In Sik(윤인식) ORCID logo https://orcid.org/0000-0003-1103-7047
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