A novel modification of Bardach’s two-flap palatoplasty for the repair of a difficult cleft palate

 

 Permissions and Reprints

Bardach described a closure of the cleft utilizing the arch of the palate, which provides the length needed for closure and is most effective only in narrow clefts. Herein, we describe a case where we utilized Bardach’s two-flap technique with a vital and easy modification, done to allow closure of a wide cleft palate and to prevent oronasal fistula formation at the junction of the hard and soft palate, which are otherwise difficult to manage with conventional flaps. The closed palate showed healthy healing, palatal lengthening, and no oronasal regurgitation. We advise using this modification to achieve the goals of palatal repair in difficult cases where tension-free closure would otherwise be achieved with more complex flap surgical techniques, such as free microvascular tissue transfer.

Publication History

Received: 14 March 2020

Accepted: 27 June 2020

Article published online:
20 March 2022

© 2021. The Korean Society of Plastic and Reconstructive Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonCommercial License, permitting unrestricted noncommercial use, distribution, and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes. (https://creativecommons.org/licenses/by-nc/4.0/)

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

• REFERENCES

• 1 Thomas C. Repair of cleft palate: evolution and current trends. J Cleft Lip Palate Craniofac Anomal 2015; 2: 6-10
  CrossrefGoogle Scholar
• 2 Bardach J. Two-flap palatoplasty: Bardach’s technique. Oper Tech Plast Reconstr Surg 1995; 2: 211-4
  CrossrefGoogle Scholar
• 3 Leow AM, Lo LJ. Palatoplasty: evolution and controversies. Chang Gung Med J 2008; 31: 335-45
  PubMedGoogle Scholar
• 4 Trier WC, Dreyer TM. Primary von Langenbeck palatoplasty with levator reconstruction: rationale and technique. Cleft Palate J 1984; 21: 254-62
  PubMedGoogle Scholar
• 5 Paniagua LM, Collares MV, Costa SS. Comparative study of three techniques of palatoplasty in patients with cleft of lip and palate via instrumental and auditory-perceptive evaluations. Int Arch Otorhinolaryngol 2010; 14: 18-31
  Google Scholar
• 6 Furlow Jr LT. Cleft palate repair by double opposing Z-plasty. Plast Reconstr Surg 1986; 78: 724-38
  CrossrefPubMedGoogle Scholar
• 7 Mann RJ, Fisher DM. Bilateral buccal flaps with double opposing Z-plasty for wider palatal clefts. Plast Reconstr Surg 1997; 100: 1139-45
  CrossrefPubMedGoogle Scholar
• 8 LaRossa D, Jackson OH, Kirschner RE. et al. The Children’s Hospital of Philadelphia modification of the Furlow double-opposing Z-palatoplasty: long-term speech and growth results. Clin Plast Surg 2004; 31: 243-9
  CrossrefPubMedGoogle Scholar
• 9 Aboul-Wafa AM. Islandized mucoperiosteal flaps: a versatile technique for closure of a wide palatal cleft. Can J Plast Surg 2012; 20: 173-7
  CrossrefPubMedGoogle Scholar
• 10 Yamaguchi K, Lonic D, Lee CH. et al. Modified Furlow palatoplasty using small double-opposing Z-plasty: surgical technique and outcome. Plast Reconstr Surg 2016; 137: 1825-31
  CrossrefPubMedGoogle Scholar
• 11 Yamaguchi K, Lonic D, Lo LJ. Modified Furlow palatoplasty using small double-opposing Z-plasty for patients with cleft lip and/or palate. Plast Reconstr Surg Glob Open 2016; 4 (9S): 16
  Google Scholar