Modified Palatoplasty Method (Busan Modification) for Incomplete Type Cleft Palate

Abstract

To achieve ultimate goals of cleft palate repair, levator muscle's appropriate reapproximation is viewed more importantly as of now, rather than simple palatal lengthening. Authors have developed modified version of 2-flap palatoplasty technique for incomplete type cleft palate and conducted follow-up study, including its early complications, speech evaluation, and facial growth measurement. Of the entire patients receiving a surgery from 2002 to 2012, the authors surveyed consecutive 100 cases of nonsyndromic incomplete cleft palate receiving our modified surgeries, and their early postoperative complication occurrence and the progress were monitored. Of them, the authors performed speech evaluation (n = 36) and facial growth measurement (n = 28) for the patients who the authors could follow-up until at least the age of 4.The medical record review has found no single, early postoperative complication requiring immediate treatment. A total of 10 cases showed delayed wound healing, but 7 of them recovered without a special problem and the other 3 showed residual fistula, recording 3% fistula formation rate. Of the 36 pronunciation evaluation cases, average score was 64.2, reaching almost to the full score of 66, but 1 case with the lowest point was found to need a corrective surgery for the clinical velopharyngeal dysfunction. Cephalometric measurement receiving 28 cases showed sella-nasion-A point angle (SNA) of 82.8° ± 3.4°, sella-nasion-B point angle (SNB) of 78.9° ± 3.9°, and a point-nasion-B point angle (ANB) of 3.9° ± 1.9°. In all range of the measurements, no significant statistical difference was found between normal population at that age and the sample group. The authors consecutively performed this modified method (Busan modification) for patients with incomplete cleft palate and consequentially found a lower rate of early postoperative complications. Moreover, relatively excellent long-term results including speech evaluation score and facial growth outcome were proved during 4 years of postoperative follow-up period.