Single-stage Palatal Lengthening Using Modified Buccinator Myomucosal and Buccal Fat Flaps
Summary:. Surgical treatment of velopharyngeal insufficiency (VPI) after primary palatoplasty poses a difficult challenge in cleft care management. Traditional treatment options have shown improved speech outcomes but oftentimes lead to airway obstruction by constriction of the posterior pharynx. Th...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer
2023-08-01
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| Series: | Plastic and Reconstructive Surgery, Global Open |
| Online Access: | http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000005200 |
| _version_ | 1797732760815665152 |
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| author | Kareem M. Termanini, MD Marina A. Lentskevich, BS Simon Moradian, MD Arun K. Gosain, MD |
| author_facet | Kareem M. Termanini, MD Marina A. Lentskevich, BS Simon Moradian, MD Arun K. Gosain, MD |
| author_sort | Kareem M. Termanini, MD |
| collection | DOAJ |
| description | Summary:. Surgical treatment of velopharyngeal insufficiency (VPI) after primary palatoplasty poses a difficult challenge in cleft care management. Traditional treatment options have shown improved speech outcomes but oftentimes lead to airway obstruction by constriction of the posterior pharynx. The buccinator myomucosal flap is an alternative flap used for VPI correction that re-establishes palatal length and velar sling anatomy by recruiting tissue from the buccal mucosa and buccinator muscle. We present innovative modifications to the original buccinator myomucosal flap by performing the procedure in one stage without a mucosal bridge, incorporating full-thickness buccinator muscle during flap elevation, and placement of bilateral buccal fat flaps. These refinements facilitate wound healing by providing a tension-free closure with both a well-vascularized myomucosal flap and interposed buccal fat flap to prevent scar contracture. Furthermore, no additional surgery is necessary for pedicle division. |
| first_indexed | 2024-03-12T12:19:12Z |
| format | Article |
| id | doaj.art-e43df707687f4bd69197e3876c802a0c |
| institution | Directory Open Access Journal |
| issn | 2169-7574 |
| language | English |
| last_indexed | 2024-03-12T12:19:12Z |
| publishDate | 2023-08-01 |
| publisher | Wolters Kluwer |
| record_format | Article |
| series | Plastic and Reconstructive Surgery, Global Open |
| spelling | doaj.art-e43df707687f4bd69197e3876c802a0c2023-08-30T06:13:50ZengWolters KluwerPlastic and Reconstructive Surgery, Global Open2169-75742023-08-01118e520010.1097/GOX.0000000000005200202308000-00039Single-stage Palatal Lengthening Using Modified Buccinator Myomucosal and Buccal Fat FlapsKareem M. Termanini, MD0Marina A. Lentskevich, BS1Simon Moradian, MD2Arun K. Gosain, MD3From the Division of Plastic Surgery, Ann and Robert H. Lurie Children’s Hospital, Chicago, Ill.From the Division of Plastic Surgery, Ann and Robert H. Lurie Children’s Hospital, Chicago, Ill.From the Division of Plastic Surgery, Ann and Robert H. Lurie Children’s Hospital, Chicago, Ill.From the Division of Plastic Surgery, Ann and Robert H. Lurie Children’s Hospital, Chicago, Ill.Summary:. Surgical treatment of velopharyngeal insufficiency (VPI) after primary palatoplasty poses a difficult challenge in cleft care management. Traditional treatment options have shown improved speech outcomes but oftentimes lead to airway obstruction by constriction of the posterior pharynx. The buccinator myomucosal flap is an alternative flap used for VPI correction that re-establishes palatal length and velar sling anatomy by recruiting tissue from the buccal mucosa and buccinator muscle. We present innovative modifications to the original buccinator myomucosal flap by performing the procedure in one stage without a mucosal bridge, incorporating full-thickness buccinator muscle during flap elevation, and placement of bilateral buccal fat flaps. These refinements facilitate wound healing by providing a tension-free closure with both a well-vascularized myomucosal flap and interposed buccal fat flap to prevent scar contracture. Furthermore, no additional surgery is necessary for pedicle division.http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000005200 |
| spellingShingle | Kareem M. Termanini, MD Marina A. Lentskevich, BS Simon Moradian, MD Arun K. Gosain, MD Single-stage Palatal Lengthening Using Modified Buccinator Myomucosal and Buccal Fat Flaps Plastic and Reconstructive Surgery, Global Open |
| title | Single-stage Palatal Lengthening Using Modified Buccinator Myomucosal and Buccal Fat Flaps |
| title_full | Single-stage Palatal Lengthening Using Modified Buccinator Myomucosal and Buccal Fat Flaps |
| title_fullStr | Single-stage Palatal Lengthening Using Modified Buccinator Myomucosal and Buccal Fat Flaps |
| title_full_unstemmed | Single-stage Palatal Lengthening Using Modified Buccinator Myomucosal and Buccal Fat Flaps |
| title_short | Single-stage Palatal Lengthening Using Modified Buccinator Myomucosal and Buccal Fat Flaps |
| title_sort | single stage palatal lengthening using modified buccinator myomucosal and buccal fat flaps |
| url | http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000005200 |
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