A case of cleft palate in a child treated by free buccal mucosa grafting to cover the raw surface of the base of a pharyngeal flap

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  • NAKANO Yoko
    The Second Department of Oral and Maxillofacial Surgery, Tokyo Dental College
  • NAKASHIMA Hideno
    The Second Department of Oral and Maxillofacial Surgery, Tokyo Dental College
  • IKUMOTO Hideyuki
    The Second Department of Oral and Maxillofacial Surgery, Tokyo Dental College
  • MOTOHASHI Yoshiko
    The Second Department of Oral and Maxillofacial Surgery, Tokyo Dental College
  • WATANABE Hajime
    Oral and Maxillofacial Surgery, Soushinkai Mitsuwadai General Hospital Department of Dentistry
  • UCHIYAMA Takeshi
    The Second Department of Oral and Maxillofacial Surgery, Tokyo Dental College

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  • 咽頭弁基部ｒａｗ　ｓｕｒｆａｃｅの被覆に遊離頬粘膜移植を応用した口蓋裂児の１例
  • ショウレイ ホウコク イントウベン キブ raw surface ノ ヒフク ニ ユウリ ホオ ネンマク イショク オ オウヨウ シタ コウガイレツジ ノ 1レイ

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Abstract

We report a case of cleft palate in a child whose speech was improved by covering the raw surface of the base of a pharyngeal flap with a free buccal mucosal graft.<BR>A 2-year-8-month-old girl with cleft palate was brought to our clinic because of speech disorders. She had undergone palatoplasty at 1 year of age, but the surgery resulted in wound dehiscence. Therefore, she underwent reoperation at 1 year 6 months. The scar on the palate was remarkable, and we observed a defect encompassing a wide area of the soft palate. There was no detectable movement of the soft palate during phonation. The distance from the edge of the palate to the posterior pharyngeal wall was lomm and remarkably wide.<BR>We planned superior-based pharyngeal flap surgery combined with re-pushback at 4 years 6 months of age, but the raw surface of the pharyngeal flap was too wide. It was impossible to cover this area with tissue from the soft palate or pharynx. Therefore, we grafted free buccal mucous membrane to this area to prevent scar contraction.<BR>Preoperatively, we recognized glottal explosive sounds in all consonants and severe hypernasality, but after 4 years she has acquired almost normal articulation.

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