Mucoperiosteal Flap Necrosis after Primary Palatoplasty in Patients with Cleft Palate.

Dr. Percy Rossell-Perry, MD PhD
Dr. Percy Rossell-Perry, MD PhD
San Martin de Porres University
Plastic Surgery
Lima, LIMA | Peru
Carolina Romero-Narvaez
Carolina Romero-Narvaez
Peru ; San Bartolome Children Hospital

Arch Plast Surg 2017 May 22;44(3):217-222. Epub 2017 May 22.

San Bartolome Mother and Children Hospital, Lima, Peru.

Background: The prevalence of flap necrosis after palatoplasty in patients with cleft palate. The prevalence of mucoperiosteal flap necrosis after palatoplasty remains unknown, and this complication is rare. This event is highly undesirable for both the patient and the surgeon. We present here a new scale to evaluate the degree of hypoplasia of the palate and identify patients with cleft palate at high risk for the development of this complication.

Methods: In this case series, a 20-year retrospective analysis (1994-2014) identified patients from our records (medical records and screening day registries) with nonsyndromic cleft palate who underwent operations at 3 centers. All of these patients underwent operations using 2-flap palatoplasty and also underwent a physical examination with photographs and documentation of the presence of palatal flap necrosis after primary palatoplasty.

Results: Palatal flap necrosis was observed in 4 cases out of 1,174 palatoplasties performed at these centers. The observed prevalence of palatal flap necrosis in these groups was 0.34%.

Conclusions: The prevalence of flap necrosis can be reduced by careful preoperative planning, and prevention is possible. The scale proposed here may help to prevent this complication; however, further studies are necessary to validate its utility.

Download full-text PDF

Source Listing
May 2017
2 Reads

Publication Analysis

Top Keywords

flap necrosis
cleft palate
palatal flap
patients cleft
palatoplasty patients
underwent operations
necrosis palatoplasty
prevalence flap
mucoperiosteal flap
necrosis primary
centers patients
2-flap palatoplasty
patients underwent
palatoplasty underwent
operations 2-flap
physical examination

Similar Publications

Risk factors leading to mucoperiosteal flap necrosis after primary palatoplasty in patents with cleft palate.

J Plast Surg Hand Surg 2017 Oct 13;51(5):348-351. Epub 2017 Jan 13.

e San Bartolome Children Hospital , Lima , Peru.

Background: Few studies have been published reporting risk factors for flap necrosis after primary palatoplasty in patients with cleft palate. This complication is rare, and the event is a disaster for both the patient and the surgeon. This study was performed to explore the associations between different risk factors and the development of flap necrosis after primary palatoplasty in patients with cleft palate. Read More

View Article
October 2017

Speech evaluation after repair of unilateral complete cleft palate using modified 2-flap palatoplasty.

J Craniofac Surg 2009 Jan;20(1):111-4; discussion 115

Department of Plastic Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.

Unlabelled: Two-flap palatoplasty using mucoperiosteal flaps is becoming popular for wide cleft palates. We found that elevation of the cleft-side mucoperiosteal flap was sufficient to close the defect without elevation or relaxing incision in the noncleft side when performing 2-flap palatoplasty for a complete unilateral cleft palate. We have termed this modified 2-flap palatoplasty. Read More

View Article
January 2009

Flap Necrosis after Palatoplasty in Patients with Cleft Palate.

Biomed Res Int 2015 26;2015:516375. Epub 2015 Jul 26.

Post Graduate Studies, School of Medicine, San Martin de Porres University, Lima, Peru ; "Outreach Surgical Center Lima PERU" ReSurge International, Schell Street No. 120 Apartment 1503 Miraflores, Lima, Peru.

Palatal necrosis after palatoplasty in patients with cleft palate is a rare but significant problem encountered by any cleft surgeon. Few studies have addressed this disastrous complication and the prevalence of this problem remains unknown. Failure of a palatal flap may be attributed to different factors like kinking or section of the pedicle, anatomical variations, tension, vascular thrombosis, type of cleft, used surgical technique, surgeon's experience, infection, and malnutrition. Read More

View Article
May 2016

The effect of surgeon experience on velopharyngeal functional outcome following palatoplasty: is there a learning curve?

Plast Reconstr Surg 1998 Oct;102(5):1375-84

Department of Plastic and Reconstructive Surgery, St. Louis Children's Hospital at Washington University School of Medicine, MO 63110, USA.

There is little information in the cleft palate literature concerning the relationship between surgeon volume and clinical outcomes. It is unknown whether such a relationship applies specifically to velopharyngeal dysfunction and the need for secondary physical management of the velopharynx. The purpose of this paper was to explore the concept of an operative learning curve for different surgeons with respect to palatoplasty. Read More

View Article
October 1998