title: The square flap method for cleft palate repair.
abstract: OBJECTIVE
  To introduce a new surgical technique for repair of cleft palate using the square flap method.
  
  
  METHODS
  A retrospective analysis of prospectively collected data.
  
  
  METHODS
  The procedure was performed from 1995 to 2004 in 21 males and 16 females with cleft palates of different types; the patients had a median age of 6.0 years and an average age of 9.4 years (range from 22 months to 23 years). In these patients, the square flap method, consisting of one rhombic flap and four triangular flaps, designed on the soft palate across the defect, was applied to the von Langenbeck procedure. After incisions, the flaps were rotated and advanced, and each flap was inserted into the opposite side and then sutured. The patients were followed from 6 months to 2 years, the velopharyngeal closure was examined by nasopharyngeal fiberscope and/ or x-ray radiography, and a clinical speech evaluation was performed.
  
  
  RESULTS
  In all cases, no problem of flap viability was encountered and all healed well. The postoperative results were satisfactory without any complications such as dehiscence, perforation, palatal fistula, or functional disturbance. The velopharyngeal closure and clinical speech evaluation were satisfactory, and the effects of the operation were stable.
  
  
  CONCLUSIONS
  The technique presented has been effective, with the advantages of palatal closure without tension, good muscular reconstruction, and sufficient lengthening of the soft palate.
authors.affiliation: Department of Plastic Surgery, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China.
authors.forename: Jing-Hong
authors.initials: JH
authors.lastname: Xu
authors.forename: Hong
authors.initials: H
authors.lastname: Chen
authors.forename: Wei-Qiang
authors.initials: WQ
authors.lastname: Tan
authors.forename: Jun
authors.initials: J
authors.lastname: Lin
authors.forename: Wei-Hua
authors.initials: WH
authors.lastname: Wu
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D002972:Cleft Palate / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D019647:Oral Surgical Procedures / Q000379:methods*; D010156:Palatal Muscles / Q000601:surgery; D021362:Palate, Hard / Q000601:surgery; D010160:Palate, Soft / Q000502:physiology; D019651:Plastic Surgery Procedures / Q000379:methods*; D012189:Retrospective Studies; D013062:Speech Articulation Tests; D013524:Surgical Flaps