The single Z-plasty for cleft palate repair: a preliminary report.
OBJECTIVE
To introduce a surgical technique for the repair of cleft palate with the single and full-thickness Z-plasty method.


METHODS
The procedure was performed from 1999 to 2006 in 34 patients with cleft palate with a median age of 6.0 years (range, 2.0 to 21 years). In these patients, in order to push the soft palate back farther, a single and full-thickness Z-plasty, designed on the soft palate across the defect, was applied to the von Langenbeck procedure. The full thickness of the soft palate was incised after the hard palate was closed by suturing the two mucoperiosteal flaps, and two Z-plasty flaps were formed. The two flaps were then transposed and closed by interrupted suturing of three layers of the palate in proper order, from nasal mucosa, levator muscle to oral mucosa. The patients were followed for 6 months to 3 years, velopharyngeal closure was examined by nasopharyngeal fiberscope and/or x-ray radiography, and a clinical speech evaluation was performed.


RESULTS
In all patients, no problem of flap viability was encountered and all healed well. The postoperative results were satisfactory without any complications such as dehiscence, perforation, or palatal fistula. The clinical speech evaluation was satisfactory, and the effects of the operation were stable.


CONCLUSIONS
The technique presented has been effective, having the advantages of palatal closure without tension and with sufficient lengthening of the soft palate.
Department of Plastic Surgery, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, People's Republic of China.
Wei-Qiang
WQ
Tan
Jing-Hong
JH
Xu
Jian-Min
JM
Yao
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D002972:Cleft Palate / Q000601:surgery*; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D019647:Oral Surgical Procedures / Q000379:methods*; D013524:Surgical Flaps; D016896:Treatment Outcome; D055815:Young Adult