title: Two-flap palatoplasty: description of the surgical technique and reporting of results at a single center.
abstract: Two-flap palatoplasty is commonly used to treat cleft palate defects, but only a few reports on outcomes have been published in the literature. We conducted a retrospective analysis of 257 cases of cleft palate treated with two-flap palatoplasty at a single center in Greece over a 13-year period. Our outcomes data included surgical complication rates, the results of speech assessments, midface development, and other parameters. We found a low rate of short- and long-term complications that required revision surgery, such as symptomatic fistula (5.4%) and velopharyngeal insufficiency (5.3%). Speech outcomes in relation to intelligibility, hypernasality, and nasal emissions were satisfactory in 70 to 86% of patients. Dental arch relationships, as estimated by the 5-Year-Olds Index, were judged to be either good or excellent in 62% of those evaluated. A considerable proportion of patients (45%) who had otitis media with effusion experienced a spontaneous resolution without the use of tympanostomy tubes 2 to 8 months after their operation. We conclude that two-flap palatoplasty is an effective procedure that warrants further attention. We describe the surgical technique in detail. Our technique includes a modified intravelar veloplasty that incorporates near-total muscle retropositioning.
authors.affiliation: Center for Craniofacial Anomalies, Department of Otolaryngology-Head and Neck Surgery, Aghia Sophia Children's Hospital, Athens, Greece.
authors.forename: Emmanouel
authors.initials: E
authors.lastname: Koudoumnakis
authors.forename: Ioannis M
authors.initials: IM
authors.lastname: Vlastos
authors.forename: Kostas
authors.initials: K
authors.lastname: Parpounas
authors.forename: Michael
authors.initials: M
authors.lastname: Houlakis
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D002972:Cleft Palate / Q000601:surgery*; D006801:Humans; D056948:Orthognathic Surgical Procedures / Q000379:methods*; D013524:Surgical Flaps; D016896:Treatment Outcome