Use of early hard palate closure using a vomer flap in cleft lip and palate patients.
OBJECTIVE
The aim of the present study was to determine the influence of the vomer flap during cleft palate closure.


METHODS
A retrospective review was performed of all consecutive unilateral/bilateral complete cleft lip and palate (Veau III en IV) children who were treated by a simultaneous lip and hard palate closure using a vomer flap. Data were collected for sex, date of birth, syndrome, adoption, cleft palate type, type of repair, date of cleft repair, cleft width, lateral incisions, fistula and location of fistula.


RESULTS
Ninety-one children (M = 62, F 29) were operated. Mean age at time of lip closure and vomer flap was 5.8 months (range 2.9 months to 49.2 months, SD 7.1) and the mean age at palate closure was 13.6 months (range 6.3 months to 79.9 months, SD 10.8). The mean cleft width at first assessment was 13.0 mm (range 7-22 mm) compared to 8.8 mm (range 4-15 mm) at second assessment (mean difference 4.6 mm, 95% CI 3.93-5.35, p < 0.01). One patient developed a fistula (1.1%) and required secondary surgery for closure.


CONCLUSIONS
The vomer flap leads to a substantial decrease in cleft width, subsequently leading to a low fistula incidence (1.1%).
Division of Pediatric Plastic Surgery, Wilhelmina Children's Hospital, Utrecht, The Netherlands. Electronic address: bja.smarius@gmail.com.
Bram J A
BJ
Smarius
Division of Pediatric Plastic Surgery, Wilhelmina Children's Hospital, Utrecht, The Netherlands; Division of Plastic Surgery Meander Medical Center, 3813 TZ Amersfoort, The Netherlands. Electronic address: c.c.breugem@umcu.nl.
Corstiaan C
CC
Breugem
D002648:Child; D002675:Child, Preschool; D002971:Cleft Lip / Q000601:surgery*; D002972:Cleft Palate / Q000601:surgery*; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D019647:Oral Surgical Procedures / Q000379:methods*; D021362:Palate, Hard / Q000601:surgery*; D019651:Plastic Surgery Procedures / Q000379:methods; D012189:Retrospective Studies; D013524:Surgical Flaps; D055172:Vomer / Q000637:transplantation*
Cleft width; Early hard palate closure; Releasing incisions; UCLP; Vomer flap