title: Radical Dissection of Greater Palatine Artery and Dynamic Reconstruction of Cleft Palate.
abstract: BACKGROUND
  Restoration of proper anatomy and physiology is an integral part of cleft palate repair. The senior author has devised a new technique of radical release of greater palatine vessels, which helps in achieving tension-free closure of palatal cleft. In addition, release and transposition of palatal muscles is performed without the use of operative microscope, resulting in improved palatal function. This technique is applicable to all types of clefts of the palate and can be performed on adult patients as well.
  
  
  METHODS
  This is a retrospective case series of cleft palate repairs performed over a period of 3 years. Single-stage repair with modified Bardach's technique for complete cleft palate and von Langenbeck's technique for incomplete cleft palate with radical release of greater palatine vessels and levator complex retropositioning was performed. The outcome measures were closure of palatal defect and speech production. A follow-up of at least 6 months was completed in each patient.
  
  
  RESULTS
  A total of 1568 patients were included in the study. Their age ranged from 9 months to 54 years. The overall fistula rate was 6.1%. Improvement of speech was observed even in adult patients.
  
  
  CONCLUSIONS
  Radical release of greater palatine artery and levator complex transposition can dramatically improve results of cleft palate repair. This technique helps in dynamic reconstruction of cleft palate and can be effectively applied in all age groups.
authors.affiliation: Services Institute of Medical Sciences, Lahore, Pakistan; Clapp Hospital, Lahore, Pakistan; Sailer Clinic, Zurich, Switzerland; and Dow University of Health Sciences, Karachi, Pakistan.
authors.forename: Ghulam Qadir
authors.initials: GQ
authors.lastname: Fayyaz
authors.affiliation: Services Institute of Medical Sciences, Lahore, Pakistan; Clapp Hospital, Lahore, Pakistan; Sailer Clinic, Zurich, Switzerland; and Dow University of Health Sciences, Karachi, Pakistan.
authors.forename: Nauman Ahmad
authors.initials: NA
authors.lastname: Gill
authors.affiliation: Services Institute of Medical Sciences, Lahore, Pakistan; Clapp Hospital, Lahore, Pakistan; Sailer Clinic, Zurich, Switzerland; and Dow University of Health Sciences, Karachi, Pakistan.
authors.forename: Ayesha
authors.initials: A
authors.lastname: Chaudry
authors.affiliation: Services Institute of Medical Sciences, Lahore, Pakistan; Clapp Hospital, Lahore, Pakistan; Sailer Clinic, Zurich, Switzerland; and Dow University of Health Sciences, Karachi, Pakistan.
authors.forename: Irfan
authors.initials: I
authors.lastname: Ishaq
authors.affiliation: Services Institute of Medical Sciences, Lahore, Pakistan; Clapp Hospital, Lahore, Pakistan; Sailer Clinic, Zurich, Switzerland; and Dow University of Health Sciences, Karachi, Pakistan.
authors.forename: Muhammad
authors.initials: M
authors.lastname: Aslam
authors.affiliation: Services Institute of Medical Sciences, Lahore, Pakistan; Clapp Hospital, Lahore, Pakistan; Sailer Clinic, Zurich, Switzerland; and Dow University of Health Sciences, Karachi, Pakistan.
authors.forename: Romaisa
authors.initials: R
authors.lastname: Shamim
authors.affiliation: Services Institute of Medical Sciences, Lahore, Pakistan; Clapp Hospital, Lahore, Pakistan; Sailer Clinic, Zurich, Switzerland; and Dow University of Health Sciences, Karachi, Pakistan.
authors.forename: Mirza Muhammad
authors.initials: MM
authors.lastname: Kafeel
authors.affiliation: Services Institute of Medical Sciences, Lahore, Pakistan; Clapp Hospital, Lahore, Pakistan; Sailer Clinic, Zurich, Switzerland; and Dow University of Health Sciences, Karachi, Pakistan.
authors.forename: Muhammad
authors.initials: M
authors.lastname: Aazam
authors.affiliation: Services Institute of Medical Sciences, Lahore, Pakistan; Clapp Hospital, Lahore, Pakistan; Sailer Clinic, Zurich, Switzerland; and Dow University of Health Sciences, Karachi, Pakistan.
authors.forename: Hermann
authors.initials: H
authors.lastname: Sailer
authors.affiliation: Services Institute of Medical Sciences, Lahore, Pakistan; Clapp Hospital, Lahore, Pakistan; Sailer Clinic, Zurich, Switzerland; and Dow University of Health Sciences, Karachi, Pakistan.
authors.forename: Muhammad Ashraf
authors.initials: MA
authors.lastname: Ganatra