[Uranostaphytopharyngoplasty using an inferior pedicle (author's transl)].

Treatment of deficiencies of the soft palate is dependent upon its condition, and the plastic surgeon is guided in his therapy by its length and suppleness. This was also the case when, in the past, a prosthesis had to be applied. If it is sufficiently long and supple a simple velopharyngoplasty, followed by phonetic reeducation, has every chance of producing a good result, at least in cooperative children and adolescents. When the soft palate is very shortened, however, a simple velopharyngoplasty does not ensure effective rhinopharyngeal occlusion and lengthening of the soft palate and the palatine mucofibrous tissue must be performed at the same time by means of a uranostaphylopharyngoplasty. In practice, this latter procedure is preferable in the majority of cases. We have used either superior or inferior flaps but over the last 25 years we have preferred the latter type of flap (Rosenthal) which produces better results because: 1) it is retracted laterally to a lesser degree, 2) it is more supple, 3) it is attached below and posteriorly to the soft palate (which permits the pharyngeal constrictor muscles, during contraction, to apply pressure against the lateral borders of the flap, and thus avoid any nasal regurgitation).