From Plastic and Cleft-Craniofacial Surgery, A&D DermePlastique; and Department of Plastic and Reconstructive Surgery, the Craniofacial Research Center, Chang Gung Memorial Hospital, Chang Gung University.
Plast Reconstr Surg. 2022 Jan 1;149(1):197-201. doi: 10.1097/PRS.0000000000008648.
Encouraging results have been described for the use of pedicled buccal fat pad flap in primary cleft palate repair. This retrospective study describes the surgical technique and early results of a technical innovation utilizing the split buccal fat flaps in modified Furlow palatoplasty with small double-opposing Z-plasty. This technique introduces buccal fat tissue for coverage of lateral denuded palate surfaces to reduce the bone exposure and scar formation to potentially attenuate maxillary growth interference and for reinforcement of the palatal areas of high tension or with incomplete closure to decrease the risk of postoperative dehiscence and oronasal fistula formation. Consecutive nonsyndromic patients (n = 56) with cleft palate were treated with this method, all of whom demonstrated fast mucosalization of lateral palatal recipient regions within 3 weeks postoperatively and showed no fistula with 12 months' follow-up. Of 19 patients (33.9 percent) who underwent auditory-perceptual assessment, 15 (78.9 percent) had normal resonance. Surgeons could add this alternative surgical maneuver to their armamentarium during the primary palatoplasty, in which coverage of lateral surfaces and reinforcement with fat tissue in the anterior soft palate space are of paramount relevance.
CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.
带蒂颊脂垫瓣在初次腭裂修复中已取得令人鼓舞的效果。本回顾性研究描述了一项技术创新的手术技术和早期结果，该技术创新在改良 Furlow 腭裂修补术中使用了分裂颊脂瓣，并结合小双反对 Z 成形术。该技术引入颊脂组织覆盖外侧裸露的腭表面，以减少骨暴露和瘢痕形成，从而潜在地减轻上颌生长干扰，并加强高张力或不完全闭合的腭区，以降低术后裂开和口鼻瘘形成的风险。采用这种方法治疗了 56 例连续的非综合征腭裂患者，所有患者术后 3 周内均快速实现了外侧腭受区的黏膜化，12 个月随访时无瘘管形成。在接受听觉感知评估的 19 名患者中（33.9%），15 名（78.9%）患者的共振正常。外科医生可以在初次腭裂修复术中增加这种替代手术操作，在该手术中，覆盖外侧表面和在前软腭空间用脂肪组织加强至关重要。
临床问题/证据水平：治疗，IV。
