Primary palatoplasty.

Clefts of the secondary palate, either isolated or accompanying a cleft lip, are characterized by a defect in the palate of varying extent and by abnormal insertion of the levator veli palatini muscles. Repair of the palate should be carried out in one stage, shortly before or after 1 year of age, and should include intravelar veloplasty. The technique of von Langenbeck palatoplasty with intravelar veloplasty has been described. This technique should provide velopharyngeal competency in 80 to 90 per cent of patients with clefts of the secondary palate.