Summary
A new method of cleft palate repair by expansion of tissue by means of osmotic expanders
implanted in the first stage of treatment is described. Self-expanding expanders manufactured
by OSMED (Ilmenau, Germany) were implanted under the mucoperiosteal layer of the hard
palate, on purpose to generate more tissue and provide facility for palate repair
performed 24–48 h later.
Nineteen children aged from 2 to 3 years were operated from January 2004 to 15 April
2005. In clefts<10 mm, tissue repair was possible without relaxing incisions. In 11 patients with clefts>10 mm, cleft palate repair was more difficult and the outcomes were less favourable.
Despite more generous dissection of the neurovascular bundles and other adjunctive
measures such as mucosal V–Y plasty [Bardach J, Salyer K. Surgical techniques in cleft lip and palate. Chicago, London: Year Book Medical Publishers, Inc.; 1987.] and suturing of the
mucosal grafts at the border of the hard and soft palate, seven 2–4 mm fistulae were noted, however.
Concluding, in spite of some shortcomings and unacceptable rate of fistula in wide
clefts, the above-presented method seems to be an attractive concept. Despite some
technical problems related mostly to still tested optimal filling phase, tissue expansion
makes palate repair easier, probably without relaxing incisions and bone denudation.
Consequently, some adverse effects on facial growth may be reduced. So far, there
is no evidence for it, however, and since this is a preliminary report, there is a
need for longer observations and larger material.
Keywords
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Article info
Publication history
Published online: January 02, 2007
Accepted:
January 1,
2006
Received:
August 30,
2005
Identification
Copyright
© 2007 The British Association of Plastic Surgeons. Published by Elsevier Inc. All rights reserved.
