[Unilateral buccinator myomucosal island flap with double opposing Z-plasty for wider palatal cleft repair].

Objective: To explore a method to repair larger cleft palate and lengthen soft palate without oral palate raw surface and scar formation, reduce the effect on maxilla and dental arch development.

Methods: A modified double opposing Z-plasty was used to lengthen soft palate and the nasal palate was closed by using large turn-over mucoperiosteal flaps on the oral surface of the junction of the hard palate and soft palate, oral raw surface on the palate was closed by a buccal myomucosal island flap.

Results: Thirty-six palates have been repaired by this procedure, all of which had satisfactory results without flap necrosis, infection, difficulties in opening mouth and facial nerve injury except two post-operative fistulas. Eight patients were followed up and all display complete velopharyngeal closure.

Conclusions: Using unilateral buccinator myomucosal island flap with double opposing Z-plasty to repair wider palatal cleft can get a satisfactory soft palate lengthening. At the same time it can avoid bone surface exposing and scar formation; it is a safe and reliable procedure.