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Early Outcomes in Buccal Myomucosal Flaps Versus Buccal Fat Pad Flaps as Adjunctive Techniques in Primary Palatoplasty
Rommy Obeid, BS, Fuad Abbas, BS, Marisa Pavia, MA, CCC-SLP, Mychajlo Kosyk, MD, MPH, Riley Marlar, DO, Antonio Rampazzo, MD, PHD, Bahar Bassiri Gharb, MD, PHD
Cleveland Clinic Foundation
2024-02-01
Presenter: Rommy Obeid, BS
Affidavit:
I certify that all of the work is original work of the author and has not been previously published or presented.
Director Name: Bahar Bassiri Gharb
Author Category: Medical Student
Presentation Category: Clinical
Abstract Category: Craniomaxillofacial
BACKGROUND : Traditionally, adjunctive flaps have been used to repair oronasal fistulas and lengthen the palate as a secondary intervention. In this study, we report our experience in primary palate repair using a combination of buccal myomucosal propeller, buccal myomucosal peninsular, and buccal fat pad flaps in conjunction with straight line and Furlow Z-plasty techniques.
METHODS: An IRB-approved retrospective review was performed of all cleft palate patients who underwent palatoplasty from 2015-2023. Patients were excluded if follow-up was less than 30 days. Age, comorbidities, cleft characteristics, palatoplasty technique, and post-operative outcomes were recorded.
RESULTS: 59 sequential cleft palate repairs were operated on in that time frame. 39 repairs utilized the buccal myomucosal flap (BMMF) and 20 utilized the buccal fat pad flap (BFF). 1 (2.6%) BMMF patient had oronasal fistula formation and 1 (5.0%) BFF flap patient had oronasal fistula formation (p=.567). Both fistulas required surgical intervention. Wound dehiscence resulted in 4 (10.3%) BMMF patients and 1 (5%) BFF patient (p=.444). There was 1 (2.5%) incidence of partial flap loss in the BMMF group and zero in the BFF group (p=.661). There were no incidences of infection, total flap loss, hematoma, seroma, or acute reoperation. Additionally, surgery for lengthening of the palate was required in just 2 BFF patients and 0 BMMF patients.
CONCLUSION: Balancing sufficient palatal length while limiting oronasal fistula incidence can be achieved equally by using either BMMF or BFF adjunctive techniques in primary palatoplasty and have reasonable complication rates as compared to the literature.
