The efficacy of vomer flap for closure of hard palate during primary lip repair. Issue 7 (July 2015)

• Record Type: Journal Article
• Authors: Deshpande, Gaurav; Wendby, Lisa; Jagtap, Rasika; Schönmeyr, Björn
• Is Part Of: Journal of plastic, reconstructive & aesthetic surgery. Volume 68:Issue 7(2015:Jul.)
• Page Start: 940
• Page End: 945
• Publication Date: 2015-07
• Subjects: Surgery, Plastic -- Great Britain -- Periodicals; Reconstructive Surgical Procedures -- Periodicals; Surgery, Plastic -- Great Britain -- Periodicals; 617.9505
• DOI: 10.1016/j.bjps.2015.03.034
• Languages: English
• ISSNs: 1748-6815

Abstract

<abstract xml:lang="en" abstract-type="author" id="abs0010"> <title id="sectitle0010">Summary</title> <sec> <title id="sectitle0015">Background and aim</title> <p id="abspara0010">This study presents the institutional experience of the use of vomer flap for early closure of hard palate during unilateral complete cleft-lip repair. The purpose of this study was to determine the survival rate of the vomer flap and to investigate its effect on the subsequent palatoplasty.</p> </sec> <sec> <title id="sectitle0020">Patients and methods</title> <p id="abspara0015">This retrospective analysis includes 101 non-syndromic patients with complete unilateral cleft lip who received a vomer flap for the closure of the hard palate during cleft-lip repair. Patients were aged 6 months to 28 years (median 1 year). Success rates of the vomer flaps were assessed clinically and through pre-operative photographs taken at the time of subsequent palate repair. Ninety-two patients returned for second-stage palate repair, and 74 patients with adequate post-operative follow-up information were statistically analysed.</p> </sec> <sec> <title id="sectitle0025">Results</title> <p id="abspara0020">Of the 101 patients who were operated with primary lip repair and simultaneous vomer flap, only 54 (52.4%) vomer flaps healed completely. Out of 92 patients who returned for subsequent palatoplasty, 71 (77.2%) were operated with the two-flap technique, and 19 (20.7%) received von Langenbeck repairs. Seven (9.1%) patients had a surgical complication. The failure of previous vomer repair and von Langenbeck surgical technique were identified as factors associated with post-operative complications.</p> </sec> <sec> <title id="sectitle0030">Conclusions</title> <p id="abspara0025">We conclude that failed vomer flaps increased the risks of complications in the subsequent palate repair. Furthermore, efforts to use von Langenbeck technique rather than the two-flap technique also resulted in increased surgical complications. As a result, we have abandoned the use of the vomer flap with primary lip repair.</p> </sec> </abstract>