BONE FLAP TECHNIQUE IN CLEFT PALATE SURGERY

The osteoplastic flap technique for exposure of the frontal sinus has been an accepted approach for cases in which obliteration or exploration of the frontal sinus has been necessary. Preservation of vascularized anterior pericranium is credited with reduction of the chances of anterior table bone resorption and subsequent cosmetic deformity. Disadvantages include the need for templates and unpredictable random fracturing in the supraorbital rim area, increasing the chance of potential injury to the periorbita and/or supraorbital neurovascular structures as well as limiting surgical exposure in some cases. Ten patients with chronic frontal sinusitis underwent frontal sinus obliteration using an anterior fable free bone graft technique over a 3 year period. The superior orbital neurovascular pedicles were easily identified and protected within its pericranial sheath in all cases. All patients had precise delineation of the frontal sinus anterior bone flap margins with no need for templates. Bone graft viability was documented in all patients, along with excellent cosmetic results comparable to the osteoplastic flap technique. A review of the literature and description of the technique are presented.

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Bone Flap Technique With Piezosurgery for Impacted Teeth Extraction and Bone Cysts Removal Without Additional Fixation

Journal of Craniofacial Surgery ◽

10.1097/scs.0000000000004913 ◽

2019 ◽

Vol 30 (1) ◽

pp. e21-e24

Author(s):

Hüseyin Akçay ◽

Birkan Tatar ◽

Keremcan Kuru ◽

Özgür Gözlüklü ◽

Murat Ulu

Keyword(s):

Bone Flap ◽

Bone Cysts ◽

Impacted Teeth ◽

Flap Technique ◽

Teeth Extraction ◽

Additional Fixation

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Technical clarification of the bone-flap method in surgery for cleft palate

The American Journal of Surgery ◽

10.1016/0002-9610(59)90176-x ◽

1959 ◽

Vol 98 (6) ◽

pp. 811-815

Author(s):

Sidney K. Wynn

Keyword(s):

Cleft Palate ◽

Bone Flap

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A novel modification of Bardach’s two-flap palatoplasty for the repair of a difficult cleft palate

Archives of Plastic Surgery ◽

10.5999/aps.2020.00416 ◽

2021 ◽

Vol 48 (1) ◽

pp. 75-79

Author(s):

Mohd Altaf Mir ◽

Nishank Manohar ◽

Debarati Chattopadhyay ◽

Sameer S Mahakalkar

Keyword(s):

Cleft Palate ◽

Soft Palate ◽

Surgical Techniques ◽

Fistula Formation ◽

Tension Free ◽

Flap Technique ◽

Oronasal Fistula ◽

Free Closure ◽

Microvascular Tissue Transfer ◽

Difficult Cases

Bardach described a closure of the cleft utilizing the arch of the palate, which provides the length needed for closure and is most effective only in narrow clefts. Herein, we describe a case where we utilized Bardach’s two-flap technique with a vital and easy modification, done to allow closure of a wide cleft palate and to prevent oronasal fistula formation at the junction of the hard and soft palate, which are otherwise difficult to manage with conventional flaps. The closed palate showed healthy healing, palatal lengthening, and no oronasal regurgitation. We advise using this modification to achieve the goals of palatal repair in difficult cases where tension-free closure would otherwise be achieved with more complex flap surgical techniques, such as free microvascular tissue transfer.

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