Mucoperiosteal Flap Necrosis After Primary Palatoplasty in Patients with Cleft Palate

Rossell-Perry P. · Surgical Atlas of Cleft Palate and Palatal Fistulae (2022) · DOI: 10.1007/978-981-15-8124-3_91

Resumen

Cleft palate is a common congenital defect affecting about one in every 700 children annually. This malformation impairs speech, feeding, hearing, and oral hygiene, requiring early surgical correction. Early cleft palate repair (around one year) is indicated and different protocols have been proposed. Different complications have been described in association with primary palatoplasty. Most common complications are bleeding, wound dehiscence, palatal fistula, velopharyngeal insufficiency, and maxillary hypoplasia. Mucoperiosteal flap necrosis after primary cleft palatoplasty is a rare but significant problem with sequels difficult to be corrected in comparison with common complications. The focus of this chapter is on the specifics of palatal flap necrosis description, including etiology, diagnosis, and management of this severe complication. A surgical protocol named as Lima protocol for primary cleft palate repair, based on personal cleft palate classification of severity and individualized surgical management, is presented in this chapter. This protocol has been designed to prevent this type of complication. The chapter is based on our 25 years’ experience in Peru caring for children with clefts in both an urban comprehensive cleft center and regular outreach programs. © Springer Nature Singapore Pte Ltd. 2022. All rights reserved.