Repair of the extremely wide hard palate cleft can be done effectively with a double transposition flap. All cases referred for closure of cleft palates from 1997 to 2005 were considered for this study. Of these, 6 were classified as extremely wide cleft palates thought not to be treatable with standard closure techniques. A double transposition flap was used in each case. All patients tolerated the procedure well; no flap failure or dehiscence was noted; and none has required secondary repair. All patients tolerated an appropriate diet following flap repair. Two patients who were gastrostomy tube dependent preoperatively no longer required gastrosotomy tubes postoperatively.
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