Bilateral Islanded Propeller Mucoperiosteal Flap Closure: A New Approach to Wide Cleft Palates

Abstract

Objective

To assess the effectiveness of a novel surgical technique, the bilateral islanded propeller mucoperiosteal flap closure, in managing wide cleft palates while integrating established surgical methods.

Design

This study included six pediatric patients with wide cleft palate who underwent surgery using this novel technique, performed by the senior author between 2022 and 2023 at a center in Eastern India. Patients were monitored for two years to evaluate surgical site-related complications and speech outcomes through both subjective and objective assessments.

Main Outcome Measure

To determine the reliability of this technique in preventing postoperative fistula formation while promoting optimal speech outcomes.

Results

Six pediatric patients underwent corrective surgery for wide cleft palate between the ages of 6 and 12 months. No postoperative complications, such as bleeding, wound dehiscence, hanging palate, or flap necrosis, were observed either immediately after surgery or at the three-week follow-up. At the two-year follow-up, there were no signs of fistula formation at the junction of the hard and soft palate or nasal regurgitation during feeding. Speech function was assessed at regular intervals using classical lateral radiographs at rest and during speech. All patients demonstrated unrestricted soft palate motion with minimal scarring.

Conclusion

The Bilateral Islanded Propeller Mucoperiosteal Flap Closure is an innovative and adaptable technique for addressing wide palatal defects. It simplifies surgical management, minimizes scarring, and enhances soft palate length and width. When performed at the appropriate stage, this method effectively preserves speech function.