• Meizhen Gu, Xiuchang Huang, Hongming Xu, Fang Chen, Yugang Jiang, and Xiaoyan Li.
• Department of Otorhinolaryngology-Head and Neck Surgery, Children's Hospital of Shanghai Jiaotong University.
• Medicine (Baltimore). 2019 Nov 1; 98 (47): e17958e17958.

Study Designclinical results of A STROBE-compliant retrospective study OBJECTIVE:: To achieving adequate pharyngeal closure and improve the pharyngeal function by a modified two-flap palatoplasty.Summary Of BackgroundExcessive tension in soft palate is the main factor causing the dysphonia after cleft palate. The tension-free suture of the soft palate is the key to achieving adequate pharyngeal closure. In this paper, a modified two-flap palatoplasty improved the pharyngeal function METHODS:: From August 2016 to December 2017, 20 patients with cleft palate were treated with a modified two-flap palatoplasty of the posterolateral symmetrical mucosal relaxation incision. The mucosal relaxation incision was performed on both posterolateral sides of the soft palate.ResultsAll cases had good healing of mucosal flap and the palate. All patients underwent endoscopic examination at 6 months after operation. The postoperative results were satisfactory, with no complications. Twelve patients had bilateral exudative otitis media before operation, 4 patients returned to normal postoperatively, and 8 patients underwent bilateral tympanic membrane catheterization; 2 patients had abnormal function of bilateral eustachian tube before operation and returned to normal postoperatively; 3 patients had unilateral exudative otitis media before operation, and all of them returned to normal; the acoustic impedance test was normal in 3 children before operation. Most children begin to learn to speak, parents are satisfied with their pronunciation, and 3 children are in speech rehabilitation due to unclear pronunciation.ConclusionsWe propose a technique to improve the function of the velopharyngeal closure which effectively reduces the incidence of pharyngeal insufficiency and occurrence of operative correction of pharyngeal closure dysfunction. The modifed two-flap palatoplasty with posterior lateral symmetric mucosal relaxation incision is beneficial for better velopharyngeal closure.

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