Flashcards on Cleft Palate: Embryology, Surgery, and Care
Cleft Palate: Embryology, Surgery, and Care for Students
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Cleft Palate Surgical Techniques
33 cards
Card 1
Question: What is the principle behind Furlow's double opposing Z-plasty for soft palate closure?
Answer: Two opposing Z-plasties are made on the oral and nasal surfaces with the central limb at the cleft margin; posteriorly based flaps include the levator
Card 2
Question: Why is the posteriorly based oral flap recommended to be on the left for a right-handed surgeon in Furlow's technique?
Answer: Because elevation of the levator muscle from the nasal mucosa is the most difficult part of the dissection, and a left posteriorly based oral flap is
Card 3
Question: What is a theoretical disadvantage of Furlow's technique?
Answer: It is nonanatomic because it completely ignores the small longitudinal uvular muscle.
Card 4
Question: What modification do some surgeons add to Furlow's technique when relaxing incisions are necessary?
Answer: Furlow described using relaxing incisions; one authors' preference is combining double opposing Z-plasty of the soft palate with a two-flap hard palat
Card 5
Question: What problem can arise when using Z-plasty in very wide clefts and what is one solution?
Answer: The distance to be traversed by the Z-plasty may be excessive; one solution is to design an island flap by joining the anteriorly based oral flap to t
Card 6
Question: Name two alternative strategies for wide clefts when Z-plasty mobility is insufficient.
Answer: 1) Extend the relaxing incision along the lateral border of the soft palate and use acellular dermal matrix for nasal defects. 2) Use straight-line cl
Card 7
Question: What is the two-stage palate repair approach and why was it proposed?
Answer: A two-stage approach repairs the soft palate early and the hard palate later; it was proposed to address concerns about adverse effects of palate repa
Card 8
Question: What is the two-flap palatoplasty (Langenbeck-type) sequence of steps for hard palate closure as described?
Answer: Incisions meet the cleft margin just behind the alveolar ridge; mucoperiosteal flaps are developed bilaterally preserving greater palatine vessels; le
Card 9
Question: What technical difficulty is noted when dissecting oral versus nasal mucosa over the levator muscle, and what tool was described to reduce injury?
Answer: Nasal mucosa adheres to the muscle making dissection difficult and prone to perforation; Sommerlad described using the operating microscope to reduce
Card 10
Question: What step is performed near the hamulus during levator muscle release in palatoplasty?
Answer: The tensor tendon is released just medial to the hamulus.