Abstract:
The
reconstructions
of
the
asymmetrical
soft
palate
cleft
is
a
surgical challenge
when
it
comes
to
achieving
symmetry
and
optimal
soft
palate
muscular function.
Three
different
versions
of
the
intravelar
veloplasty
have
been
used:
the intravelar
veloplasty
(1969)
(type
I),
the
modification
according
to
anatomical defects
(1991)
(type
II),
and
the
modification
using
part
of
Sommerlad’s
technique and
part
of
Ivanov’s
technique
(2008)
(type
III).
The
perioperative
outcomes
of
the type
II
and
type
III
intravelar
veloplasty
were
assessed
and
compared
in asymmetrical
cleft
cases.
Two
hundred
and
seventy-seven
soft
palate
clefts
were reconstructed:
153
type
II
and
124
type
III.
Of
these,
49
were
asymmetrical
(17.7%); 23
underwent
the
type
II
procedure
and
26
the
type
III
procedure.
Of
the
type
II procedure
cases,
30.4%
remained
asymmetrical
postoperatively
compared
to
3.8%of
the
type
III
cases.
The
uvula
appeared
subjectively
atrophic
in
47.8%
of
the
type II
cases
and
in
7.7%
of
type
III
cases.
Oro-nasal
fistula
occurred
in
13.0%
of
the
type II
cases
and
3.8%
of
the
type
III
cases.
Speech
results
will
only
be
assessed
after
4 years
of
age.
The
type
III
modified
intravelar
veloplasty
has
had
a
major
beneficial impact
on
patients
who
had
an
asymmetrical
soft
palate
cleft.
