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Pharyngeal flaps after one- and two-stage repair of the cleft palate: a 25-year review of 520 patients Vedung SCleft Palate Craniofac J 1995[May]; 32 (3): 206-15; discussion 215-6Between 1962 and 1976, a one-stage surgical procedure was performed on 328 cases of cleft lip and palate or isolated cleft palate. From 1977 to 1986, a two-stage surgical procedure was performed on 192 patients. After one-stage repair, 22 (6.7%) required a pharyngeal flap at the age of 6 years, and 13 (7%) required a flap after two-stage repair. When the patients were 14 years or older, 56 (17%) needed a flap after one-stage repair, and 14 (24%) required a flap after two-stage repair. Two-stage repair at 24 months and 5.2 years resulted in more patients in need of pharyngeal flaps than those who had repair at 12 to 18 months and 3 years. In both groups, at age 10, the incidence of flaps was approximately 20% after closure of isolated cleft palate involving the hard palate, with 11 to 12% in patients with unilateral cleft lip and palate (UCLP) or clefts of the soft palate only, and 14 to 16% in patients with bilateral cleft lip and palate (BCLP). The pharyngeal flap was more often used in girls than in boys, especially in cases with CP only. Approximately 85% of the flaps were carried out before the age of 10 years, and only a few flaps may have been related to involution of the adenoid. The incidence of fistulas was higher after one-stage repair of cleft lip and palate (CLP) (p < .05) and lower in patients with CP only (p < .05), compared with the results after two-stage repair. Pharyngeal flaps were slightly more common after two-stage repair.(ABSTRACT TRUNCATED AT 250 WORDS)|Adolescent[MESH]|Age Factors[MESH]|Chi-Square Distribution[MESH]|Child[MESH]|Child, Preschool[MESH]|Cleft Lip/*surgery[MESH]|Cleft Palate/complications/*surgery[MESH]|Female[MESH]|Humans[MESH]|Male[MESH]|Outcome and Process Assessment, Health Care[MESH]|Palate, Soft/surgery[MESH]|Reoperation[MESH]|Retrospective Studies[MESH]|Surgery, Oral/*methods[MESH]|Surgical Flaps/*methods[MESH]|Time Factors[MESH]|Velopharyngeal Insufficiency/etiology/surgery[MESH] |
