ePlasty: Vol. 17
Palatal Lengthening With Double-Opposing Buccal Flaps for Velopharyngeal Insufficiency
Paige C. Goote, BS,a Nicholas S. Adams, MD,a,b and Robert J. Mann, MDa,b,c

aMichigan State University College of Human Medicine, Grand Rapids, Mich; bGRMEP/Michigan State University Plastic Surgery Residency, Grand Rapids, Mich; and cHelen DeVos Children's Hospital Pediatric Plastic and Craniofacial Surgery, Grand Rapids, Mich

Correspondence: nick.adams@grmep.com
Keywords: palate lengthening, cleft palate, velopharyngeal dysfunction, buccal flap, speech surgery


A 5-year old boy presented to the pediatric plastic surgery clinic for hypernasal speech. He was born with a cleft palate and underwent repair at 11 months of age. A short velum was noted (Fig 1), so he underwent palatal lengthening with double-opposing buccal flaps. Postoperatively, his hypernasality was corrected.

Figure 1. Hard and soft palates of a 5-year-old boy with a history of Furlow double-opposing Z-plasty palatoplasty (dashed line). Note the short palatal length and nonanatomical location of the velum relative to the posterior pharyngeal wall.