International Journal of Oral and Maxillofacial Surgery
Technical NoteCongenital Craniofacial AnomaliesReconstruction of the palatal aponeurosis with autogenous fascia lata in secondary radical intravelar veloplasty: a new method
Section snippets
Surgical procedures
In cleft palate patients the tensor-aponeurosis is missing1. In residual muscular deformity after primary repair with minimal or no muscle dissection, the sagittally oriented muscles are often attached to the palatal bones and do not create muscular slings (Fig. 2a and b). In secondary IVV, the muscles are detached from the palatal bones, dissected from the oral and nasal mucosa, and positioned backwards. The muscular slings of the soft palate are then reconstituted, in particular the slings of
Case report
Owing to severe VPI, a 9-year-old boy with unilateral cleft lip palate deformity was treated by secondary radical IVV and reconstruction of the dead space with fascia lata. (Fig. 3e–h) Preoperatively, the nasendoscopic view indicates severe muscular deformity characterized by a large groove in the middle of the nasal surface of the velum. During phonation (/k/ in “Coca-Cola”), velar movement was minimal and no velopharyngeal closure could be achieved. Eighteen months postoperatively,
Discussion
Radical IVV with backward positioning of the palatal muscles results in a dead space between the retro-displaced musculature and the posterior borders of the palatal bones. There have been attempts to treat this dead space in order to occlude it and to keep the muscles in a posterior position. Mattress suturing has been proposed as a treatment option9, but proper reconstruction of the tensor-aponeurosis is not possible with this procedure.
The idea of reconstructing the tensor-aponeurosis is not
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The use of a biostatic fascia lata thigh allograft as a scaffold for autologous human culture of fibroblasts - An in vitro study
2015, Annals of AnatomyCitation Excerpt :The tissue has been used in various areas of medicine since the 1970s (Coulam et al., 1973; Davidorf et al., 1974; Hinton et al., 1992; Ionescu et al., 1972). In maxillo-facial surgery Smolka et al. used autogenous thigh fascia lata to reconstruct the palatal aponeurosis in secondary radical intravelar veloplasty (Smolka et al., 2008). However, this procedure required a second surgical site.
Physical properties of Scarpa's fascia
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