Effect of the Release of Nasal Mucosa on Palatal Lengthening During the Repair of Unilateral Complete Cleft Palate

Background: Tension-free closure of the nasal lining is possible in all clefts, provided that the nasal mucosa is appropriately released off the skull base.Aim and objectives: To assess the effect of unilateral full cleft palate repair on velopharyngeal valve function by analyzing the effects of posterior nasal spine-released transverse and longitudinal musculus uvulae and levator veli palatini fibers.Patients and methods: The Plastic Surgery Department at Al-Azhar University Hospitals and the Operation Smile Donation Mission in Egypt conducted this prospective, randomized clinical research. Sixty cleft palate patients (Veau types 2 and 3) were included in the study. The patients were split into two equal groups randomly: the first group underwent radical release of the nasal mucosa, whereas the second group underwent conventional nasal mucosa release.Results: Patients controlled using the radical release technique had an average age of 2.7 ± 1.5 years, while those treated using the standard release technique had an average age of 3.39 ± 1.58 years. Males and females were distributed equally in both groups. There was no association between the type of defect and the improvement of regurgitation in both groups. There were insignificant differences between both groups regarding the improvement in regurgitation. However, regurgitation improved more in the radical dissection group than in the traditional dissection group.Conclusion: The cleft palate may be closed tension-free after a radical release of the nasal mucosa, which reduces the occurrence of velopharyngeal insufficiency.