Use of the Bozola`s buccal flap for the reconstruction of residual palate defects in children

Background. Cleft lip and palate are common congenital anomalies. Modern surgical modalities do not exclude complications. Residual palate defects (RPDs) are severe complications of primary cleft palate repair affecting the quality of life of patients. Purpose – to evaluate the effectiveness of surgical treatment of children with RPDs using a buccal myomucosal flap in combination with the formation of the nasal layer with local tissues in the RPD area. Materials and Methods. Surgical treatment was provided to 5 patients aged 5 to 16 years with RPDs after primary uranoplasty. The surgical procedure was performed using a buccinator myomucosal flap based on the buccal branch of the internal maxillary artery. The nasal layer was restored with marginal myomucosal flaps placed on the defect cavity like a «turn-off flap». Treatment outcomes were assessed taking into account the multipurposeness of the method, the reliability of flap engraftment, and the restoration of functional disorders. Results. Surgical treatment of RPDs using a buccal myomucosal flap in combination with the proposed operative procedures for reproducing the nasal layer in the defect area is general and leads to the elimination of the palate defect, normalization of the length, and mobility of the soft palate. Conclusions. The formation of a nasal layer during the surgical treatment of RPDs in children optimizes the wound process by separating the nasal and oral cavities. The buccal myomucosal flap is a reliable graft. The combination of the proposed surgical techniques for the reconstruction of RPDs in children provides a reliable treatment outcome and improves the quality of life of patients. This method emphasizes the effectiveness of the combination of surgical techniques in the treatment of RPDs in children.