Thesis (M.Sc.) - Cairo University - Faculty of Oral and Dental Medicine - Department of Oral and Maxillofacial Surgery

Aim: To evaluate the efficacy of using the cleft margin flap (L-flap) in closing the naso-alveolar defect at the time of primary cleft lip repair by modified Millard technique, with simultaneous closure of the anterior palate using Vomerine flap. Methodology: Twenty-four patients, with ages ranging from 3 to 6 months, with non-syndromic unilateral complete cleft lip and palate, were operated on by incorporation of the marginal lateral mucosal flap (L-flap) which is usually discarded during primary cleft lip repair by modified Millard technique together with the anterior palatal closure using Vomerine flap (VF). The L-flap was designed to be gingivally based, then transposed through the alveolar gap and sutured to the anterior end of the Vomerine flap. Arabic written informed consents were obtained from all of the patient's parents Results: Decreased incidence of naso-alveolar fistula formation has been showed. Conclusion:The introduced method is reliable and effective, with a high success rate in minimizing the naso-alveolar fistula incidence at an early stage which is of utmost importance to the patient and to the surgeon at the same time

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