Abstract
This patient was operated for right-sided unilateral complete cleft palate and developed a fistula, from the soft palate extending anteriorly to the junction of hard and soft palate and dehiscence of uvula and part of the soft palate. Palate length is quite short and muscle movements rae poor. She cannot develop and sustain intraoral pressure to produce consonants and has severe nasal air emission. The voice quality is severely compromised to be of Glottal type with severe type of hypernasality. Patients have developed severe compensatory articulation errors with extreme hypernasality. As per Pakistan Comprehensive Fistula Classification, this patient has fistula adjoining regions: FAR, M4-5, S3, V3, and D2.
Plan of Management: This young girl with a large midline fistula involving M4, and M5, approximately 10x13 mm, has very poor movement of the soft palate (S3, V3). Management plan should be palate re-repair and levator dissection and retro-positioning just anterior to the uvula. As velopharyngeal status is V3, pharyngeal flap should be added to lengthen the palate and improve the speech outcome.
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Fayyaz, G.Q., Mahmood, F. (2022). M4-5 for Palate Re-repair. In: Fayyaz, G.Q. (eds) Surgical Atlas of Cleft Palate and Palatal Fistulae. Springer, Singapore. https://doi.org/10.1007/978-981-15-8124-3_105
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DOI: https://doi.org/10.1007/978-981-15-8124-3_105
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