The Two Flap Palatoplasty by Bardach Compared with the Other Methods in Cleft Palate

Lee, Jang Ho; Sohn, Ho Sung; Lee, Keun Cheol; Park, Jung Min; Kim, Seok Kwun

Abstract

The purpose of palatoplasty in cleft palate patient is to close the palatal defect completely and create an adequately functioning velopharyngeal mechanism for normal speech production, and to form normal growth of maxilla. Authors tried to analyze postoperative result in two-flap palatoplasty by Bardach' method in terms of operation time, fistula incidence, speech production. The postoperative analysis was done retrospectively in 131 consecutive nonsyndromic patients with cleft palate repaired by a single operator. The patients suffered from complete cleft palate (99 cases) and incomplete cleft palate (32 cases). The complete cleft palate patients were repaired by Wardill-Kilner method (53 cases) and Bardach method (46 cases). All incomplete cleft palate patient were repaired by Furlow method (32 cases). The age of patients who had cleft repair was 8 to 18 months. Mean age was 11.7 months and mean follow- up period was 21 months. Mean operation time was similar in patients with Wardill-Kilner method, Furlow method, Bardach method. The fistula rate of Bardach method was lower than other methods. Hypernasality test and articulation test were done by speech evaluation table which was consisted of 29 different words. We ascertained the truth of adequate speech production in patients with Bardach method as a results of our study. The 2 flap palatoplasty by Bardach method is not a difficult method compared with other methods. And it can be suggested to close the cleft palate with minimal or no exposure of palatal bone and reduce the fistula incidence. In addition, it can provide adequate production of speech in cleft palate patients.