Palatal Closure in Cleft Lip and Palate Patients

Palatal clefts can be observed as isolated clefts or as a part of uni- or bilateral clefts of lip, alveolus, and palate. The aims of palatoplasty are to improve feeding, to achieve normal speech, to ensure normal middle ear function and hearing, and to minimize maxillary growth restriction. Therefore, repair of the soft and hard palate is of utmost functional importance for the patient. The technique of soft palate closure developed by Sommerlad combines minimal hard palate dissection with radical retropositioning of the velar muscles. Differently from the Sommerlad technique, tensor tenotomy should be avoided. The repair is performed under the operating microscope. For the hard palate closure, different approaches are possible. Langenbeck flaps are common. Concerning speech outcome and maxillary growth, good results can be obtained with different surgical protocols. Literature data suggest that surgical skills may be an important factor in determining success.