ACADEMIC RESEARCH IN MODERN SCIENCE
International scientific-online conference
169
APPLICATION OF BUCCAL FAT PAD IN WIDE CLEFT PALATE
CLOSURE: FUNCTIONAL AND ANATOMICAL OUTCOMES IN EARLY
CHILDHOOD
Rejamatov T.R.
National Children's Medical Center of Tashkent
https://doi.org/10.5281/zenodo.15261261
Abstract
This study explores the application of the buccal fat pad flap in the surgical
treatment of wide cleft palates in young children. A total of 48 patients aged 10
to 24 months were evaluated, with 24 receiving the buccal fat pad flap and 24
undergoing conventional closure. The technique demonstrated significant
improvement in wound healing and reduction in complications. Oronasal fistula
rates decreased from 41.6% to 12.5%, and scar-related contractures were
observed in only 8.3% of cases with the flap. The buccal fat pad proves to be a
reliable, low-risk method that enhances both anatomical repair and functional
recovery.
Keywords
buccal fat pad, cleft palate repair, oronasal fistula, pediatric surgery, wide
cleft, velopharyngeal function, facial development, scar contracture
Relevance
Wide cleft palate closure in early childhood remains a complex
reconstructive challenge due to the high risk of postoperative complications
such as oronasal fistulas, scar contractures, and impaired maxillary growth.
Traditional palatoplasty techniques often fail to provide sufficient soft tissue
coverage in severe cases, leading to excessive tension and healing issues. The
buccal fat pad flap offers an innovative solution due to its rich vascularity, ease
of harvest, and compatibility with oral mucosa. Despite its growing use in adult
reconstructive surgery, its application in pediatric cleft surgery has received
limited attention. This study addresses this gap by providing a comparative
analysis of outcomes with and without the buccal fat pad in young children.
Improved healing, reduced complication rates, and better functional outcomes
highlight the technique's clinical significance. These results support the broader
integration of the buccal fat pad flap into standard surgical protocols for
managing complex cleft palates in early childhood.
Objective
To evaluate the clinical effectiveness of the buccal fat pad flap in reducing
complications and improving functional and anatomical outcomes in the surgical
repair of wide cleft palates in children under 2 years of age.
ACADEMIC RESEARCH IN MODERN SCIENCE
International scientific-online conference
170
Materials and Methods
The study included 48 pediatric patients (aged 10–24 months) diagnosed
with wide cleft palates. Patients were divided into two equal groups: Group A
(n=24) underwent standard two-layer palatoplasty, while Group B (n=24)
received an additional buccal fat pad flap. Postoperative evaluation included
clinical observation, fistula occurrence, scar assessment, and velopharyngeal
function using nasoendoscopy and speech analysis. Follow-up was conducted
over 12 months. Statistical analysis was performed using SPSS v26.0, applying
chi-square and t-tests to determine significance (p < 0.05). Ethical approval and
informed parental consent were obtained for all cases.
Results
In Group B (with buccal fat pad flap), oronasal fistulas occurred in 12.5% of
cases, compared to 41.6% in Group A (p = 0.01). Scar contractures were present
in 8.3% of Group B, versus 33.3% in Group A. Velopharyngeal function was rated
adequate in 91.6% of Group B, compared to 66.6% in the control group. Healing
of lateral palatal zones was complete in 95.8% of Group B, with partial
dehiscence observed in only 1 patient. No cases of donor site morbidity or
significant bleeding were recorded. These results support the buccal fat pad flap
as a safe and effective method for complex cleft repair.
Conclusion
The buccal fat pad flap significantly improves outcomes in wide cleft palate
closure in children under two years old. The technique reduces the incidence of
fistulas by over 60%, minimizes scar-related complications by 75%, and
promotes more consistent healing across the palatal surface. Functional
improvements, particularly in velopharyngeal competence, support better
speech outcomes. With minimal donor site morbidity and excellent adaptability
to the surgical site, the flap is a valuable adjunct to conventional palatoplasty.
These findings recommend its inclusion in protocols for managing complex
palatal defects during the critical period of craniofacial growth and speech
development.
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