ABSTRACT
Cleft palate repair aims at producing closure of the cleft with reasonably lengthy palate in order to have competent velopharyngeal closure. Various procedures have been described and used for this purpose Primary lengthening of the nasal layer is one of these procedures. The aim of this study is to evaluate two procedures of primary nasal layer lengthening, with or without a turned in buccal flap. The total number of our patients is 36. Twelve patients of our study did not undergo nasal layer lengthening technique and considered as control [group A]. Twenty four patients underwent lengthening of nasal layer technique. In 12 of them [group B] the raw area of nasal layer was covered only by oral layer flaps and 12 cases of them [group C] the raw area of nasal layer was covered by unilateral buccal flap. All patients who had this technique [group B and C] obtained an acceptable lengthening of the palate and it approached the posterior pharyngeal wall. Three patients to whom we used nasal layer lengthening technique without buccal flap developed complications; two fistulas and one case of infection, while patients with nasal layer lengthening with buccal flap and patient without nasal layer lengthening technique showed lower level of complications. Nasal layer lengthening technique is a favorable technique for palatal lengthening in cleft palate repair if accompanied by buccal flap