الفهرس 
Historical BackgroundOnly 14 pages are availabe for public view
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Abstract
Cleft palate is one of the most common congenital anomaly of the orofacial structures. Clefting is the fourth most common of all birth defect.
Deep understand of the embryology and anatomy of the palate and physiology of the velopharyngeal sphincter is critical to attain a sound closure that takes both the anatomy and physiology in consideration.
The risk factors of clefting include some genetic and environmental elements such as some drugs and also smoking during pregnancy.
Commonly the cleft palate is associated with cleft lip. Dealing with cleft lip surgically must be considered earlier before the surgical repair of cleft palate.
There are also associated problems with the cleft palate such as feeding difficulty and recurrent otitis media.
The optimal time of repair of the secondary cleft palate deformity presents a challenge to the pediatric plastic surgeons. Some surgeons advocate early cleft repair to enhance speech development and the others believe that early repair will disturb the facial growth.
There is no consensus about the technique of choice to repair the secondary palate. But the most commonly used techniques includes a straight line closure like von Langenbeck technique and Bardach two palatoplasty technique, and a pushback technique of Veau-Wardill-Kilner and double opposing Z-plasty of Furlow.
Also there is a great debate about the staging of repair whether in one stage or in two stage.
Inclusion of some adjuvant techniques like pharyngeal flap and vomerine flap to the primary repair may be required especially with very wide clefts to avoid fistula formation.
The cleft surgery like any other surgery is not devoid of complication. Early complications include airway obstruction, bleeding, wound infection, and wound dehiscence. The late ones include velopharyngeal insufficiency, retarded maxillary growth and fistula formation.
The good results depends on the surgeon’s understanding and view of individual case that allow him to choose the proper time and technique most suitable to the case, also it depends on the harmony between the members of the cleft team.
There is a continuous research and innovation of new techniques and approaches to solve that complex problem such as using distraction osteogenesis and foetal surgery to avoid the complication of the conventional surgery.
Finally, family and community support is of the major importance for the child, as care and understanding will help the child to grow up with sense of confidence that extend beyond the physical defects.