الفهرس 
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Abstract
Cleft palate is considered as one of the most frequent congenital abnormalities of the face. Short palates with misoriented musculature is always a problem affecting speech. These considerations have pushed surgeons to modify palatoplasty techniques to get better speech outcomes.
Objectives: To evaluate the use of buccal myomucosal flap combined with Furlow double z plasty technique on lengthening the palate in primary cleft palate repair and to assess changes in maxillary arches after 6 months of surgery.
Materials and methods: Twelve cleft palate patients were done using classical furlow z-plasty operation without suturing the right sided anteriorly based mucosal flap to the edge of the hard palate. This space was further filled with a left posteriorly based buccinator myomucosal flap.
Results: Among 12 patients with an age range of 9-18 months, the palatal lengthening was of a postoperative mean of 30.10 (±1.91) compared to preoperative mean of 22.90 (±2.76).Paired t-test was used showing significant difference of pre and postoperative (P<0.001).
Conclusion: Despite that this technique needs more time and effort in dissecting and suturing, the use of Buccinator myomucosal flap with Furlow z-plasty showed satisfactory and predictable outcome on palatal lengthening. It provides further more attachment by soft pliable tissue to the hard palate making it more mobile.
Keywords: Furlow z-plasty, Buccinator myomucosal, Palatal lengthening