A method of "unilateral operation" for early repair of unilateral complete cleft palate. Preliminary report.

OBJECTIVE This article describes a method of "unilateral operation" and the preliminary results of a group of patients with unilateral complete cleft palate undergoing the operation at early age. DESIGN The "unilateral operation" consists of four relaxation maneuvers. After all of the four maneuvers have been performed on the deformed side of an unilateral complete cleft palate, the deformed side can be moved posteriorly and medially to contact with the normal side. Then the cleft can be closed without tension. RESULTS From 1995 to 1998, 19 cases of unilateral complete cleft palate were repaired with this method at 5-12 months of age. Postoperatively, there were no deaths nor dehiscences. Under the care and guidance of an experienced speech pathologist, 15 of 17 of these children have normal vocal quality at 1-2 years of age. CONCLUSIONS The "unilateral operation" is a rational, adequate, and safe method for early repair of unilateral complete cleft palate. It's design addresses four principles. First, operating only on the deformed side of a unilateral complete cleft palate leaves the normal side unperturbed. Second, complete relaxation of the deformed side is achieved before closing the cleft. Third, in comparison with conventional procedures, which operate on both sides of the palate, this method has the advantage of less surgical trauma, less blood loss, and shorter time of operation. Fourth, all of these advantages are beneficial to early cleft palate repair, which is an important factor in achieving good speech.