Cleft with out fistula but also creation of

  
Cleft Palatal repair create a proper oropharyngeal physiological functions,
such as middle ear pressure regulation, development of speech and prevent
recurrent chest infection.

   
The purpose of the cleft palate repair is not only palatal defect
closure with out fistula but also creation of a physiologically well
functioning vellopharyngeal apparatus that permits adequate velopharyngeal
functions and development of normal speech quality.

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  Velopharyngeal closure is achieved by
tension in the velum and its elevation toward the pharyngeal wall that moves
toward the rising velum and diminishes the lumen of the velopharynx. In cleft
palate and secondary velopharyngeal incompetence, the velopharynx is partial or
totally abnormal in morphology and in muscular structure and function. (1)
companied palatoplasty with paharyngeoplasty 
for cleft palate repair with dynamic vellopharengeal function resulted
from proper muscular repair procedures has been reported in many literature.

(2)

   
1861 Von Langenbeck, described his technique for cleft palate repair.Then
Billroth thought that fracturing the ptyrigoid hamulus would improve the
outcomes of cleft palate repair at 1868.

 
 In 1937, Kilner and Wardill
described the V-Y repositioning technique for repair of incomplete clefts or
cleft of secondary palate. (3) Furlow, in 1986, described a
double-reverse Z-plasty technique to close palatal defect and elongate the soft
palate. (4)

 

 Von Langenbeck principle was the base for all
the modification of cleft palate repair. All this modification was trying to
reduce post operative fistula and optimizing the the vellopharyngeal
physiological functions. 

This study aims to evaluate the
results of correction of cleft palate with palatal muscles reconstruction.