Facial Artery Myomucosal Flap Versus Buccinator Flap for Secondary Cleft Palate Repair

Background: Numerous surgical approaches are useful to treat palatal fistulas secondary cleft palate deformities. Regional flaps have been described for secondary reconstruction of cleft palate, so the facial artery musculo mucosal (FAMM) flap and the buccinator myomucosal flap are examples. The aim of this study is to assess the complication rate of 2 different flaps for fistula repair. Methods: This is a retrospective outcome study of a number of patients with secondary cleft palate deformities admitted to our center and operated by a single surgeon using these techniques from 2015 to May 2024. Surgical outcomes followed at least 6 months after secondary cleft palate repair were compared based on physical exam. Multivariate analysis has been used to estimate how the independent variables affect the dependent variables and their relationship. Results: A total of 134 cleft palate patients with palatal fistulas have been operated using the FAMM or buccinator myomucosal flap by a single surgeon (P.R.P.) from 2015 to May 2024. Statistical significant differences were observed regarding the flap necrosis and dehiscence in favor of inferiorly based FAMM flap in this study. No differences about donor site complications and were observed between studied groups. Conclusions: Facial artery musculo mucosal flap is a safer alternative in comparison with the buccinator myomucosal flap for secondary cleft palate repair. Increased rates of flap necrosis and dehiscence have been observed using the buccal flap. The viability of this flap may be affected by the surgical dissection done during primary cleft palate repair.