Buccinator Myomucosal Flap With Furlow Palatoplasty and VPI

Anatomical Restoration Cleft Palate Technique (ARC) for Secondary Velopharyngeal Incompetence Post Cleft Palate Repair

Nasopharyngoscopic examination of the 20 patients with secondary VPI following 2 flap palatoplasty will be done for visualization of the velopharyngeal port, allowing assessment of the pattern and grade of velopharyngeal closure during speech and the presence or absence of a velopharyngeal gap and after VPI repair by Buccinator myomucosal flap with Furlow palatoplasty

Inclusion Criteria:

• 5-6 years old children with previous treated complete cleft palate with 2 flap palatoplasty technique, nonsyndromic.
• lip and palate repair performed by one craniofacial surgeon

Exclusion Criteria:

• Patients with syndromic cleft lip.
• Bilateral cleft lip
• Patient older younger 5 years.
• Associated Cardiac anomalies.
• Any systemic condition