A new folded pharyngeal flap. Preliminary report.

In an attempt to minimize postoperative scar contracture and shrinkage after a pharyngeal flap operation, a folded flap operation was devised. This operation was performed on 14 patients with velopharyngeal inadequacy. A superiorly-based flap was elevated from the posterior pharyngeal wall and was folded with the mucosa outside. The flap-velum connection was made through raw surfaces produced on each lateral ridge of the flap and the two penetrating incisions on the sides of the soft palate. In none of the cases did detachment of the flap or any other complications occur. This rather simple technique which aims to prevent scar contracture of the flap will permit further elaboration of the flap design-depending on the extent of velopharyngeal incompetence.