A technique for lining the palatopharyngeal flap with a single hinge flap.

A new technique for lining the superiorly based pharyngeal flap is described. After the soft palate in the oral mucosa is incised, the muscular velum is dissected laterally. A flap is then prepared on the nasal side of the palate with its pedicle on one side of the posterior edge of the palate. The pharyngeal flap is sutured into the donor defect of the palatal flap, which is reflected and used to line the pharyngeal flap. Both surface and bulk are added to the pharyngeal flap and the obturating effect is increased. This method is therefore especially indicated in patients with primary velopharyngeal insufficiency and decreased lateral pharyngeal mobility. In 8 patients studied over a two-year period we achieved reduced nasality and no rhinolalia clausa.