Page 49 - BSAVA Manual of Canine and Feline Head, Neck and Thoracic Surgery, 2nd Edition

eline Head,
A Manual of Canine and F
V
y
Thoracic Surger
Neck and
BSA
BSAVA Manual of Canine and Feline Head, Neck and Thoracic Surgery
OPERATIVE TECHNIQUE 3.3
VetBooks.ir Cleft palate repair

PATIENT POSITIONING
Dorsal recumbency. The head is positioned so that the palate is parallel to the table. The mouth is taped open to permit
optimal visualization during surgery.
ASSISTANT

Optional.

ADDITIONAL INSTRUMENTS
Periosteal elevator.
SURGICAL TECHNIQUE: OVERLAPPING FLAP TECHNIQUE
Approach

Incisions are made in the mucoperiosteum to the bone at the medial margin of the hard palate defect on one side,
forming flap B, and along the dental margin about 2 mm away from the gingiva and to the rostral and caudal margins of
the defect on the other side, forming flap A.
Surgical manipulations: hard palate repair

1 Elevate the flaps with a periosteal elevator, flap A laterally and flap B medially. Take care not to transect the major
palatine artery, which exits the palatine shelf of the maxillary bone 0.5–1 cm medial to the maxillary fourth
premolar. When the artery is identified, further careful dissection close to it will release it from surrounding tissue,
and it will readily stretch to accommodate the rotation of the flap.
2 Fold flap A on itself, turn it and suture it under flap B, so that connective tissue surfaces are in contact.

ard palate Incisions are made in
defect. the mucoperiosteum
of the hard palate.

B
A

levating flap B.

levating levating flap Flap is
flap . . ote the turned on
ma or palatine itself and
artery sutured
arro ed under flap B
attached to A so that
the flap. connective
B tissue
A surfaces are
B in contact.

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