Z-Plasty-Revision Surgery

Patients with previous history of surgeries for cleft palate frequently have speech problems. The muscles of the soft palate if not approximated properly during primary surgery can lead to contracture of muscles. This leads to improper seal formation between pharynx and muscles of soft palate during the speech. Failure to form a proper seal between soft palate and pharynx leads to nasal air escape during speech. This is known as Hypernasality of speech. A surgical procedure is known as Z- Plasty is performed to correct this situation. In this procedure, the muscles of soft palate are dissected and sutured in a manner resembling Z shape. This surgical procedure leads to lengthening of the muscles of the soft palate. 

Cone beam ct scan before and after images taken after speech surgery

The increased length of the soft palate helps to form a seal with the pharynx during the speech. Thus Z-plasty procedure helps in reducing nasal air escape and attaining a clear speech in cleft palate patients. 

This was an 8-year-old patient who had his cleft palate surgery done elsewhere almost 7 years ago. He also had speech therapy sessions for a few years. Recently, he was referred to us by one of the local pediatricians when he was getting there for the repeated common cold. Dr. Sunil Richardson and his Craniofacial team assessed him clinically, also took the help of the Speech Pathologist, Cone Beam CT Scan, Lateral Fluoroscopy and decided to perform the speech surgery. The patient, however, has to follow the surgery with speech therapy sessions for 4 months postoperatively.