Kotlarek, Katelyn J.Jaskolka, Michael S.Fang, XiangmingEllis, CharlesBlemker, Silvia S.Horswell, BruceKloostra, PaulPerry, Jamie L.2024-06-202024-06-202022-05Kotlarek, K. J., Jaskolka, M. S., Fang, X., Ellis, C., Blemker, S. S., Horswell, B., Kloostra, P., & Perry, J. L. (2022). A Preliminary Study of Anatomical Changes Following the Use of a Pedicled Buccal Fat Pad Flap During Primary Palatoplasty. The Cleft Palate-Craniofacial Journal : Official Publication of the American Cleft Palate-Craniofacial Association, 59(5), 614–621. https://doi.org/10.1177/10556656211014070https://hdl.handle.net/1805/41658Objective: The purpose of this study was to examine the surgical impact of the pedicled BFP flap on the LVP muscle and surrounding VP anatomy following primary palatoplasty. Design: Observational, prospective Setting: MRI studies were completed at 3 imaging facilities. All participants with BFP flap were operated on by the same surgeon. Participants: Five pediatric participants with CP±L who underwent primary palatoplasty with BFP flap placement. Comparison groups consisted of 10 participants: 5 with CP±L who did not receive the BFP flap and 5 healthy controls. Interventions: All participants underwent nonsedated MRI 2–5 years postoperatively. Main Outcomes and Measures: Anatomical measures of the velopharynx and LVP among the 3 participant groups Results: Median values were significantly different among groups for velar length (p = .042), effective velar length (p = .048), effective VP ratio (p = .046), LVP length (p = .021), extravelar LVP length (p = .009), and LVP origin-origin distance (p = .030). Post hoc analysis revealed a statistically significant difference between the BFP and traditional repair groups for effective VP ratio (p = .040), extravelar LVP length (p = .033), and LVP length (p = .022). Conclusions: This study provides preliminary support that the BFP flap creates a longer velum, with increased distance between the posterior hard palate and the LVP, and a larger effective VP ratio compared to traditional surgical techniques. Future research is needed to determine if this procedure provides a more favorable mechanism for VP closure.en-USPublisher PolicypalatoplastyoutcomesMRIArticle