ICCPCA Cleft Webinar: Cleft palate repair- What I wish I’d known- Brian Sommerlad

Upcoming webinar: Cleft palate repair-What I wish I’d known: Keynote by Dr Brian Sommerlad + Panel Discussion with Dr Romesh Gunasekara & Dr Luqman Majid

Brian Sommerlad has shared an outline of his talk (below).

CLEFT PALATE REPAIR –

Programme Outline (as shared by Brian Sommerlad):
What I know (or think I know!)

• Instruments and magnification
• Anatomy
• Peri-operative
• My technique
• Outcomes

What I wish I had known

• The value of lateral videofluoroscopy in understanding palate function
• Using the microscope for palate repair– requires perseverance
• The damage caused by the VWK pushback
• The benefits of closing the hard palate by a vomerine flap at lip repair

What I don’t know (and perhaps no-one knows)

• The role of the tensor?
• Whether to preserve the fascia around the levator?
• How to manage the descending and transverse fibres of palate-pharyngeus?
• How radically is it safe mobilise the greater neuro-vascular bundle?
• How far back should the levator be retro-positioned?
• Is there a place for lengthening the palate at primary repair?
• How radical can muscle dissection be?
• What is the optimal age for palate repair?
• Does radical muscle repair improve Eustachian function and hearing?
• Is submucous cleft palate a different condition to isolated cleft palate?
• What are the arguments for and against the Furlow palatoplasty?
• Is one operation right for every surgeon?

Final message

• Surgical skill is most important
• Numbers are important
• Know your outcomes
• Work as part of a team

References:

• “A technique for palate repair”   Plastic & Reconstructive Surgery 2003; 112: 1542-1548
• “The use of the operating microscope in cleft palate repair and pharyngoplasty”   Plastic & Reconstructive Surgery 2003; 112:1540-1541
• “Palate Re-repair Revisited”  (with F Mehendale, M J Birch, D Sell, C Hattee, K Harland)  2002 The Cleft Palate-Craniofacial Journal  2002; 39 (3): 295-307
• “Submucous cleft palate – a system of grading and a review of a consecutive series of 40 submucous cleft  palate repairs”  (with C Fenn, K Harland, D Sell, M Birch, R Dave, M Lees  and A Barnett)  The Cleft Palate- Craniofacial Journal 2004; 41: 114-123
• “Cleft palate Repair with Minimal Hard Palate Dissection and Radical Muscle Reconstruction” In “Comprehensive Cleft Care”  2^nd Edition Eds:  J Losee & R Kirschner  2015  McGraw-Hill

ICCPCA (International Confederation of Cleft Lip and Palate and Related Craniofacial Anomalies) has organised this 6-part series of webinars from leading cleft surgeons worldwide from January to June 2021.

Future webinars:

• Bilateral cleft lip and nose repair – Keynote from David Fisher (20th March 2021)
• Speech surgery – April 2021
• Alveolar bone grafting – May 2021
• Cleft septorhinoplasty – June 2021

Past webinars – ‘What I wish I’d known’ series:

• Unilateral Cleft Lip and Palate- Philip Chen (Taiwan)

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