Abstract: Objective To explore the effects of two kinds of operation (levator veli palatini retropositioning & levator veli palatini retropositioning combined with buccal fat pad flap and pharyngeal flap) on the incidence of fistula and speech intelligibility in older children with cleft palate. Methods Sixty cases with cleft palate(4 to 9 years old)were divided into 2 groups randomly, and were treated with levator veli palatini retropositioning (group A) and levator veli palatini retropositioning combined with buccal fat pad flap and pharyngeal flap(Group B)respectively.The incidence of palatal fistula and speech intelligibility in the 2 groups were observed and compared. Results The incidence of fistula in group A was higher than in group B (P<0.05). The speech intelligibility was improved in both group A and group B (P<0.05). The speech intelligibility and scar formation in group B was both better than in group A (P<0.05).Conclusion For older children with cleft palate, levator veli palatini retropositioning combined with buccal fat pad flap and pharyngeal flap can reduce the incidence of palatal fistula effectively, and also can obtain better speech intelligibility. Since this method can avoid bone exposure, so as to reduce scar formation and the effect on maxillary growth, it is a functional cleft palate repair method and worthy to be recommended.

Key words: Levator veli palatini retropositioning, Buccal fat pad flap, Pharyngeal flap, Speech intelligibility, Palatal fistula