Modified VIP-CT flap in late maxillary alveolar cleft surgery

ObjectiveThis article describes a new application for the modified vascularized interpositional periosteal-connective tissue flap (modified VIP-CT flap) to solve problematic cases of late maxillary alveolar cleft bone grafting.MethodsThis study analysed the ability of the VIP-CT flap to provide coverage of bone grafts in maxillary alveolar cleft surgery. Donor site morbidity was also evaluated.ResultsThirteen patients were operated on using this technique, seven patients were female, the age range was between 12 and 25 years, and all of them were missing at least one permanent anterior tooth adjacent to the cleft. Two patients had bilateral alveolar clefts. In most of the operated patients one VIP-CT flap was used, but in two patients (cases 3 and 4) bilateral VIP-CT flaps were used for treatment of wide alveolar clefts. In case 3 both of the flaps were used for closure of the oral side and in case 4 one flap was used for nasal closure and another for oral side coverage. Two patients had alveolar cleft only with normal palatal anatomy, and the remaining patients had previously operated cleft palates (11 patients).ConclusionVIP-CT flaps can readily be used in adult patients with cleft lip (alveolar only) and in many operated unilateral and bilateral complete cleft lip and palate patients successfully.