PURPOSE OF REVIEW Massive palatal defects resulting from palatoplasty failures arising from cleft palate repair complications present ongoing challenges in clinical practice. The purpose of this review is to provide up-to-date insights into aetiology, risk factors, surgical techniques, and adjunctive therapies, aiming to enhance the understanding of such complex cases, and optimize patient outcomes. RECENT FINDINGS Primary palatoplasty has fistula recurrence rates ranging from 2.4% to 55%. Factors such as cleft width, surgical repair method, and patient characteristics, influence the likelihood of failure. Classifications such as the Pakistan Comprehensive Classification and Richardson's criteria aid in assessing defects. Surgical options range from local flaps and revision palatoplasty to regional flaps (e.g., buccinator myomucosal, facial artery-based flaps, tongue flaps, nasal septal flaps) to free microvascular flaps. Alternative approaches include obturator prostheses, and acellular dermal matrix has been used as an adjuvant to multiple repair techniques. Hyperbaric oxygen therapy has emerged as an adjunctive therapy to enhance tissue healing. SUMMARY This comprehensive review underscores the intricate challenges associated with massive palatal defects resulting from palatoplasty failures. The diverse range of surgical and nonsurgical options emphasizes the importance of patient-centric, individualized approaches. Practitioners, armed with evidence-based insights, can navigate these complexities, offering tailored interventions for improved patient outcomes.

中文翻译：

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管理继发于腭成形术失败的巨大腭缺损：深入分析。


综述目的由于腭裂修复并发症引起的腭成形术失败而导致的大面积腭缺损在临床实践中提出了持续的挑战。本次综述的目的是提供对病因、危险因素、手术技术和辅助治疗的最新见解，旨在增强对此类复杂病例的理解，并优化患者的治疗效果。最新发现 原发性腭成形术的瘘管复发率在 2.4% 至 55% 之间。裂隙宽度、手术修复方法和患者特征等因素都会影响失败的可能性。巴基斯坦综合分类和理查森标准等分类有助于评估缺陷。手术选择范围从局部皮瓣和翻修腭成形术到区域皮瓣（例如颊肌粘膜皮瓣、面动脉皮瓣、舌皮瓣、鼻中隔皮瓣）到游离微血管皮瓣。替代方法包括闭孔假体，脱细胞真皮基质已被用作多种修复技术的佐剂。高压氧疗法已成为增强组织愈合的辅助疗法。摘要 这篇全面的综述强调了与腭成形术失败导致的大量腭缺损​​相关的复杂挑战。手术和非手术选择的多样化强调了以患者为中心、个体化方法的重要性。拥有基于证据的见解的从业者可以应对这些复杂性，提供量身定制的干预措施以改善患者的治疗结果。