Objective: The purpose of this paper is to provide the experience in using the pedicled buccal fat pad (BFP) graft in cleft palate repair when healing by secondary intention may need to be considered due to the width of the cleft; the qualitative or quantitative tissue constraints, the dead cavity between the oral and nasal layers or single layer closure of the hard palate with the vomer and marginal pedicled mucosoperiosteal flap.
Methods: The body and buccal extension of BFP is gently torn out from its bed and advanced into the palate vault around the posterior aspect of the maxilla to cover the raw surface of the hard palate cleft and/or fill the dead cavity between the oral and nasal tissue layers, specifically in the conjunction of the hard and soft palate.
Results: Six cleft palates were repaired with the BFP graft. The postoperative course was uneventful. The BFP graft is viable without the occurrence of fistula or infection.
Conclusion: The pedicled BFP graft has provided an excellent soft tissue support for secondary epithelialization when primary dehiscence has or would have otherwise thwarted ultimate closure of the palatal defect. The pedicled BFP graft permits closure of palatal defects that could not be repaired by conventional procedures.