{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T22:21:01Z","timestamp":1791670861579,"version":"4.3.4"},"reference-count":28,"publisher":"SAGE Publications","issue":"9","license":[{"start":{"date-parts":[[2025,12,10]],"date-time":"2025-12-10T00:00:00Z","timestamp":1765324800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["The Cleft Palate Craniofacial Journal"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>The vomer flap is a versatile surgical technique used in cleft palate repair, primarily to reconstruct the nasal layer of the hard palate. Its implementation has gained renewed interest due to its anatomical advantages and potential for reducing postoperative complications, especially oronasal fistulas.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This narrative review aims to evaluate the historical evolution, technical variations, clinical indications, outcomes, and limitations of the vomer flap in both unilateral and bilateral cleft palate repair.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A systematic literature search was conducted across PubMed, Embase, and Cochrane Library databases, including studies published from 1981 to April 2024. Articles were selected based on relevance to vomer flap use in cleft surgery, focusing on surgical outcomes, functional results, complication rates, and long-term effects on maxillary growth.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Three main techniques were identified for unilateral clefts: cephalically based, caudally based, and open-book vomer flaps. For bilateral clefts, cephalically based and open-book configurations demonstrated superior anatomical adaptation and lower fistula rates compared to caudally based flaps. The vomer flap is particularly advantageous in early repairs and wide clefts, with evidence suggesting a minimal adverse effect on maxillary development. However, high variability in technique and outcome reporting limits comparability.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The vomer flap remains a valuable tool in cleft palate repair, offering a balance between surgical efficacy and preservation of growth potential. It's appropriate application, based on cleft morphology and surgical objectives, can enhance functional and aesthetic outcomes. Further prospective studies are needed to standardize technique and validate long-term benefits.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10556656251405349","type":"journal-article","created":{"date-parts":[[2025,12,10]],"date-time":"2025-12-10T16:24:36Z","timestamp":1765383876000},"page":"3093-3105","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["The Vomer Flap in Cleft Palate Repair: A Comprehensive Review of Indications, Techniques, and Outcomes"],"prefix":"10.1177","volume":"63","author":[{"given":"Rogelio","family":"Mart\u00ednez-Wagner","sequence":"first","affiliation":[{"name":"Hospital General Dr. Manuel Gea Gonz\u00e1lez"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alejandro","family":"Fukumoto-Inukai Kenzo","sequence":"additional","affiliation":[{"name":"Hospital General Dr. Manuel Gea Gonz\u00e1lez"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-9178-0195","authenticated-orcid":false,"given":"Jos\u00e9 Emiliano","family":"Gonz\u00e1lez Flores","sequence":"additional","affiliation":[{"name":"Escuela de Medicina y Ciencias de la Salud del Instituto Tecnol\u00f3gico y de Estudios Superiores de Monterrey ITESM, Campus Ciudad de M\u00e9xico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alejandra Nicole","family":"Llamas Ostos","sequence":"additional","affiliation":[{"name":"Hospital General Dr. Manuel Gea Gonz\u00e1lez"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dami\u00e1n","family":"Palafox","sequence":"additional","affiliation":[{"name":"Hospital General Dr. Manuel Gea Gonz\u00e1lez"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hernando A.","family":"V\u00e1zquez-S\u00e1nchez","sequence":"additional","affiliation":[{"name":"Hospital General Dr. Manuel Gea Gonz\u00e1lez"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B\u00e9jar Chapa","family":"Mar\u00eda de Jes\u00fas Killa","sequence":"additional","affiliation":[{"name":"Wright State University Boonshoft School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,12,10]]},"reference":[{"issue":"1","key":"e_1_3_2_2_2","first-page":"34","article-title":"Early simultaneous vomer flap with primary cleft lip repair: Does it bring more benefits?","volume":"60","author":"Putri IL","year":"2023","unstructured":"Putri IL, Widiono ES, Liana S, Ruberto S, Dyah Kencono Wungu C. Early simultaneous vomer flap with primary cleft lip repair: Does it bring more benefits? Cleft Palate Craniofac J. 2023;60(1):34\u201344.","journal-title":"Cleft Palate Craniofac J"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00238-021-01818-0"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1597\/11-085"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00784-013-1084-2"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/0007-1226(85)90088-6"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1010-5182(87)80004-0"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjps.2017.02.026"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1597\/02-080"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1007\/978-981-15-3889-6_33-1"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1177\/1055665618770060"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcms.2016.05.011"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1097\/SCS.0000000000007964"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjps.2017.02.026"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1097\/SCS.0b013e3181d8eaa6"},{"issue":"9","key":"e_1_3_2_16_2","article-title":"Vomer flaps support velopharyngeal competency, fistula-free repair, and 3D construction of normal anatomy in patients with cleft palate","volume":"9","author":"Koch H","year":"2021","unstructured":"Koch H, Schmidt G, Toubekis E, Wermker K, Runte C, S\u00f6nnichsen K, Krimmel M. Vomer flaps support velopharyngeal competency, fistula-free repair, and 3D construction of normal anatomy in patients with cleft palate. 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