Wiki Vomer flap AND "linear"palatoplasty?

sinman0531

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Does this sound like 42200 and 42235, or just 42235?

perform incision which was carried down to the level of the midline rhaphe limited to the soft palate and secondary hard palate to allow for advancement. The posterior palatal shelf was dissected using this approach at the subperiosteal level and the posterior musculature was then disinserted off the posterior palatal shelf including posterior tonsillar palatopharyngeus, medial Pterygoid muscles. The lateral nasal wall was dissected off the medial pterygoid at subperiosteal level until the base of skull was reached. This allowed us a turnover flap of the nasal mucosa. The vomer was incised in the midline over limited distance on the midline posteriorly. This allowed us to reapproximate and suspend the nasal mucosa at subperiosteal level in that location. Next, the nasal mucosa of the soft palate with a small amount of muscle was approximated using interrupted sutures of 5-0 Vicryl. The oral closure was done in similar fashion using small amount mucosa and more perimysium and muscle layer closure. This was done in interrupted sutures. Inverted horizontal mattress sutures were placed to approximate nasal mucosa to the vomer periosteum at the level of the secondary hard palate.
 
i am thinking 42235

The physician repairs the hard palate by closing the communication between the oral and nasal cavities. A combination of mucosal and mucoperiosteal flaps are used to repair the defect. The margins of the defect are incised and dissected to develop mucosal, muscular, and mucoperiosteal layers. The mucoperiosteum of the vomer (nasal septum) is elevated and sutured to the mucoperiosteum of the hard palate. This closes the communication between the oral and nasal cavities. Incisions are made in the palatal mucosa adjacent to the alveolar (tooth-bearing) bone. The mucosa is elevated and loosened from the bony palate. The palatal mucosa is closed in layers.
 
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