ABSTRACT
The first major step towards modern cleft palate surgery was made in 1862 by Bernhard von Langenbeck. He suggested closing the palate with two medially mobilized bipedicled mucoperiosteal flaps. In principle, this method is still in use today. A similar procedure was developed by the British surgeons Kilner and Wardill3 in the late 1920s and early 1930s. In 1959, this so-called 'pushback' procedure was modified by Widmaier who suggested a supraperiosteal dissection of the flaps to reduce growth impediment of the maxilla. He introduced the use of a caudally based vomerine flap, first described by the British surgeon A. Campbell in 1926, to close the hard palate. There is more agreement among cleft surgeons about the timing of the soft palate closure. An early repair before the onset of speech in the first year of life seems to lead to the best speech results.
