ABSTRACT
Elongated soft palate is often one component of brachycephalic airway syndrome. BAS consists of stenotic nares, elongated soft palate, everted laryngeal saccules and occasionally hypoplastic trachea. ii. Treatment is by staphylectomy or surgical resection of the obstructing portion of the palate. The soft palate should slightly overlap the epiglottis but not interfere with the rima glottidis. At surgery, stay sutures are placed in the lateral aspects of the soft palate and it is retracted rostrally. The palate is resected using a cut-and-sew technique: excess palate is excised in one-third portions and immediately oversewn with absorbable suture material. Enough palate is resected to prevent interference with the larynx, but should not be resected beyond the caudal aspect of the tonsils (136). If BAS is present, concurrent rhinoplasty, tonsillectomy and laryngeal sacculectomy is performed. iii. The most common postoperative complication is pharyngeal edema. This is minimized by using gentle technique, avoiding electrocautery, and administering an antiinflammatory dose of corticosteroids (e.g. dexamethasone 0.1 mg/kg) before surgery. Hemorrhage is best controlled by limited incision and rapid suturing of the mucosal edges; pressure is applied if hemorrhage persists after suturing. Excessive palate removal may cause nasal reflux by failure to cover the nasopharynx during swallowing.
