Repair of wide palatal clefts can be difficult by incomplete mobilization of palatal flaps. One method to reduce lateral restriction is outfracture of the greater palatine foramen and medialization of the greater palatine vessels. We present a guarded osteotome designed to reduce injury of the neurovascular bundle during osteotomy of the greater palatine foramen in cleft palate repair. It is simple to use and may be especially helpful in the wide cleft.
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