Abstract: PURPOSE: The aim of this study was to analyse the location and cause of postoperative bleeding after posterior pharyngeal flap surgery and to investigate the surgical techniques for managing bleeding. METHODS: Patients who received pharyngoplasty with posterior pharyngeal flap in the Cleft Lip and Palate Treatment and Research Centre of Shanghai Jiao Tong University School of Medicine from January 2003 to December 2017 were reviewed, and postoperative bleeding in the surgical area was retrospectively analyzed. RESULTS: During 15 year's study, a total of 1141 patients received posterior pharyngeal flap pharyngoplasty. Among them, nine(0.79%) experienced significant postoperative bleeding with exploration of haemostasis. They were sent back to the operating room for exploration of bleeding under general anaesthesia. The sites of bleeding included 4 cases (44.5%) in the soft palate, 2 cases (22.2%) in the pharyngeal flap pedicle, and 3 cases (33.3%) in the nasopharynx. CONCLUSIONS: During posterior pharyngeal flap pharyngoplasty, particular attention should be paid to protection of blood vessels in the soft palate and handling of the vascular pedicle. Postoperative bleeding is very dangerous and generally requires immediate exploration in the operating room under general anaesthesia.

Key words: Cleft palate, Posterior pharyngeal flap pharyngoplasty, Bleeding