Background: Cleft palate repair aims at producing closure of the cleft with reasonable lengthy palate in order to have competent velopharyngeal closure. There are various procedures concentrate on the lengthening of the palate like: Veu Wardill and Kilner, Furlow double opposing Z-plasty, Mukherji bilateral mucosal cheek flap, and Kaplan unilateral mucosal cheek flap etc. Buccal mucosal flap for nasal layer combined with Z-Plasty in the oral layer of the soft palate is one of these procedure provide reasonable length for cleft palate repair. Objective: The aim of this study is to evaluate palatal lengthening by combination of unilateral retromolar buccal mucosal flap with Z-plasty and assessment of speech improvement. Patients and methods: A prospective study of 22 patients of non-syndromic cleft palate underwent palatoplasty by unilateral retromolar buccal mucosal flap combined with Z-plasty of the mucous membrane of the oral layer in period from December 2008 to September 2009. All patients evaluated regarding the type of the cleft by Veau’s classification, the length and the width of the cleft palate measured by using a ruler and the depth of eth nasopharynx (from the
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