What is the role of cleft palatal ostectomy in cleft palate repair and in which direction should you do the osteoctomy?

this is a complicated procedure used only some maestros in the art

when a cleft palate is too wide,it will be impossible to get a tension free closure of the mucoperiosteal flap even with neuro vascular bundle release

the only way to get a tension free closure is a guarded postero medial , distal palatal ostectomy (demonstrated  by my mentor Prof John Mulliken of Childrens Boston) where he uses a fine neurovascular guard and removes a small wedge of palatal bone

the flaps fall in the centre as a result