Repair of submucous cleft palate with Furlow palatoplasty

Abstract Objective Submucous cleft palate is a congenital anomaly caused by abnormal insertion of the levator veli palatini muscles to the posterior border of the hard palate, normally these muscles unite together to form the levator sling. Velopharyngeal insufficiency (VPI) may occur in about 10% o...

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Bibliographic Details
Published in:International journal of pediatric otorhinolaryngology 2012-07, Vol.76 (7), p.1012-1016
Main Authors: Abdel-Aziz, Mosaad, El-Hoshy, Hassan, Naguib, Nader, Talaat, Nassim
Format: Article
Language:English
Subjects:
Child
Child, Preschool
Cleft Palate - complications
Cleft Palate - surgery
Female
Furlow palatoplasty
Humans
Hypernasal speech
Male
Otolaryngology
Pediatrics
Prospective Studies
Submucous cleft palate
Surgical Flaps
Treatment Outcome
Velopharyngeal insufficiency
Velopharyngeal Insufficiency - etiology
Velopharyngeal Insufficiency - surgery
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Description
Summary:Abstract Objective Submucous cleft palate is a congenital anomaly caused by abnormal insertion of the levator veli palatini muscles to the posterior border of the hard palate, normally these muscles unite together to form the levator sling. Velopharyngeal insufficiency (VPI) may occur in about 10% of cases, our previous treatment protocol was pharyngeal flap that may result in obstructive breathing. Furlow technique seems to be a more physiologic solution as it reconstructs the levator sling. The aim of this study was to determine the efficacy of Furlow palatoplasty in treatment of submucous cleft palate cases presented with VPI. Methods This prospective study was conducted on 15 children with symptomatic submucous cleft palate. All cases were treated by Furlow double opposing Z-plasty technique for repositioning of levator muscles, preoperative and postoperative speech evaluation was done using auditory perceptual assessment and nasometry, while velopharyngeal closure was assessed with flexible nasopharyngoscopy. Results Significant improvement of speech and overall nasalance score were achieved. Flexible nasopharyngoscopy showed complete velopharyngeal closure of 13 cases (86.7%), while one case needed secondary pharyngoplasty for correction of residual VPI and the parents of the other case refused secondary surgery as the speech improvement of their child was satisfactory. Conclusions Furlow palatoplasty technique is an effective method in treatment of VPI in cases of submucous cleft palate as it has high success rate with no morbidity.
ISSN:0165-5876
1872-8464
DOI:10.1016/j.ijporl.2012.03.021