A Comparative Study to Evaluate the Functional Effect of Unilateral Uvuloplasty after Primary Palatoplasty

Rossell-Perry, Percy; Olivencia-Flores, Claudia; Gavino-Gutierrez, Arquímedes M.; Caceres-Nano, Evelyn; Cotrina-Rabanal, Omar

doi:10.1097/gox.0000000000000393

Cited by 8 publications

(5 citation statements)

References 24 publications

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“…Any lengthening of the palate anticipated from this technique is posterior to the position of the reconstructed levator sling (levator knee) and is not expected to increase the functional length of the velum which closes against the posterior pharyngeal wall. This is in contrast to the 2 studies by Rossell-Perry who was seeking a functional effect and found better speech in 1 of the 2 studies (Rossell-Perry, 2015). We hope that our reply clarifies the confusion.…”

contrasting

confidence: 84%

About the One Hemi-Uvula Repair Technique During Palatoplasty

Elsherbiny

Mazeed

Saied

et al. 2020

The Cleft Palate-Craniofacial Journal

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This is a response to a letter replying to our paper discussing the significance of the uvula during palatoplasty and our surgical technique of uvula repair. The hemi-uvula repair technique was developed independently in our department. In our publication, we fully cited the 2 studies by Rossell-Perry et al about uvula repair and acknowledged them to be the first to publish the concept of using one hemi-uvula. Upon further study, the mistake of omitting 2 references from the list, although they were cited in the text, was found to have occurred during the transition between publishers of this journal (corrected in Erratum). We highlighted some of the differences in the studies and techniques, which are already discussed in our paper, for further clarification.

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contrasting

confidence: 84%

About the One Hemi-Uvula Repair Technique During Palatoplasty

Elsherbiny

Mazeed

Saied

et al. 2020

The Cleft Palate-Craniofacial Journal

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“…5 The aesthetic and functional outcomes of this method have been studied previously, reducing the velopharyngeal space and improving velopharyngeal function. 7 In the present study, the velar muscles were repaired, preserving the tensor veli palatini attachments to the hamulus. The rate of mild-to-severe velopharyngeal insufficiency in the present study was acceptable and lower than that (8.7%) among patients who underwent conventional intravelar veloplasty performed by the same surgeon.…”

Section: Discussionmentioning

confidence: 97%

An Innovative Palatoplasty for Primary Cleft Palate Repair

Rossell-Perry¹

2021

Plastic and Reconstructive Surgery - Global Open

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Summary: Many surgical techniques have been developed to restore function in patients with cleft palate. Despite the development of many surgical techniques for primary cleft palate repair there is no standard procedure that ensures palatal function as that in normal children. Furlow’s and intravelar veloplasty are the most common methods for velar repair in patients with cleft palate; however, some limitations have been described by different authors. The objective of this study was to present an innovative method for primary cleft palate repair that addresses the shortcomings of conventional methods. Since 2017, 88 consecutive patients with nonsyndromic unilateral cleft palate have undergone primary anatomical repair of palatal deformity using this technique. This method combines nasal mucosa Z plasty and muscular overlapping with the use of one hemiuvula for uvular repair (unilateral uvuloplasty). The nasal mucosa Z plasty produces velar lengthening by transposition of nasal mucosa and myomucosal flaps. The unilateral uvuloplasty reduces anatomically the velopharyngeal gap and increases the velar length, thus reducing velopharyngeal distance. This innovative palatoplasty, achieves proper anatomical and functional reconstruction of the repaired palate. Only four patients (4.54%) developed mild or severe hypernasality and one patient (1.13%) had postoperative palatal fistula in this group of patients. This innovative technique results in low rates of nondesirable outcomes, improving limitations of conventional methods. Reduced oral mucosa incisions, limited velar muscle dissection, and preservation of the tensor veli palatini anatomy are some of the benefits of this technique.

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“…The two-flap palatoplasty group underwent Bardach’s two-flap palatoplasty 18 plus the Sommerlad type of intravelar veloplasty 21 and unilateral uvuloplasty. 22 , 23 …”

Section: Methodsmentioning

confidence: 99%

Effect of Relaxing Incisions on the Maxillary Growth after Primary Unilateral Cleft Palate Repair in Mild and Moderate Cases: A Randomized Clinical Trial

Rossell-Perry

Cotrina-Rabanal²,

Figallo-Hudtwalcker³

et al. 2017

Plastic and Reconstructive Surgery - Global Open

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Background:The purpose of this study was to evaluate the association between the use of relaxing incisions and maxillary growth disturbance after primary palatoplasty in patients with unilateral cleft lip and palate.Methods:This is a prospective, randomized, double-blind controlled trial study with ethical committee approval between 2 groups of patients with unilateral cleft lip and palate who were operated on using the two-flap and one-flap techniques from 2008 to 2011. Two groups of patients with unilateral cleft lip and palate were operated on using the mentioned techniques by the Outreach Surgical Center Program Lima since 2008. Data collection was accomplished by evaluation of maxillary arch dimensions and dental arch relationships (scored using the 5-year-olds’ index).Results:The mean score for the 5-year-olds’ index was 2.57 for two-flap technique and 2.80 for one-flap technique without statistical significant differences (P = 0.71). Our comparative study did not find statistically significant differences in maxillary arch dimensions between the studied techniques for unilateral cleft palate repair. Good levels of agreement were observed according to the κ statistics.Conclusions:The results arising from this clinical trial do not provide statistical evidence that one technique let us obtain better maxillary development than the other at 5 years. The use of relaxing incisions was not associated with maxillary growth impairment. A technique with limited relaxing incisions does not has better maxillary growth. Additional longer term study is necessary to confirm this preliminary report.

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A Comparative Study to Evaluate the Functional Effect of Unilateral Uvuloplasty after Primary Palatoplasty

Cited by 8 publications

References 24 publications

About the One Hemi-Uvula Repair Technique During Palatoplasty

About the One Hemi-Uvula Repair Technique During Palatoplasty

An Innovative Palatoplasty for Primary Cleft Palate Repair

Effect of Relaxing Incisions on the Maxillary Growth after Primary Unilateral Cleft Palate Repair in Mild and Moderate Cases: A Randomized Clinical Trial

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