Predictors of Success in Furlow Palatoplasty for Submucous Clefts

Mardini, Samir; Chim, Harvey; Seselgyte, Rimante; Kuo, John S.

doi:10.1097/prs.0000000000001934

Cited by 23 publications

(18 citation statements)

References 13 publications

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“…In our study, the frequency of the circular pattern (36.7%) was found to be the highest followed by a coronal pattern (23.5%), which is in accordance with Mardini et al 's study (59.7% and 29.8%, respectively); however, it is in contrast to the findings of Garcia et al, who reported 37% and 44% incidence, respectively (14,16). In another study, a higher incidence of a circular closure pattern (62.31%) followed by a coronal closure pattern (33.21%) in 268 submucous clefts was reported (17).…”

Section: Discussionsupporting

confidence: 91%

Submucous cleft palate: from diagnosis to management

Kayikci¹,

TIRANK²,

Çalış³

et al. 2018

Turk J Med Sci

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This retrospective study, following approval of the institutional review board (GO 17/633-31), was conducted at Hacettepe University Cleft Lip and Palate, Craniomaxillofacial Anomalies Research, Treatment and Application Center; currently, the only officially approved Background/aim: The aim of this study was to investigate submucous cleft palate (SMCP) patients in order to document the age of diagnosis, cause of referral, symptoms and palate findings, objective evaluation of nasalance and velopharyngeal dysfunction (VPD), and intervention type. Material and methods: The archive of Hacettepe University Cleft Lip and Palate, Craniomaxillofacial Anomalies Research, Treatment, and Application Center was reviewed retrospectively, and 166 patients diagnosed with SMCP were documented. Results: The mean age of the patients at the time of initial referral was 10 years and 3 months ± 8 years and 5 months with the youngest being 1 month and the oldest 44 years old. The primary complaint of 127 (76.5%) patients was speech disorder. Seventy-nine patients underwent surgery, and the mean age was determined as 10 years ± 6 years and 8 months. Conclusion: The diagnosis of SMCP continues to be rather late, being delayed until a prominent speech disorder is present. Studies for the awareness of health professionals are of great importance for the early diagnosis and intervention of SMCP in order to prevent adverse effects.

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Section: Discussionsupporting

confidence: 91%

Submucous cleft palate: from diagnosis to management

Kayikci¹,

TIRANK²,

Çalış³

et al. 2018

Turk J Med Sci

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“…Patients with circular closure pattern have been reported to have more lateral wall movement; thus, the possibility of successful outcome is greater when the soft palate is lengthened (Abdel-Aziz et al, 2015; Mardini et al, 2016). In addition, some authors suggested that the treatment of VPI after cleft palate repair depends on the velopharyngeal closure pattern (Abdel-Aziz et al, 2011).…”

Section: Discussionmentioning

confidence: 99%

Velar Closing Ratio As a Predictor for the Verlopharyngeal Function After Double Opposing Z-Plasty for Postpalatoplasty Velopharyngeal Insufficiency in Patients With Cleft Palate

Huang

Hsieh

et al. 2020

The Cleft Palate Craniofacial Journal

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Background: This study was designed to identify the potential predictors of postoperative velopharyngeal function after double opposing Z-plasty (DOZP) for the treatment of velopharyngeal insufficiency (VPI) in patients who had prior palatoplasty for cleft palate. Methods: This retrospective study reviewed the medical records of consecutive patients who received DOZP for VPI after receiving a prior palatoplasty treating cleft palate between 2004 and 2017. The speech outcome of patient was measured using the Pittsburgh Weighted Speech Scale (PWSS) at 6 months following surgery and determined the outcome suggests velopharyngeal competence (PWSS ≤2) or incompetence (PWSS >2). Stepwise logistic regression was used to identify the variables for the prediction of competent surgical outcome. The specific receiver operating characteristic curves with an area under the curve (AUC) was used to evaluate the predictor related to the surgical outcome as competence. Results: The study included 93 patients. Age, relative velar length, velar lengthening, and closure pattern were not significantly associated with postoperative competence status of the patient. The only variable that predicted a successful surgical outcome was preoperative velar closing ratio. However, the accuracy of velar closing ratio in predicting a competent surgical outcome is only moderate (AUC = 70.37). Conclusion: The results of this study showed that preoperative velar closing ratio may predict, with moderate accuracy, a successful surgical outcome in patients with postpalatoplasty VPI who undergo DOZP. Therefore, in patients with a low preoperative velar closing ratio, some alternative surgical methods other than DOZP may be considered to avoid unsatisfactory surgical outcome.

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“…Recent years more studies are published mentioning positive operation outcomes using Furlow-plasty in SMCP children [27,29,31,34,35]. Sullivan et al (2010) recommend double-opposing Z-palatoplasty as the primary operation for children younger than 4 to 5 years with SMCP (overt or occult) and velopharyngeal insufficiency [29].…”

Section: Hemifacial Microsomia With Microtiamentioning

confidence: 99%

Surgical management in submucous cleft palate patients

et al. 2021

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Objectives The submucous cleft palate (SMCP) is considered to be the most subtle type of cleft palate. Early detection is important to allow on time intervention by speech therapy and/or surgical repair before the children already develop compensatory speech mechanisms. The purpose of this study was to investigate at what time children with a SMCP present, to determine when children are operated, and to analyze the postoperative outcomes for in SMCP children. Patient and methods Medical records from 766 individuals registered in the cleft registry in the Wilhelmina’s Children’s’ Hospital, Utrecht, were retrospectively reviewed. Inclusion criteria were children diagnosed with SMCP. The following data were collected: age at diagnosis, physical examination, age at surgery, surgical technique, speech therapy pre- and post-surgery, otitis media, secondary cleft surgery, family history, syndromes, and other anomalies. Results In total, 56 SMCP children were identified. The mean age of diagnosis was 44.0 months (range 0–150, SD = 37.0). In 48 children (85.7%), surgical intervention was performed (Furlow plasty, intravelar veloplasty, pharyngoplasty, or Furlow combined with buccal flap). Conclusion This retrospective study reconfirms that SMCP often presents late, even in a country with a modern healthcare system and adequate follow-up of all newborns by the so-called youth doctors in “children’s healthcare centers” up to the age of 4 years old. Almost 86% of patients ultimately needed palate surgery when SMCP was suspected. Clinical relevance Any child presenting with repeated episodes of otitis media, nasal regurgitation, or speech difficulties should have prompt consideration for SMCP as diagnosis.

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Predictors of Success in Furlow Palatoplasty for Submucous Clefts

Abstract: Risk, III.

Cited by 23 publications

References 13 publications

Submucous cleft palate: from diagnosis to management

Submucous cleft palate: from diagnosis to management

Velar Closing Ratio As a Predictor for the Verlopharyngeal Function After Double Opposing Z-Plasty for Postpalatoplasty Velopharyngeal Insufficiency in Patients With Cleft Palate

Surgical management in submucous cleft palate patients

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