Speech resonance and surgical complications after primary palatoplasty with intravelar veloplasty in patients with cleft lip and palate

Bosi, Victor Zillo; Brandão, Giovana Rinalde; Yamashita, Renata Paciello

doi:10.5935/2177-1235.2016rbcp0007

Cited by 6 publications

(5 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Bosi et al evaluated immediate and late complications after palatoplasty with IVVP which showed 16.67% inci-dence of fistulae and 18.6% incidence of hypernasality incidence. 15 A systematic review was conducted by Timbang et al to compare the speech outcomes and fistula rates following repair of the cleft palate with Furlow double-opposing Zplasty and IVVP techniques. On analyzing 12 studies, the mean failure rates were higher with IVVP than Furlow's DOZ.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Hybrid Palatoplasty: A Simplified DOZ (Double Opposing Z Plasty) with Palatal Myoplasty for Primary Palate Repair

Damalachervu

Yellinedi

Nuvvula

et al. 2023

Indian J Plast Surg

View full text Add to dashboard Cite

Introduction Surgical techniques for soft palate repair aiming for zero velopharyngeal insufficiency (VPI) are still not achieved. Straight line closure of the soft palate by various techniques of intravelar veloplasty (IVVP) leads to higher incidence of VPI due to scar contracture. Furlow's Z plasty has long, narrow, thin mucosal flaps and mucomuscular flaps with malaligned muscle closure. We present a technique of “hybrid palatoplasty” which borrows from and adds to the existing methods, is robust, is easy to replicate, and results in normal speech consistently. Aim (1) To design a technique of “hybrid palatoplasty”—combining double opposing Z (DOZ) plasty and IVVP, which is applicable to all types of cleft palate. (2) To evaluate the results of cleft palate children operated using the technique of “hybrid palatoplasty” from 2014 to 2015 in terms of surgical complications (fistulae and dehiscence) and incidence of VPI. Methods Our procedure combines aspects of both DOZ and IVVP. It is simplified with design of smaller Z plasties. On one side, from the oral Z plasty muscle is dissected off and sutured to the nasal mucomuscular flap of the opposite side to complete the palatal sling. Oral Z plasty is purely mucosal and reverse of the nasal side. A total of 123 cases, operated below 5 years of age were followed up. Speech was assessed by direct evaluation and tele-evaluation. Results A total of 123 cases, below 5 years of age, were operated between 2014 and 2016 with at least 5 years of follow-up. Note that 120 had normal speech, and 3 had VPI of which 2 were subsequently corrected and went on to develop normal speech. Conclusion This novel “hybrid palatoplasty” is a simple technique with good speech outcome as it combines the principles of Z plasty and direct muscle repair with palatal sling formation.

show abstract

Section: Discussionmentioning

confidence: 99%

“…Bosi et al evaluated immediate and late complications after palatoplasty with IVVP which showed 16.67% incidence of fistulae and 18.6% incidence of hypernasality incidence. 15 …”

Section: Discussionmentioning

confidence: 99%

Hybrid Palatoplasty: A Simplified DOZ (Double Opposing Z Plasty) with Palatal Myoplasty for Primary Palate Repair

Damalachervu

Yellinedi

Nuvvula

et al. 2023

Indian J Plast Surg

View full text Add to dashboard Cite

show abstract

“…Bleeding was found in 5.6% of cases. In another Brazilian paper (Bosi, 2016), late postoperative complications (>24 hours) in 60 patients were studied. Bleeding was identified in 3 (5%) patients, fistulas were reported in 16.6% of patients and hard palate dehiscence in 5% of the sample.…”

Section: Discussionmentioning

confidence: 99%

Should Cleft Surgery Always be Performed During the Matutine Time? Analysis of Early and Late Postoperative Complications in a Cleft Center

Restrepo

Sato

Cardoso

et al. 2020

The Cleft Palate-Craniofacial Journal

View full text Add to dashboard Cite

Objective: Surgeries performed in the afternoon schedule were discouraged by Smile Train Foundation for patients younger than 2 years. The aim of this study is to present the incidence of complications discriminating time of surgery (morning/afternoon) in a reference center in Curitiba (Brazil) during 2017. Design: Retrospective study that evaluated all cleft surgeries that were performed at Assistance Center for Cleft Lip and Palate during 2017. Complications correlated with surgery period (morning/afternoon), type of surgery, and operating surgeon were studied. Statistical analysis was performed to find any association between discrete variables. Setting: Tertiary, institutional Participants: One hundred eighty-seven patients with cleft lip and/or cleft palate/cleft lip and palate, who were evaluated and submitted to surgery in the center and had less than 24 months of age, were included in the study. Interventions: One hundred twenty-four cheiloplasties and 63 palatoplasties were performed. Main Outcome Measure: Incidence of complications. Results: From the total of cheiloplasties, the number of complications was 2 (1.6%) and from the total of palatoplasties the number of complications was 11 (17%); 8.1% of surgeries that were performed in the morning had any complication compared to 5.1% of surgeries performed in the afternoon. Statistical analysis of discrete variables with χ2 test showed no correlation between surgery schedule and complications (χ2 = 0.62). Conclusion: The number of complications was not higher in the afternoon scheduled surgeries. Surgeon expertise had a statistically significant correlation with the absence of complications (χ2 = 20.57).

show abstract

“…The procedure of choice for primary cleft palate repair at our institution is a modified Furlow palatoplasty which has been demonstrated in numerous studies to have reliable speech outcomes with good palatal motion and length for proper oropharyngeal port closure during speech (Yu et al, 2001; Khosla et al, 2008; Williams et al, 2011; Jackson et al, 2013; Bosi et al, 2016). The Furlow palate repair has also been demonstrated to be a good choice for secondary palatal correction after straight-line palate repair with evidence of velopharyngeal insufficiency (VPI) causing hypernasal speech (Chen et al, 1994; Noorchashm et al, 2006; Nayar et al, 2014).…”

Section: Introductionmentioning

confidence: 99%

Conversion Furlow Palatoplasty and the Use of Preoperative Video Nasendoscopy

Kaye

Tracy

Noel-Macdonnell

et al. 2021

The Cleft Palate-Craniofacial Journal

View full text Add to dashboard Cite

Objective: To assess outcomes after conversion Furlow palatoplasty with and without routine preoperative flexible fiberoptic video nasendoscopy (FFVN). Design: Retrospective cohort study. Setting: Tertiary Children’s Hospital. Patients: Greater than 3 years of age with cleft palate and velopharyngeal insufficiency (VPI) after straight-line palatoplasty requiring secondary surgery performed with a Furlow palatoplasty. Main Outcome Measures: The number of children with and without routine FFVN prior to conversion Furlow palatoplasty for VPI after initial straight-line palatoplasty. Groups were compared for surgical timing, speech outcomes, and need for additional surgery after conversion Furlow palatoplasty. Results: Fifty-eight patients underwent preoperative FFVN versus 29 without. Mean age at FFVN was 73.8 (SD 34) months. Mean age for secondary palatal surgery by conversion Furlow palatoplasty was 81.5 (SD 34.8) months with FFVN versus 73.4 (SD 34.0) months without FFVN. There was a significant difference ( P < .001) for VPI diagnosis and time to surgery between the groups. Preoperative hypernasality ratings were similar between groups. Postoperatively 65.5% of FFVN and non-FFVN patients corrected to normal resonance. Only 6.9% of all patients rated moderate-severe hypernasality after surgery compared to 42.5% preoperatively. Of total, 5.7% of patients had unchanged hypernasality and only 1 patient rated worse. Seven patients ultimately required additional surgery in attempt to normalize their resonance. Conclusions: Routine preoperative FFVN does not offer any advantage for improved outcomes in children undergoing conversion Furlow palatoplasty after straight-line repair. Routine preoperative FFVN was associated with increased time to surgery after diagnosis of VPI compared to those without FFVN.

show abstract

Speech resonance and surgical complications after primary palatoplasty with intravelar veloplasty in patients with cleft lip and palate

Cited by 6 publications

References 0 publications

Hybrid Palatoplasty: A Simplified DOZ (Double Opposing Z Plasty) with Palatal Myoplasty for Primary Palate Repair

Hybrid Palatoplasty: A Simplified DOZ (Double Opposing Z Plasty) with Palatal Myoplasty for Primary Palate Repair

Should Cleft Surgery Always be Performed During the Matutine Time? Analysis of Early and Late Postoperative Complications in a Cleft Center

Conversion Furlow Palatoplasty and the Use of Preoperative Video Nasendoscopy

Contact Info

Product

Resources

About