Use of a modified Furlow Z-plasty as a secondary cleft palate repair procedure to reduce velopharyngeal insufficiency

Reddy, Rajgopal R.; Reddy, Srinivas Gosla; Banala, Bhavya; Bronkhorst, Ewald M.; Kummer, Ann W.; Kuijpers-Jagtman, Anne Marie; Bergé, Stefaan

doi:10.1016/j.ijom.2015.07.006

Cited by 15 publications

(8 citation statements)

References 23 publications

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“…65 Furlow palatoplasty has been shown to be an effective treatment for VPI following primary palate repair with velopharyngeal closure rates of 82 to 89% 56,66 and significant improvements in speech assessment scores. [66][67][68][69][70] Similar success has been reported with pharyngeal flaps and DSP. Successful correction of VPI with pharyngeal flaps and sphincter pharyngoplasty is reported to be between 74 to 89% and 72 to 85%, respectively.…”

Section: Surgical Planningmentioning

confidence: 63%

Revision Surgery of the Cleft Palate

Levinson

Rousso

2020

Seminars in Plastic Surgery

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Cleft palate repairs often require secondary surgeries and/or revisions for a variety of reasons. The most common causes are symptomatic oronasal fistulas and velopharyngeal insufficiency. Complications from primary surgery, such as wound dehiscence, infection, and hematomas, contribute to the relatively high rate of revision surgery. Prevention of postoperative complications that may lead to fistula or velopharyngeal insufficiency is key, and many techniques have been described that have reportedly decreased the incidence of secondary surgery. Management varies depending on the nature of the fistulous defect and the type of velopharyngeal insufficiency. Numerous surgical options exist to fix this deficiency.

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Section: Surgical Planningmentioning

confidence: 63%

Revision Surgery of the Cleft Palate

Levinson

Rousso

2020

Seminars in Plastic Surgery

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“…There is also the possibility of needing a revision pharyngeal surgery (Por et al, 2010). In stark contrast, the Furlow procedure has been reported to be a reliable option for management of VPD, either as an isolated procedure, a “primer procedure,” or as an adjunct to a pharyngeal flap of some manner (Chen et al, 1994; Hudson et al, 1995; Perkins et al, 2005; Gosain and Arneja, 2007; Nayar et al, 2014; Chim et al, 2015; Pet et al, 2015; Reddy et al, 2016). When used as a stand-alone procedure, the morbidity is minimal to none (Chen et al, 1994; Perkins et al, 2005; Chim et al, 2015).…”

Section: Discussionmentioning

confidence: 99%

Furlow Palatoplasty for Velopharyngeal Dysfunction Management: Auditing and Predicting Outcomes

Bonanthaya

Jalil

Sasikumar

et al. 2021

The Cleft Palate-Craniofacial Journal

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Objective The Furlow palatoplasty is a proven procedure in the management of secondary velopharyngeal dysfunction in patients with cleft palate. But the selection of cases, the degree of clinical success, and the preoperative predictors of the same are less established. This study is an effort to retrospectively look at outcomes, in a large series of velopharyngeal dysfunction cases treated with the Furlow palatoplasty alone. Design Retrospective analysis of preoperative and postoperative speech and videofluoroscopic data. Setting Tertiary care center. Patients/Participants Ninety-two patients who were diagnosed with velopharyngeal dysfunction post primary cleft palate repair. Interventions Furlow palatoplasty for velopharyngeal dysfunction post primary cleft palate repair. Main outcome measures Variables analyzed were perceptual speech parameters and, closure ratios obtained from lateral video-fluoroscopic images. Results Overall, 81.5% had postoperative improvements in their lateral video-fluoroscopic parameters, 63% improved their nasality scores, and 65.2% had improved speech intelligibility. A simple linear regression was done to predict the postoperative closure ratio. Preoperative closure ratio, hypernasality (moderate and severe), and audible nasal air emission are predictors for postoperative closure ratio. Conclusions The Furlow palatoplasty alone led to complete resolution, or significant improvement of velopharyngeal dysfunction in a majority of patients, despite the cohort having a wide range of severity in terms of degree of dysfunction. The predictive formula will be validated in a further study.

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“…The operative technique included levator muscle repositioning using intravelar veloplasty or double opposing Z-plasty (Furlow) and posteriorly based buccinator myomucosal flaps for palatal lengthening (unilateral or bilateral) [6,7]. Briefly, one of two techniques were done for Levator muscle repositioning.…”

Section: Methodsmentioning

confidence: 99%