Furlow palatoplasty for previously repaired cleft palate with velopharyngeal insufficiency

Abstract Objective Velopharyngeal insufficiency (VPI) is a common complication after cleft palate repair, it may be due to lack of levator sling reconstruction and/or palatal shortening. Furlow palatoplasty has the advantages of retro-positioning of levator palati muscles and palatal lengthening. Th...

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Published in:International journal of pediatric otorhinolaryngology 2015-10, Vol.79 (10), p.1748-1751
Main Authors: Abdel-Aziz, Mosaad, Nassar, Ahmed, Rashed, Mohammed, Naguib, Nader, El-Tahan, Abdel-Rahman
Format: Article
Language:English
Subjects:
Adolescent
Child
Child, Preschool
Cleft palate
Cleft Palate - surgery
Endoscopy - adverse effects
Female
Furlow palatoplasty
Humans
Hypernasality
Male
Otolaryngology
Palate, Soft - surgery
Pediatrics
Pharynx - surgery
Postoperative Complications - etiology
Postoperative Complications - surgery
Reoperation
Speech
Treatment Outcome
Velopharyngeal insufficiency
Velopharyngeal Insufficiency - etiology
Velopharyngeal Insufficiency - surgery
Voice Quality
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Summary:Abstract Objective Velopharyngeal insufficiency (VPI) is a common complication after cleft palate repair, it may be due to lack of levator sling reconstruction and/or palatal shortening. Furlow palatoplasty has the advantages of retro-positioning of levator palati muscles and palatal lengthening. The aim of this study was to assess the efficacy of Furlow palatoplasty in the treatment of VPI in patients who undergone previous palatoplasty. Methods Twenty-three children with post-palatoplasty VPI were included in the study. Furlow technique which was not used in the primary repair, has been used as a secondary corrective surgery. Preoperative and postoperative evaluation of velopharyngeal function was performed, using auditory perceptual assessment (APA) and nasometry for speech, and flexible nasopharyngoscopy for velopharyngeal closure. Results Significant improvement of APA and nasalance score for oral and nasal sentences was achieved. Flexible nasopharyngoscopy showed complete velopharyngeal closure in 19 patients (82%) postoperatively. Conclusion Furlow palatoplasty is considered a useful treatment option for VPI in patients with previously repaired cleft palate, it improves the speech and velopharyngeal closure.
ISSN:0165-5876
1872-8464
DOI:10.1016/j.ijporl.2015.07.044