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Furlow palatoplasty

Jordan W Swanson, Brianne T Mitchell, Marilyn Cohen, Cynthia Solot, Oksana Jackson, David Low, Scott P Bartlett, Jesse A Taylor
BACKGROUND: Because some patients with submucous cleft palate (SMCP) are asymptomatic, surgical treatment is conventionally delayed until hypernasal resonance is identified during speech production. We aim to identify whether speech outcomes after repair of a SMCP is influenced by age of repair. METHODS: We retrospectively studied nonsyndromic children with SMCP. Speech results, before and after any surgical treatment or physical management of the palate were compared using the Pittsburgh Weighted Speech Scoring system...
March 21, 2017: Annals of Plastic Surgery
Mert Calis, Galip Gencay Ustun, Mehtap Ozturk, Riza Onder Gunaydin, Mavis Emel Kulak Kayikci, Figen Ozgur
Submucous cleft palate (SMCP) is a relatively rare variant of the common pathology of cleft palate with specific anatomic and clinical features. Even though there are many surgical options defined previously to correct the SMCP, correction of the velopharyngeal insufficiency and obtaining ideal speech results remains as a challenge. The aim of this article was to compare the speech benefits of Furlow double opposing Z plasty and posterior pharyngeal flap operation combined with intravelar veloplasty for the correction of SMCP using objective assessment tools...
February 16, 2017: Journal of Craniofacial Surgery
K Madachi, R Takagi, T Asahito, Y Kodama, R Ominato, A Iida, K Ono, I Saito
The effects on craniofacial growth of two different soft palate repair techniques in two-stage palatoplasty were investigated. This was a retrospective, cross-sectional cohort study of 68 children with non-syndromic, complete unilateral cleft lip and palate. Thirty-four patients were treated with the modified Furlow method (F-group) and the remaining 34 with the Widmaier-Perko method (P-group). Craniofacial growth was assessed by analyzing 12 angular and 12 linear measurements on lateral cephalograms. Composite facial diagrams from the two groups were compared with those of a control non-cleft group...
February 4, 2017: International Journal of Oral and Maxillofacial Surgery
F Li, H-T Wang, Y-Y Chen, W-L Wu, J-Y Liu, J-S Hao, D-Y Luo
This study was performed to investigate the incidence of and risk factors for postoperative cleft relapse and oronasal fistula after Furlow palatoplasty in infants. Sixty-two infants with cleft palate, aged 6-12 months (mean 8.25 months), who underwent cleft repair by Furlow double opposing Z-plasty between March 2012 and August 2014, were enrolled in the study. Risk factors for postoperative cleft relapse and oronasal fistula after Furlow palatoplasty were identified by logistic regression analysis. The incidence rates of cleft relapse at 1 week and oronasal fistula at 3 months after surgery were 24...
March 2017: International Journal of Oral and Maxillofacial Surgery
Pamela A Rudnicki, Christopher Tsang, Mark A Vecchiotti, Andrew R Scott
Importance: Indications for Furlow palatoplasty include primary repair of cleft palate as well as secondary repair, or secondary palatoplasty for treatment of velopharyngeal insufficiency. Speculation exists surrounding the benefit of secondary Furlow palatoplasty in cases of a previously well-reconstructed palate or a short but otherwise anatomically normal soft palate because it has been theorized that reorientation of a previously reconstructed or normal muscular levator sling should in fact worsen palatal motion...
February 1, 2017: JAMA Otolaryngology—Head & Neck Surgery
Byung Jun Kim, Tae Hyun Choi, Sukwha Kim
BACKGROUND:   Blood loss during cleft palate surgery has been investigated in previous research, but there is no report regarding blood loss when performing Furlow's double opposing Z-plasty (DOZ). In the present study, we evaluated intraoperative blood loss in patients with cleft palate who underwent the DOZ procedure. MATERIALS AND METHODS:   Intraoperative blood loss was prospectively investigated in 59 patients undergoing palatoplasty with DOZ by a single surgeon between August 2012 and July 2013...
September 12, 2016: Cleft Palate-craniofacial Journal
Cuneyt M Alper, Joseph E Losee, James T Seroky, Ellen M Mandel, Beverly C Richert, William J Doyle
OBJECTIVE: To describe the temporal pattern of otitis media with effusion (OME) resolution for a cohort of nonsyndromic cleft palate children enrolled before palatoplasty and followed through 5 years of age. DESIGN: This is a prospective, longitudinal study of the time course for OME resolution in infants and children with palatal clefts. SETTING: Cleft Palate Craniofacial Center of a tertiary care pediatric hospital. PARTICIPANTS: This study included 52 children with cleft palate (29 boys, 45 white, Veau 1 through 4) who had a Furlow-type palatoplasty between 10 and 24 months of age performed by one of six surgeons...
September 2016: Cleft Palate-craniofacial Journal
Ana Flavia Rodrigues da Silva, Jeniffer de Cássia Rillo Dutka, Adna Maressa Pereira do Amaral, Maíra de Souza Périco, Maria Inês Pegoraro-Krook
OBJECTIVE:  To describe and compare measures of velar length, velar thickness, and depth of the nasopharynx between two groups of patients with velopharyngeal dysfunction after primary palatoplasty: one received the modified Langenbeck procedure and the other the Furlow procedure. DESIGN:  Comparative study involving a convenience sample of videofluoroscopic films established prospectively. SETTING:  Surgeries and videofluoroscopic assessments were conducted at a craniofacial center...
July 18, 2016: Cleft Palate-craniofacial Journal
Kazuaki Yamaguchi, Daniel Lonic, Che-Hsiung Lee, Claudia Yun, Lun-Jou Lo
BACKGROUND: A smaller Z-plasty is applied in a modified Furlow palatoplasty. The purpose of this study was to assess its surgical and functional outcome. METHODS: The surgical technique included mucoperiosteal flap elevation in the hard palate, complete pedicle dissection and release, double-opposing Z-plasty using 5-mm limbs and muscle dissection in the soft palate, and the buccal fat pad covering lateral relaxing wounds. A retrospective chart review was conducted for 231 consecutive nonsyndromic patients undergoing modified palatoplasty from May of 2007 to December of 2014...
June 2016: Plastic and Reconstructive Surgery
Mekonen Eshete, Liliana Camison, Fikre Abate, Taye Hailu, Yohannes Demissie, Ibrahim Mohammed, Azeez Butali, H Wolfgang Losken, Alexander M Spiess
UNLABELLED: Although cleft lip and cleft palate are among the most common congenital malformations, the presence of an isolated congenital palatal fistula along with a submucous cleft is very rare. This appears as an oval-shaped, full-thickness fenestration in the palatal midline that does not fully extend anteriorly or posteriorly, accompanied by the findings of a submucous cleft. Because of the uncommon nature of this entity, there is controversy about its etiology, diagnosis, and management...
February 2016: Plastic and Reconstructive Surgery. Global Open
Samir Mardini, Harvey Chim, Rimante Seselgyte, Philip Kuo-Ting Chen
BACKGROUND: The aim of this study was to evaluate, through multivariate ordinal logistic regression, variables contributing to good postoperative speech outcomes following Furlow palatoplasty. METHODS: A series of 91 consecutive patients was evaluated. Variables analyzed included demographics; speech perceptual assessment; and measures on videonasopharyngoscopy and videofluoroscopy such as preoperative closure pattern, velopharyngeal gap, and lateral pharyngeal wall motion...
January 2016: Plastic and Reconstructive Surgery
Evan B Katzel, Sameer Shakir, Sanjay Naran, Zoe MacIsaac, Liliana Camison, Matthew Greives, Jesse A Goldstein, Lorelei J Grunwaldt, Matthew D Ford, Joseph E Losee
BACKGROUND: Velopharyngeal insufficiency affects as many as one in three patients after cleft palate repair. Correction using a posterior pharyngeal flap (PPF) has been shown to improve clinical speech symptomatology; however, PPFs can be complicated by hyponasality and obstructive sleep apnea. The goal of this study was to assess if speech outcomes revert after clinically indicated PPF takedown. METHODS: The cleft-craniofacial database of the Children's Hospital of Pittsburgh at the University of Pittsburgh Medical Center was retrospectively queried to identify patients with a diagnosis of velopharyngeal insufficiency treated with PPF who ultimately required takedown...
October 2016: Annals of Plastic Surgery
Wakako Tome, Kohtaro Yashiro, Mikihiko Kogo, Takashi Yamashiro
OBJECTIVE:   To clarify the differences in the long-term effects of maxillary expansion (ME) and protraction (MP) in patients with complete unilateral cleft lip, alveolus, and palate (UCLP) undergoing two types of palatoplasty. DESIGN:   Retrospective longitudinal study. SETTING:   Institutional study. PATIENTS AND INTERVENTIONS:   Thirty-eight patients with UCLP treated at Osaka University Dental Hospital, Japan, were divided into two groups: 19 patients were treated using Wardill-Kilner push-back palatoplasty (PB), and 19 patients were treated with early two-stage palatoplasty according to the modified Furlow technique (ETS)...
September 25, 2015: Cleft Palate-craniofacial Journal
Mosaad Abdel-Aziz, Ahmed Nassar, Mohammed Rashed, Nader Naguib, Abdel-Rahman El-Tahan
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...
October 2015: International Journal of Pediatric Otorhinolaryngology
Joon Seok Lee, Jae Bong Kim, Jeong Woo Lee, Jung Dug Yang, Ho Yun Chung, Byung Chae Cho, Kang Young Choi
BACKGROUND: Palatoplasty is aimed to achieve normal speech, improve food intake, and ensure successful maxillary growth. However, the velopharyngeal function is harder to control than other functions. Therefore, many studies on the prognostic factor of velopharyngeal insufficiency have been conducted. This study aimed to evaluate the relationships between speech outcomes and multimodality based on intraoral and preoperative three-dimensional computerized tomographic (CT) findings. METHODS: Among 73 children with cleft palate who underwent palatoplasty between April 2011 and August 2014 at Kyungpook National University Hospital (KNUH), 27 were retrospectively evaluated...
October 2015: Journal of Cranio-maxillo-facial Surgery
R R Reddy, S G Reddy, B Banala, E Bronkhorst, A W Kummer, A M Kuijpers-Jagtman, S J Bergé
Cleft palate repair is done to allow for normal speech by separating the oral and nasal cavities and creating a functioning velopharyngeal valve. However, despite cleft palate repair, some patients demonstrate velopharyngeal insufficiency (VPI). An attempt was made to determine the effectiveness of a modified secondary Furlow Z-plasty in improving VPI. Fifty-five children aged between 12 and 15 years, with postoperative VPI following primary palatoplasty, were included in the study. These children underwent a modified Furlow Z-plasty...
February 2016: International Journal of Oral and Maxillofacial Surgery
M S Brgoch, K M Dodson, T C Kim, D M Kim, R Trivelpiece, J L Rhodes
BACKGROUND: Chronic otitis media with effusion is a persistent complication essentially universal in children with cleft palate. The prevalence of chronic otitis media with effusion is hypothesized to be a result of Eustachian tube dysfunction secondary to the anomalous insertion of the palatal musculature. This study was designed to evaluate the timing of tympanostomy tube placement and the effect of primary palatoplasty technique on the recovery of Eustachian tube function and resolution of chronic otitis media with effusion...
2015: Eplasty
Jonathan R Skirko, Edward M Weaver, Jonathan A Perkins, Sara Kinter, Linda Eblen, Julie Martina, Kathleen C Y Sie
OBJECTIVES: (1) To define the minimal clinically important difference (MCID) of the Velopharyngeal Insufficiency (VPI) Effects on Life Outcomes (VELO) instrument, and (2) to test for the change in quality of life (QOL) after VPI surgery. STUDY DESIGN: Prospective observational cohort. SETTING: VPI clinic at a tertiary pediatric medical center. SUBJECTS AND METHODS: Children with VPI and their parents completed the VELO instrument (higher score is better QOL) at enrollment and then underwent VPI surgery (Furlow palatoplasty or sphincter pharyngoplasty, n = 32), other treatments (obturator or oronasal fistula repair, n = 7), or no treatment (n = 18)...
November 2015: Otolaryngology—Head and Neck Surgery
Rosana Prado-Oliveira, Ilza Lazarini Marques, Luiz de Souza, Telma Vidoto de Souza-Brosco, Jeniffer de Cássia Rillo Dutka
PURPOSE: To report the outcomes of primary palatoplasty in Robin Sequence (RS); to verify the relationship between modalities of assessment of nasality; to compare nasality between techniques at palatoplasty. METHODS: This study involved the identification of hypernasality in four modalities: live assessment with 4-point scale; live assessment with cul-de-sac test; multiple listeners' ratings of recorded phrase; nasometric assessment. Live ratings of speech nasality and nasalance scores were retrieved from charts, while a recorded phrase was rated by listeners for occurrence of hypernasality...
January 2015: CoDAS
Shinji Kobayashi, Takashi Hirakawa, Toshihiko Fukawa, Jiro Maegawa
BACKGROUND AND AIMS: In bilateral cleft lip and palate (BCLP) with premaxillary protrusion, a good outcome with adequate maxillary development is difficult to achieve. The purpose of this article is to evaluate the maxillary growth after using presurgical orthopedics (PSO), gingivoperiosteoplasty (GPP), Furlow palatoplasty, and maxillary protraction appliance (MPA) for BCLP with premaxillary protrusion. PATIENTS AND METHODS: Seven patients with complete BCLP with premaxillary protrusion were treated by PSO, cheiloplasty, GPP, and Furlow palatoplasty...
June 2015: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
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