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Published on: June 20, 2018
Early two-stage palatoplasty using modified Furlow's veloplasty.
Juntaro Nishio1, Tadashi Yamanishi, Hiroshi Kohara
1Department of Oral and Maxillofacial Surgery, Osaka Medical Center and Research Institute for Maternal and Child Health, Izumi, Osaka, Japan. nishioj@mch.pref.osaka.jp
Summary
Early two-stage palatoplasty significantly improves dental occlusion in children with unilateral cleft lip and palate (UCLP). This protocol offers better outcomes by 4 years of age compared to traditional methods.
Area of Science:
- Craniofacial surgery
- Pediatric dentistry
- Plastic surgery
Background:
- Unilateral cleft lip and palate (UCLP) presents challenges in achieving optimal velopharyngeal function and maxillary growth.
- Current surgical protocols aim to address these complex anatomical and functional deficits.
- Early intervention is crucial for long-term outcomes in UCLP patients.
Purpose of the Study:
- To evaluate the efficacy of a novel early two-stage palatoplasty protocol with modified Furlow veloplasty in UCLP patients.
- To compare the dental occlusion outcomes at 4 years of age between the new protocol and traditional pushback palatoplasty.
- To assess the impact of the surgical timing and technique on maxillofacial development.
Main Methods:
- Retrospective institutional study involving 72 UCLP patients.
- Patients were divided into two groups: early two-stage palatoplasty (ETS, n=30) and Wardill-Kilner pushback palatoplasty (PB, n=42).
- The ETS protocol involved soft palate repair at 12 months and hard palate closure at 18 months, with lip repair at 3 months.
Main Results:
- The ETS group demonstrated significantly superior occlusal conditions compared to the PB group.
- Normal occlusion incidence at the non-cleft side central incisor was 66.7% in the ETS group versus 7.1% in the PB group.
- These findings highlight a marked improvement in dental alignment with the early two-stage approach.
Conclusions:
- The early two-stage palatoplasty protocol is advantageous for UCLP children.
- This protocol leads to better dental occlusion by 4 years of age.
- The modified Furlow veloplasty within the early two-stage approach shows promise for improved maxillofacial development.
