Double-reversing z-plasty (Furlow palatoplasty)

Dr. Leonard Furlow first described the double-reversing z-plasty technique for cleft soft palate repair in 1978. This approach allows for repair of an overt or submucous cleft palate, but just as an importantly, provides additional length to the palate and also realigns the palatal musculature. The Furlow palatoplasty (the name by which the procedure is commonly referred) has therefore been instrumental in the treatment of velopharyngeal insufficiency. The primary aims of this chapter are to provide the clinician with the indications for when to consider utilizing the Furlow palatoplasty and to give a stepwise description of how to perform the procedure.