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Two-stage palatoplasty using a modified Furlow procedure.

N Nadjmi1, R Van Erum, M De Bodt

  • 1OMFS, University Hospital Antwerp (UA), Belgium. nasser@nadjmi.com

International Journal of Oral and Maxillofacial Surgery
|February 26, 2013
PubMed
Summary

This study shows a modified Furlow palatoplasty with a cheek flap improves speech and reduces hypernasality in wide cleft palate repair. The technique resulted in zero fistulas and excellent short-term maxillary growth.

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Area of Science:

  • Craniofacial Surgery
  • Pediatric Plastic Surgery
  • Speech Pathology

Background:

  • Wide cleft palate repair presents challenges in achieving optimal speech outcomes and minimizing complications.
  • The Furlow palatoplasty is a common technique, but modifications may enhance results.

Purpose of the Study:

  • To evaluate a modified two-stage palatal repair combining Furlow palatoplasty with a unilateral myomucosal cheek flap.
  • To assess speech outcomes, fistula formation, and maxillary growth in patients with wide cleft palate.

Main Methods:

  • A prospective, successive cohort study of 40 nonsyndromic patients with wide cleft palate.
  • Comparison between a control group (Furlow palatoplasty) and a study group (modified Furlow palatoplasty with cheek flap).
  • Hard palate closure was performed 9-12 months post-initial repair.

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Main Results:

  • The modified technique (study group) showed superior Bzoch speech quality scores and significantly reduced hypernasality.
  • Zero fistula formation was observed in the study group.
  • Significant reduction in palatal cleft width and excellent short-term maxillary growth were noted.

Conclusions:

  • The modified Furlow palatoplasty with a unilateral myomucosal cheek flap offers improved speech outcomes and no fistula formation.
  • This technique is promising for managing wide cleft palates, with good early maxillary growth.
  • Long-term effects on facial development require further investigation.