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The double-reversing Z-plasty in primary palatoplasty: operative experience and early results
B B Horswell1, C L Castiglione, A E Poole
1University of Connecticut, Farmington.
Insights
The Furlow double-reversing Z-plasty effectively repaired cleft palates in 34 children, showing good soft palate mobility and velopharyngeal function post-surgery. This technique offers a favorable outcome for pediatric palate reconstruction.
Area of Science:
- Plastic Surgery
- Pediatric Surgery
- Speech Pathology
Background:
- Cleft palate repair is crucial for speech development and facial growth.
- The Furlow double-reversing Z-plasty is a technique for soft palate closure.
Purpose of the Study:
- To evaluate the efficacy and outcomes of the Furlow double-reversing Z-plasty in children with cleft palate.
- To assess intraoperative factors, postoperative complications, and speech results.
Main Methods:
- Retrospective review of 34 children undergoing Furlow double-reversing Z-plasty for cleft palate.
- Analysis of operative time, blood loss, hospital stay, and complications.
- Early speech evaluation focusing on palate mobility and velopharyngeal function.
Main Results:
- Favorable intraoperative experience with acceptable operating time and blood loss.
- Low complication rate including temporary stridor, one hard palate dehiscence, and three oronasal fistulae.
- Excellent soft palate mobility (33/34) and observable velopharyngeal function, with mild velar compromise in some patients.
Conclusions:
- The Furlow double-reversing Z-plasty is a safe and effective method for cleft palate repair in children.
- The procedure demonstrates good functional outcomes regarding speech and velopharyngeal function.
- Further research can explore long-term speech results and compare with other techniques.
Abstract:
The double-reversing Z-plasty of Furlow for closure of the soft palate was used in 34 children with various types of cleft palate. Mean age at repair was 12.8 months. Intraoperative experience was favorable, with acceptable operating time and blood loss. Length of hospitalization averaged 1.9 days. Postoperatively, two children experienced temporary stridor, which resolved within 24 to 48 hours. One child had dehiscence of the hard palate (Von Lagenbeck repair) 4 weeks postoperatively, and three children developed small oronasal fistulae. Early speech evaluation demonstrated adequate soft palate mobility in 33 of 34 patients, with observable velopharyngeal function. Twelve children had mild velar compromise, with eight exhibiting slight nasal air escape.
