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Palatoplasty: Furlow's double reversing Z-plasty versus intravelar veloplasty
E Gunther1, J R Wisser, M A Cohen
1Mary Imogene Bassett Hospital, Cooperstown, New York, USA.
Objective:
To evaluate the efficacy of Furlow's double reversing z-plasty (Furlow) versus intravelar veloplasty with longitudinal closure including palatal muscle reorientation (IVV).
Design:
Retrospective, single-institution, single-surgeon comparison.
Patients:
One hundred nineteen consecutive cleft palate patients were enrolled; 34 syndromic and 9 language-impaired patients were removed from speech and reoperation analysis. Furlow and IVV groups were similar with respect to sex and mean age at primary repair.
Interventions:
One surgeon performed all surgery and one of two speech pathologists conducted language and speech evaluations at 3 years of age without prior knowledge of the surgical technique utilized.
Outcome Measures:
Outcome measures included frequency of palatal fistulae, speech abnormalities, and need for secondary pharyngoplasty procedures.
Results:
Patients who had undergone IVV demonstrated a 34% higher incidence of hoarseness, nasal escape, and hypernasality at 3 years of age than did Furlow patients. These same patients likewise required significantly more secondary pharyngoplasty procedures. No significant difference was noted between fistulae frequencies.
Conclusions:
These findings suggest that Furlow palatoplasty may provide a better clinical outcome than intravelar veloplasty.