Palatoplasty: Furlow's Double Reversing Z-Plasty versus Intravelar Veloplasty

Abstract

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.