Clinical Outcomes of the Furlow Z-Plasty for Primary Cleft Palate Repair

Objective: To review the clinical outcomes following the Furlow Z-plasty for primary cleft palate repair. The primary objective was to determine if the presence of an associated sequence or syndrome (i.e., Pierre Robin sequence), age at palate repair, cleft type, or surgeon experience influenced spe...

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Veröffentlicht in:The Cleft palate-craniofacial journal 2008-09, Vol.45 (5), p.501-510
Hauptverfasser: Khosla, Rohit K., Mabry, Kelly, Castiglione, Charles L.
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creator Khosla, Rohit K.
Mabry, Kelly
Castiglione, Charles L.
description Objective: To review the clinical outcomes following the Furlow Z-plasty for primary cleft palate repair. The primary objective was to determine if the presence of an associated sequence or syndrome (i.e., Pierre Robin sequence), age at palate repair, cleft type, or surgeon experience influenced speech outcomes after a Furlow Z-plasty. Design: The outcomes of 140 patients who underwent palate repair were analyzed retrospectively. Speech evaluations were performed to score the severity of hypernasality, nasal escape, articulation errors, and velopharyngeal insufficiency. Results: The mean age at latest evaluation was 4 years 9 months (age range 2 years old to 12 years old and 4 months). Of the 140 patients, 83% had no evidence of hypernasality, 91% had no presence of nasal escape, and 69% had no articulation errors. Overall, 84% of patients had no evidence of velopharyngeal insufficiency. Secondary posterior pharyngeal flap to correct velopharyngeal insufficiency was required in only 2.1% of patients. The formation of an oronasal fistula occurred in only 3.6% of patients. Nonsyndromic patients with Pierre Robin sequence and syndromic patients did just as well as purely nonsyndromic patients in terms of velopharyngeal insufficiency, hypernasality, and nasal escape. Syndromic patients were more likely to make mild-to-moderate articulation errors. In addition, age at palate repair, cleft type, and surgeon experience had no statistically significant effect on speech results. Conclusions: The Furlow Z-plasty yielded excellent speech results in our patient population with minimal and acceptable rates of fistula formation, velopharyngeal insufficiency, and the need for additional corrective surgery.
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The primary objective was to determine if the presence of an associated sequence or syndrome (i.e., Pierre Robin sequence), age at palate repair, cleft type, or surgeon experience influenced speech outcomes after a Furlow Z-plasty. Design: The outcomes of 140 patients who underwent palate repair were analyzed retrospectively. Speech evaluations were performed to score the severity of hypernasality, nasal escape, articulation errors, and velopharyngeal insufficiency. Results: The mean age at latest evaluation was 4 years 9 months (age range 2 years old to 12 years old and 4 months). Of the 140 patients, 83% had no evidence of hypernasality, 91% had no presence of nasal escape, and 69% had no articulation errors. Overall, 84% of patients had no evidence of velopharyngeal insufficiency. Secondary posterior pharyngeal flap to correct velopharyngeal insufficiency was required in only 2.1% of patients. The formation of an oronasal fistula occurred in only 3.6% of patients. Nonsyndromic patients with Pierre Robin sequence and syndromic patients did just as well as purely nonsyndromic patients in terms of velopharyngeal insufficiency, hypernasality, and nasal escape. Syndromic patients were more likely to make mild-to-moderate articulation errors. In addition, age at palate repair, cleft type, and surgeon experience had no statistically significant effect on speech results. Conclusions: The Furlow Z-plasty yielded excellent speech results in our patient population with minimal and acceptable rates of fistula formation, velopharyngeal insufficiency, and the need for additional corrective surgery.</description><identifier>ISSN: 1055-6656</identifier><identifier>EISSN: 1545-1569</identifier><identifier>DOI: 10.1597/07-063.1</identifier><identifier>PMID: 18788872</identifier><identifier>CODEN: CPJOEG</identifier><language>eng</language><publisher>Los Angeles, CA: SAGE Publications</publisher><subject>Age Factors ; Articulation Disorders - etiology ; Biological and medical sciences ; Child ; Child, Preschool ; Cleft Palate - classification ; Cleft Palate - surgery ; Clinical outcomes ; Deformities ; Dentistry ; Facial bones, jaws, teeth, parodontium: diseases, semeiology ; Female ; Humans ; Male ; Medical sciences ; Non tumoral diseases ; Nose Diseases - etiology ; Oral Fistula - etiology ; Otorhinolaryngology. Stomatology ; Pharynx - surgery ; Pierre Robin Syndrome - complications ; Postoperative Complications ; Reconstructive Surgical Procedures - methods ; Respiratory Tract Fistula - etiology ; Retrospective Studies ; Speech ; Speech Disorders - etiology ; Studies ; Surgical Flaps ; Treatment Outcome ; Upper respiratory tract, upper alimentary tract, paranasal sinuses, salivary glands: diseases, semeiology ; Velopharyngeal Insufficiency - etiology ; Velopharyngeal Insufficiency - surgery ; Voice Disorders - etiology</subject><ispartof>The Cleft palate-craniofacial journal, 2008-09, Vol.45 (5), p.501-510</ispartof><rights>2008 American Cleft Palate-Craniofacial Association</rights><rights>2008 INIST-CNRS</rights><rights>Copyright Allen Press Publishing Services Sep 2008</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c368t-cdf142fc371f04a298b5e3aaf02a0310696e3c127b6f5e18f8bec2436805a25d3</citedby><cites>FETCH-LOGICAL-c368t-cdf142fc371f04a298b5e3aaf02a0310696e3c127b6f5e18f8bec2436805a25d3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://journals.sagepub.com/doi/pdf/10.1597/07-063.1$$EPDF$$P50$$Gsage$$H</linktopdf><linktohtml>$$Uhttps://journals.sagepub.com/doi/10.1597/07-063.1$$EHTML$$P50$$Gsage$$H</linktohtml><link.rule.ids>309,310,314,780,784,789,790,21819,23930,23931,25140,27924,27925,43621,43622</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&amp;idt=20665320$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/18788872$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Khosla, Rohit K.</creatorcontrib><creatorcontrib>Mabry, Kelly</creatorcontrib><creatorcontrib>Castiglione, Charles L.</creatorcontrib><title>Clinical Outcomes of the Furlow Z-Plasty for Primary Cleft Palate Repair</title><title>The Cleft palate-craniofacial journal</title><addtitle>Cleft Palate Craniofac J</addtitle><description>Objective: To review the clinical outcomes following the Furlow Z-plasty for primary cleft palate repair. The primary objective was to determine if the presence of an associated sequence or syndrome (i.e., Pierre Robin sequence), age at palate repair, cleft type, or surgeon experience influenced speech outcomes after a Furlow Z-plasty. Design: The outcomes of 140 patients who underwent palate repair were analyzed retrospectively. Speech evaluations were performed to score the severity of hypernasality, nasal escape, articulation errors, and velopharyngeal insufficiency. Results: The mean age at latest evaluation was 4 years 9 months (age range 2 years old to 12 years old and 4 months). Of the 140 patients, 83% had no evidence of hypernasality, 91% had no presence of nasal escape, and 69% had no articulation errors. Overall, 84% of patients had no evidence of velopharyngeal insufficiency. Secondary posterior pharyngeal flap to correct velopharyngeal insufficiency was required in only 2.1% of patients. The formation of an oronasal fistula occurred in only 3.6% of patients. Nonsyndromic patients with Pierre Robin sequence and syndromic patients did just as well as purely nonsyndromic patients in terms of velopharyngeal insufficiency, hypernasality, and nasal escape. Syndromic patients were more likely to make mild-to-moderate articulation errors. In addition, age at palate repair, cleft type, and surgeon experience had no statistically significant effect on speech results. 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The primary objective was to determine if the presence of an associated sequence or syndrome (i.e., Pierre Robin sequence), age at palate repair, cleft type, or surgeon experience influenced speech outcomes after a Furlow Z-plasty. Design: The outcomes of 140 patients who underwent palate repair were analyzed retrospectively. Speech evaluations were performed to score the severity of hypernasality, nasal escape, articulation errors, and velopharyngeal insufficiency. Results: The mean age at latest evaluation was 4 years 9 months (age range 2 years old to 12 years old and 4 months). Of the 140 patients, 83% had no evidence of hypernasality, 91% had no presence of nasal escape, and 69% had no articulation errors. Overall, 84% of patients had no evidence of velopharyngeal insufficiency. Secondary posterior pharyngeal flap to correct velopharyngeal insufficiency was required in only 2.1% of patients. The formation of an oronasal fistula occurred in only 3.6% of patients. Nonsyndromic patients with Pierre Robin sequence and syndromic patients did just as well as purely nonsyndromic patients in terms of velopharyngeal insufficiency, hypernasality, and nasal escape. Syndromic patients were more likely to make mild-to-moderate articulation errors. In addition, age at palate repair, cleft type, and surgeon experience had no statistically significant effect on speech results. Conclusions: The Furlow Z-plasty yielded excellent speech results in our patient population with minimal and acceptable rates of fistula formation, velopharyngeal insufficiency, and the need for additional corrective surgery.</abstract><cop>Los Angeles, CA</cop><pub>SAGE Publications</pub><pmid>18788872</pmid><doi>10.1597/07-063.1</doi><tpages>10</tpages></addata></record>
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subjects Age Factors
Articulation Disorders - etiology
Biological and medical sciences
Child
Child, Preschool
Cleft Palate - classification
Cleft Palate - surgery
Clinical outcomes
Deformities
Dentistry
Facial bones, jaws, teeth, parodontium: diseases, semeiology
Female
Humans
Male
Medical sciences
Non tumoral diseases
Nose Diseases - etiology
Oral Fistula - etiology
Otorhinolaryngology. Stomatology
Pharynx - surgery
Pierre Robin Syndrome - complications
Postoperative Complications
Reconstructive Surgical Procedures - methods
Respiratory Tract Fistula - etiology
Retrospective Studies
Speech
Speech Disorders - etiology
Studies
Surgical Flaps
Treatment Outcome
Upper respiratory tract, upper alimentary tract, paranasal sinuses, salivary glands: diseases, semeiology
Velopharyngeal Insufficiency - etiology
Velopharyngeal Insufficiency - surgery
Voice Disorders - etiology
title Clinical Outcomes of the Furlow Z-Plasty for Primary Cleft Palate Repair
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