Double-Opposing Z-Plasty for Secondary Surgical Management of Velopharyngeal Insufficiency Following Primary Furlow Palatoplasty

The Cleft Palate-craniofacial Journal : Official Publication of the American Cleft Palate-Craniofacial Association
A K GosainWalter M Sweeney

Abstract

The present study investigates the efficacy of performing a "palate rerepair" utilizing a double-opposing z-palatoplasty (DOZ) following primary Furlow palatoplasty. Retrospective study. Tertiary referral academic center for craniofacial surgery. 15 consecutive patients who presented with velopharyngeal insufficiency (VPI) after primary Furlow palatoplasty. All subjects were evaluated using the perceptual speech assessment (PSA) scale. Criteria for inclusion in the study were (1) velopharyngeal gap size on phonation of 7 mm or less and (2) lateral wall motion at least 40% normal. Mean PSA score was 7.13 + 3.31 (range 3-13) preoperatively, and decreased to 1.80 + 2.83 (range 0-11; P < .001 vs baseline) 3 months or more after surgery. A sphincter pharyngoplasty was performed as a tertiary procedure in 2 patients due to persistent nasal air emission. There was no symptomatic airway compromise following secondary or tertiary management in all patients. Presence of a cleft lip, lateral wall motion, and velopharyngeal gap size did not impact outcomes. We have demonstrated that a DOZ performed secondarily is anatomically possible following Furlow palatoplasty and can restore function of the levator muscle despite significant scarring ...Continue Reading

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Sep 23, 2014·The Cleft Palate-craniofacial Journal : Official Publication of the American Cleft Palate-Craniofacial Association·Harvey ChimArun K Gosain

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Citations

Mar 29, 2019·Plastic and Reconstructive Surgery·Cecil S QiuArun K Gosain
Jun 11, 2020·Current Opinion in Otolaryngology & Head and Neck Surgery·Michael M LindeborgDavid A Shaye
Sep 12, 2020·The Cleft Palate-craniofacial Journal : Official Publication of the American Cleft Palate-Craniofacial Association·Cheng-Chun WuJui-Pin Lai
Nov 26, 2020·Plastic and Reconstructive Surgery·Katelyn G MakarChristian J Vercler
Aug 18, 2021·The Cleft Palate-craniofacial Journal : Official Publication of the American Cleft Palate-Craniofacial Association·Krishnamurthy BonanthayaPritham N Shetty

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