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Outcomes of combined Furlow palatoplasty and sphincter pharyngoplasty for velopharyngeal insufficiency.
Otolaryngol Head Neck Surg. 2014 Feb; 150(2):216-21.OH

Abstract

OBJECTIVE

To compare surgical outcomes between pharyngeal flap, sphincter pharyngoplasty, and combined Furlow palatoplasty and sphincter pharyngoplasty in the management of pediatric velopharyngeal insufficiency.

STUDY DESIGN

Case series with chart review.

SETTING

Tertiary care pediatric hospital.

SUBJECTS AND METHODS

After exclusion of children with velocardiofacial syndrome, 96 patients who underwent surgical intervention between 2008 and 2012 were identified. Surgical interventions were categorized as pharyngeal flap, sphincter pharyngoplasty, and combined Furlow palatoplasty and sphincter pharyngoplasty. Main outcome measures included perceptual speech analyses, complications, and surgical revision rates.

RESULTS

Of the 96 reviewed patients, 38 (39.6%) underwent pharyngeal flap, 20 (20.8%) sphincter pharyngoplasty, and 38 (39.6%) combined Furlow palatoplasty and sphincter pharyngoplasty. Choice of surgical intervention was based on patient characteristics, observed palatal length, and formal speech assessments. There were no differences in patient demographics or preoperative perceptual speech analysis scores among the 3 surgical groups. The mean speech improvement was significantly greater in both the pharyngeal flap (P = .031) and combined procedure (P = .013) compared with sphincter pharyngoplasty alone, but no differences were observed between the pharyngeal flap and combined procedure (P = .797). There were no differences in complications among the 3 surgical interventions (P = .220). The combined procedure required significantly less surgical revisions than the pharyngeal flap (P = .019).

CONCLUSION

Combined Furlow palatoplasty and sphincter pharyngoplasty is an effective procedure for the management of pediatric velopharyngeal insufficiency and may result in superior speech outcomes and lower revision rates than sphincter pharyngoplasty and pharyngeal flap, respectively.

Authors+Show Affiliations

Children's Hospitals and Clinics of Minnesota, Minneapolis, Minnesota, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

24323907

Citation

Bohm, Lauren A., et al. "Outcomes of Combined Furlow Palatoplasty and Sphincter Pharyngoplasty for Velopharyngeal Insufficiency." Otolaryngology--head and Neck Surgery : Official Journal of American Academy of Otolaryngology-Head and Neck Surgery, vol. 150, no. 2, 2014, pp. 216-21.
Bohm LA, Padgitt N, Tibesar RJ, et al. Outcomes of combined Furlow palatoplasty and sphincter pharyngoplasty for velopharyngeal insufficiency. Otolaryngol Head Neck Surg. 2014;150(2):216-21.
Bohm, L. A., Padgitt, N., Tibesar, R. J., Lander, T. A., & Sidman, J. D. (2014). Outcomes of combined Furlow palatoplasty and sphincter pharyngoplasty for velopharyngeal insufficiency. Otolaryngology--head and Neck Surgery : Official Journal of American Academy of Otolaryngology-Head and Neck Surgery, 150(2), 216-21. https://doi.org/10.1177/0194599813513715
Bohm LA, et al. Outcomes of Combined Furlow Palatoplasty and Sphincter Pharyngoplasty for Velopharyngeal Insufficiency. Otolaryngol Head Neck Surg. 2014;150(2):216-21. PubMed PMID: 24323907.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Outcomes of combined Furlow palatoplasty and sphincter pharyngoplasty for velopharyngeal insufficiency. AU - Bohm,Lauren A, AU - Padgitt,Noëlle, AU - Tibesar,Robert J, AU - Lander,Timothy A, AU - Sidman,James D, Y1 - 2013/12/09/ PY - 2013/12/11/entrez PY - 2013/12/11/pubmed PY - 2014/4/15/medline KW - Furlow palatoplasty KW - outcomes KW - pediatric KW - sphincter pharyngoplasty KW - velopharyngeal insufficiency SP - 216 EP - 21 JF - Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery JO - Otolaryngol Head Neck Surg VL - 150 IS - 2 N2 - OBJECTIVE: To compare surgical outcomes between pharyngeal flap, sphincter pharyngoplasty, and combined Furlow palatoplasty and sphincter pharyngoplasty in the management of pediatric velopharyngeal insufficiency. STUDY DESIGN: Case series with chart review. SETTING: Tertiary care pediatric hospital. SUBJECTS AND METHODS: After exclusion of children with velocardiofacial syndrome, 96 patients who underwent surgical intervention between 2008 and 2012 were identified. Surgical interventions were categorized as pharyngeal flap, sphincter pharyngoplasty, and combined Furlow palatoplasty and sphincter pharyngoplasty. Main outcome measures included perceptual speech analyses, complications, and surgical revision rates. RESULTS: Of the 96 reviewed patients, 38 (39.6%) underwent pharyngeal flap, 20 (20.8%) sphincter pharyngoplasty, and 38 (39.6%) combined Furlow palatoplasty and sphincter pharyngoplasty. Choice of surgical intervention was based on patient characteristics, observed palatal length, and formal speech assessments. There were no differences in patient demographics or preoperative perceptual speech analysis scores among the 3 surgical groups. The mean speech improvement was significantly greater in both the pharyngeal flap (P = .031) and combined procedure (P = .013) compared with sphincter pharyngoplasty alone, but no differences were observed between the pharyngeal flap and combined procedure (P = .797). There were no differences in complications among the 3 surgical interventions (P = .220). The combined procedure required significantly less surgical revisions than the pharyngeal flap (P = .019). CONCLUSION: Combined Furlow palatoplasty and sphincter pharyngoplasty is an effective procedure for the management of pediatric velopharyngeal insufficiency and may result in superior speech outcomes and lower revision rates than sphincter pharyngoplasty and pharyngeal flap, respectively. SN - 1097-6817 UR - https://www.unboundmedicine.com/medline/citation/24323907/Outcomes_of_combined_Furlow_palatoplasty_and_sphincter_pharyngoplasty_for_velopharyngeal_insufficiency_ L2 - http://journals.sagepub.com/doi/full/10.1177/0194599813513715?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -