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Redo double-opposing Z-plasty is effective for correction of marginal velopharyngeal insufficiency.
J Plast Reconstr Aesthet Surg 2015; 68(9):1215-20JP

Abstract

OBJECTIVE

Double-opposing Z-plasty (DOZ) of the Furlow method has been successfully used for the correction of marginal velopharyngeal insufficiency (VPI) by reconstructing the levator muscle and lengthening the soft palate. For a recurrent or residual marginal VPI, it was questioned whether redo DOZ could be applied to correct the problem and minimize surgical morbidity. This study reported the outcome of the redo DOZ.

MATERIALS AND METHODS

The DOZ procedure was the method of choice for marginal VPI in the authors' center. To evaluate the effectiveness of the redo operation, patients with cleft palate with or without cleft lip treated from 2005 to 2014 were reviewed. Inclusion criteria were non-syndromic patients who underwent the second DOZ for the correction of marginal VPI. Clinical information, speech assessment, and nasopharyngoscopic findings were reviewed.

RESULTS

The velopharyngeal function was improved from marginal to adequate in all 13 patients either subjectively or objectively. The resonance became normal in nine patients after the surgery, and the change was statistically significant. Preoperative audible nasal emission improved in four out of five patients. Complications were minor or transient including one patient with snoring. No patient complained of airway or sleep problems.

CONCLUSION

Although the levator muscle sling might be disturbed by the redo DOZ procedure, the surgery was effective in correcting the residual VPI with low morbidity.

Authors+Show Affiliations

Medical School of Chang Gung University, Taoyuan, Taiwan.Speech Pathologist in the Craniofacial Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan.Speech Pathologist in the Craniofacial Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan.Plastic and Reconstructive Surgery, Craniofacial Center, and Craniofacial Research Center, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan. Electronic address: lunjoulo@cgmh.org.tw.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

26140988

Citation

Hsu, Po-Jung, et al. "Redo Double-opposing Z-plasty Is Effective for Correction of Marginal Velopharyngeal Insufficiency." Journal of Plastic, Reconstructive & Aesthetic Surgery : JPRAS, vol. 68, no. 9, 2015, pp. 1215-20.
Hsu PJ, Wang SH, Yun C, et al. Redo double-opposing Z-plasty is effective for correction of marginal velopharyngeal insufficiency. J Plast Reconstr Aesthet Surg. 2015;68(9):1215-20.
Hsu, P. J., Wang, S. H., Yun, C., & Lo, L. J. (2015). Redo double-opposing Z-plasty is effective for correction of marginal velopharyngeal insufficiency. Journal of Plastic, Reconstructive & Aesthetic Surgery : JPRAS, 68(9), pp. 1215-20. doi:10.1016/j.bjps.2015.05.014.
Hsu PJ, et al. Redo Double-opposing Z-plasty Is Effective for Correction of Marginal Velopharyngeal Insufficiency. J Plast Reconstr Aesthet Surg. 2015;68(9):1215-20. PubMed PMID: 26140988.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Redo double-opposing Z-plasty is effective for correction of marginal velopharyngeal insufficiency. AU - Hsu,Po-Jung, AU - Wang,Shu-Hui, AU - Yun,Claudia, AU - Lo,Lun-Jou, Y1 - 2015/06/04/ PY - 2015/03/12/received PY - 2015/05/05/accepted PY - 2015/7/5/entrez PY - 2015/7/5/pubmed PY - 2015/11/18/medline KW - Cleft palate KW - Double-opposing Z-plasty KW - Furlow palatoplasty KW - Velopharyngeal insufficiency SP - 1215 EP - 20 JF - Journal of plastic, reconstructive & aesthetic surgery : JPRAS JO - J Plast Reconstr Aesthet Surg VL - 68 IS - 9 N2 - OBJECTIVE: Double-opposing Z-plasty (DOZ) of the Furlow method has been successfully used for the correction of marginal velopharyngeal insufficiency (VPI) by reconstructing the levator muscle and lengthening the soft palate. For a recurrent or residual marginal VPI, it was questioned whether redo DOZ could be applied to correct the problem and minimize surgical morbidity. This study reported the outcome of the redo DOZ. MATERIALS AND METHODS: The DOZ procedure was the method of choice for marginal VPI in the authors' center. To evaluate the effectiveness of the redo operation, patients with cleft palate with or without cleft lip treated from 2005 to 2014 were reviewed. Inclusion criteria were non-syndromic patients who underwent the second DOZ for the correction of marginal VPI. Clinical information, speech assessment, and nasopharyngoscopic findings were reviewed. RESULTS: The velopharyngeal function was improved from marginal to adequate in all 13 patients either subjectively or objectively. The resonance became normal in nine patients after the surgery, and the change was statistically significant. Preoperative audible nasal emission improved in four out of five patients. Complications were minor or transient including one patient with snoring. No patient complained of airway or sleep problems. CONCLUSION: Although the levator muscle sling might be disturbed by the redo DOZ procedure, the surgery was effective in correcting the residual VPI with low morbidity. SN - 1878-0539 UR - https://www.unboundmedicine.com/medline/citation/26140988/Redo_double_opposing_Z_plasty_is_effective_for_correction_of_marginal_velopharyngeal_insufficiency_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1748-6815(15)00242-9 DB - PRIME DP - Unbound Medicine ER -