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Use of a modified Furlow Z-plasty as a secondary cleft palate repair procedure to reduce velopharyngeal insufficiency.
Int J Oral Maxillofac Surg 2016; 45(2):170-6IJ

Abstract

Cleft palate repair is done to allow for normal speech by separating the oral and nasal cavities and creating a functioning velopharyngeal valve. However, despite cleft palate repair, some patients demonstrate velopharyngeal insufficiency (VPI). An attempt was made to determine the effectiveness of a modified secondary Furlow Z-plasty in improving VPI. Fifty-five children aged between 12 and 15 years, with postoperative VPI following primary palatoplasty, were included in the study. These children underwent a modified Furlow Z-plasty. Nasometry was done to determine the change in velopharyngeal function due to the secondary Furlow Z-plasty by comparing the preoperative with the 1-year postoperative nasalance scores. A test-retest study was performed to determine the reliability of the nasometric measures. Reliability measurements of the nasometer passages revealed good reliability for 18 out of the 25 speech passages. There was a statistically significant reduction in VPI at 1 year postoperative in patients who were treated with the modified Furlow Z-plasty, with a P-value of <0.001 in all passages, except velar plosives, which had a P-value of 0.002. Patients with VPI after primary palatoplasty and treated using a modified Furlow Z-plasty had significantly lower nasalance scores at 1 year postoperative, indicating significantly improved velopharyngeal function.

Authors+Show Affiliations

GSR Institute of Craniofacial Surgery, Vinay Nagar Colony, Saidabad, Hyderabad, India. Electronic address: raj@craniofacialinstitute.org.GSR Institute of Craniofacial Surgery, Vinay Nagar Colony, Saidabad, Hyderabad, India.GSR Institute of Craniofacial Surgery, Vinay Nagar Colony, Saidabad, Hyderabad, India.Radboud University Nijmegen Medical Centre, Nijmegen, Netherlands.Cincinnati Children's Hospital Medical Center and the University of Cincinnati Medical Center, Cincinnati, OH, USA.Radboud University Nijmegen Medical Centre, Nijmegen, Netherlands.Radboud University Nijmegen Medical Centre, Nijmegen, Netherlands.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

26253843

Citation

Reddy, R R., et al. "Use of a Modified Furlow Z-plasty as a Secondary Cleft Palate Repair Procedure to Reduce Velopharyngeal Insufficiency." International Journal of Oral and Maxillofacial Surgery, vol. 45, no. 2, 2016, pp. 170-6.
Reddy RR, Reddy SG, Banala B, et al. Use of a modified Furlow Z-plasty as a secondary cleft palate repair procedure to reduce velopharyngeal insufficiency. Int J Oral Maxillofac Surg. 2016;45(2):170-6.
Reddy, R. R., Reddy, S. G., Banala, B., Bronkhorst, E., Kummer, A. W., Kuijpers-Jagtman, A. M., & Bergé, S. J. (2016). Use of a modified Furlow Z-plasty as a secondary cleft palate repair procedure to reduce velopharyngeal insufficiency. International Journal of Oral and Maxillofacial Surgery, 45(2), pp. 170-6. doi:10.1016/j.ijom.2015.07.006.
Reddy RR, et al. Use of a Modified Furlow Z-plasty as a Secondary Cleft Palate Repair Procedure to Reduce Velopharyngeal Insufficiency. Int J Oral Maxillofac Surg. 2016;45(2):170-6. PubMed PMID: 26253843.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Use of a modified Furlow Z-plasty as a secondary cleft palate repair procedure to reduce velopharyngeal insufficiency. AU - Reddy,R R, AU - Reddy,S G, AU - Banala,B, AU - Bronkhorst,E, AU - Kummer,A W, AU - Kuijpers-Jagtman,A M, AU - Bergé,S J, Y1 - 2015/08/05/ PY - 2014/11/11/received PY - 2015/03/22/revised PY - 2015/07/14/accepted PY - 2015/8/9/entrez PY - 2015/8/9/pubmed PY - 2016/10/22/medline KW - Furlow Z-plasty KW - cleft palate KW - hypernasality KW - nasometry KW - secondary palatoplasty KW - speech KW - velopharyngeal insufficiency SP - 170 EP - 6 JF - International journal of oral and maxillofacial surgery JO - Int J Oral Maxillofac Surg VL - 45 IS - 2 N2 - Cleft palate repair is done to allow for normal speech by separating the oral and nasal cavities and creating a functioning velopharyngeal valve. However, despite cleft palate repair, some patients demonstrate velopharyngeal insufficiency (VPI). An attempt was made to determine the effectiveness of a modified secondary Furlow Z-plasty in improving VPI. Fifty-five children aged between 12 and 15 years, with postoperative VPI following primary palatoplasty, were included in the study. These children underwent a modified Furlow Z-plasty. Nasometry was done to determine the change in velopharyngeal function due to the secondary Furlow Z-plasty by comparing the preoperative with the 1-year postoperative nasalance scores. A test-retest study was performed to determine the reliability of the nasometric measures. Reliability measurements of the nasometer passages revealed good reliability for 18 out of the 25 speech passages. There was a statistically significant reduction in VPI at 1 year postoperative in patients who were treated with the modified Furlow Z-plasty, with a P-value of <0.001 in all passages, except velar plosives, which had a P-value of 0.002. Patients with VPI after primary palatoplasty and treated using a modified Furlow Z-plasty had significantly lower nasalance scores at 1 year postoperative, indicating significantly improved velopharyngeal function. SN - 1399-0020 UR - https://www.unboundmedicine.com/medline/citation/26253843/Use_of_a_modified_Furlow_Z_plasty_as_a_secondary_cleft_palate_repair_procedure_to_reduce_velopharyngeal_insufficiency_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0901-5027(15)00265-9 DB - PRIME DP - Unbound Medicine ER -