Outcomes of Primary Furlow Double-Opposing Z-plasty for the Treatment of Symptomatic Submucous Cleft Palate

J Craniofac Surg. 2023 Oct 1;34(7):2066-2070. doi: 10.1097/SCS.0000000000009385. Epub 2023 May 24.

Abstract

Background: Submucous cleft palate (SMCP) requires surgical repair if symptomatic. The Furlow double-opposing Z-plasty is the preferred method in Helsinki cleft center.

Aims: To assess the efficacy and complications of Furlow Z-plasty in the treatment of symptomatic SMCP.

Methods: This retrospective study reviewed documentation of 40 consecutive patients with symptomatic SMCP who underwent primary Furlow Z-plasty by 2 high-volume cleft surgeons at a single center between 2008 and 2017. Patients underwent perceptual and instrumental evaluation of velopharyngeal function (VPF) by speech pathologists preoperatively and postoperatively.

Results: The median age at Furlow Z-plasty was 4.8 years (SD 2.6, range 3.1-13.6). The overall success rate, including postoperative competent or borderline competent VPF, was 83%, and 10% required secondary surgery for residual velopharyngeal insufficiency. The success rate was 85% in nonsyndromic, and 67% in syndromic patients with no significant difference ( P =0.279). Complications arose in only 2 (5%) patients. No children were found to have obstructive sleep apnea postoperatively.

Conclusion: Furlow primary Z-plasty is a safe and effective operation for symptomatic SMCP with a success rate of 83% with only 5% rate of complications.

MeSH terms

  • Adolescent
  • Child
  • Child, Preschool
  • Cleft Palate* / complications
  • Humans
  • Palate, Soft / surgery
  • Plastic Surgery Procedures*
  • Retrospective Studies
  • Treatment Outcome
  • Velopharyngeal Insufficiency* / etiology