The Children's Hospital of Philadelphia modification of the Furlow double-opposing z-palatoplasty: Long-term speech and growth results

Don LaRossa, Oksana Hunenko Jackson, Richard E. Kirschner, David W. Low, Cynthia B. Solot, Marilyn A. Cohen, Rosario Mayro, Peter Wang, Nancy Minugh-Purvis, Peter Randall

Research output: Contribution to journalReview articlepeer-review

96 Scopus citations

Abstract

Of the 261 nonsyndromic patients we studied, over 90% had minimal or absent hypernasality, almost 86% had inconsistent or no nasal emission, and 95% had no articulation errors related to velar function. The patients with a Pittsburgh score indicating an incompetent velopharyngeal mechanism comprised only about 6% of the group. Ninety-four percent had a socially functional speech quality. Secondary surgery was done in 6.5% of patients and was done or was recommended in about 8% of patients. Patients with isolated cleft palate seemed to do less well, although their outcomes were not statistically different from those with complete unilateral and bilateral clefts. Relaxing incisions have kept our fistula rate to an acceptably low rate of 6.8%. No major soft palate dehiscences or hard palate flap losses have occurred. The speech outcomes we are achieving are improved over our historical results and compared with published reports using nondouble reversing z-palatoplasty techniques. Similar outcomes with the Furlow repair have been confirmed [17-19]. Maxillary growth, occlusion, and the need for orthognathic surgery do not seem to be influenced by the CHOP modification of the Furlow double-opposing z-palatoplasty. These modifications facilitate a tension free-closure and a low fistula rate.

Original languageEnglish (US)
Pages (from-to)243-249
Number of pages7
JournalClinics in Plastic Surgery
Volume31
Issue number2
DOIs
StatePublished - Apr 2004

ASJC Scopus subject areas

  • Surgery

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