The Furlow Z-plasty in two-staged palatal repair modifications and complications.
OBJECTIVE
To report the modifications and complications of the Furlow palatoplasty for two-stage closure of the palate.


METHODS
Prospective study of a consecutive series of 45 primary closures of the soft palate portion of clefts extending into the hard palate; mean (S.D.) age at repair 12 (2) months; median follow-up 4 years 4 months (range 2 months to 9 years). The hard palatal part of the cleft was closed in 18 patients at the mean age of 3 years 11 months.


RESULTS
The main modifications that we made were the use of quilting sutures, lateral V-Y closures, and fibrin glue application, and the omission of lateral releasing incisions. Patients stayed in hospital for a median of 4 days (range 3-8 days). Two patients had postoperative partial obstruction of the airway and were given steroids. In six patients, a smaller portion of the oral layer of the wound broke down; it healed by secondary intention in five, but resulted in partial dehiscence in one. There were no oronasal fistulas in the 18 patients who had delayed closure of the hard palate part of the cleft. Secondary pharyngoplasty was not necessary in any patient.


CONCLUSIONS
Furlow's technique has been modified for use in the two-stage closure of complete cleft palates (with or without cleft lip or alveolus) with an acceptable rate of complications.
Mommaerts
M Y
MY
Cleft and Craniofacial Centre Brugge, Division of Maxillo-Facial Surgery, General Hospital, St. Jan, Ruddershove 10, 8000 Bruges, Belgium. maurice.mommaerts@azbrugge.be
Combes
F A A M
FA
Drake
D
D
D000402:Airway Obstruction / Q000209:etiology; D002972:Cleft Palate / Q000601:surgery*; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D019647:Oral Surgical Procedures / Q000009:adverse effects* / Q000379:methods*; D010160:Palate, Soft / Q000601:surgery*; D011446:Prospective Studies; D013529:Surgical Wound Dehiscence / Q000209:etiology; D013536:Suture Techniques