Early two-stage palatoplasty using modified Furlow's veloplasty.
OBJECTIVE
To achieve sufficient velopharyngeal function and maxillary growth for patients with unilateral cleft lip and palate (UCLP), the authors have designed a new treatment protocol for palate closure involving early two-stage palatoplasty with modified Furlow veloplasty. Details of the surgical protocol and the outcomes of the dental occlusion of patients at 4 years of age are presented.


METHODS
This was an institutional retrospective study.


METHODS
Seventy-two UCLP patients were divided into two groups based on their treatment protocols: patients treated using the early two-stage palatoplasty protocol (ETS group; n = 30) and patients treated using Wardill-Kilner pushback palatoplasty performed at 1 year of age (PB group; n = 42).


METHODS
The features of the ETS protocol are as follows: The soft palate is repaired at 12 months of age using a modified Furlow technique. The residual cleft in the hard palate is closed at 18 months of age.Lip repair is carried out at 3 months of age with a modified Millard technique for all subjects.


RESULTS
The ETS group showed a significantly better occlusal condition than the PB group.The incidence of normal occlusion at the non-cleft side central incisor was 7.1% in the PB group; whereas, it was 66.7% in the ETS group.


CONCLUSIONS
The results indicate that the early two-stage protocol is advantageous for UCLP children in attaining better dental occlusion at 4 years of age.
Department of Oral and Maxillofacial Surgery, Osaka Medical Center and Research Institute for Maternal and Child Health, Izumi, Osaka, Japan. nishioj@mch.pref.osaka.jp
Juntaro
J
Nishio
Tadashi
T
Yamanishi
Hiroshi
H
Kohara
Yoshiko
Y
Hirano
Michiyo
M
Sako
Tadafumi
T
Adachi
Takao
T
Mukai
Shigenori
S
Miya
D002675:Child, Preschool; D002971:Cleft Lip / Q000601:surgery; D002972:Cleft Palate / Q000601:surgery*; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008310:Malocclusion / Q000517:prevention & control*; D008437:Maxilla / Q000254:growth & development; D008445:Maxillofacial Development; D019647:Oral Surgical Procedures / Q000379:methods*; D021362:Palate, Hard / Q000601:surgery*; D010160:Palate, Soft / Q000601:surgery*; D019651:Plastic Surgery Procedures / Q000379:methods; D012189:Retrospective Studies; D013997:Time Factors