Prospective clinical trial comparing outcome measures between Furlow and von Langenbeck Palatoplasties for UCLP.
The goal of this prospective randomized clinical trial was to compare 2 cohorts of standardized cleft patients with regard to functional speech outcome and the presence or absence of palatal fistulae. The 2 cohorts are randomized to undergo either a conventional von Langenbeck repair with intravelar velarplasty or the double-opposing Z-plasty Furlow procedure. A prospective 2 × 2 × 2 factorial clinical trial was used in which each subject was randomly assigned to 1 of 8 different groups: 1 of 2 different lip repairs (Spina vs. Millard), 1 of 2 different palatal repair (von Langenbeck vs. Furlow), and 1 of 2 different ages at time of palatal surgery (9-12 months vs. 15-18 months). All surgeries were performed by the same 4 surgeons. A cul-de-sac test of hypernasality and a mirror test of nasal air emission were selected as primary outcome measures for velopharyngeal function. Both a surgeon and speech pathologist examined patients for the presence of palatal fistulae. In this study, the Furlow double-opposing Z-palatoplasty resulted in significantly better velopharyngeal function for speech than the von Langenbeck procedure as determined by the perceptual cul-de-sac test of hypernasality. Fistula occurrence was significantly higher for the Furlow procedure than for the von Langenbeck. Fistulas were more likely to occur in patients with wider clefts and when relaxing incisions were not used.
Craniofacial Center, College of Dentistry, University of Florida, Gainesville, FL, USA. williams @dental.ufl.edu
William N
WN
Williams
M Brent
MB
Seagle
Maria Ines
MI
Pegoraro-Krook
Telma V
TV
Souza
Luis
L
Garla
Marcos L
ML
Silva
José S
JS
Machado Neto
Jeniffer C R
JC
Dutka
John
J
Nackashi
Steve
S
Boggs
Jonathan
J
Shuster
Jacquelyn
J
Moorhead
William
W
Wharton
Maria I G
MI
Graciano
Maria C
MC
Pimentel
Mariza
M
Feniman
Silvia H A
SH
Piazentin-Penna
Joseph
J
Kemker
Maria C
MC
Zimmermann
Cristina
C
Bento-Gonçalvez
Hilton
H
Borgo
Ilza L
IL
Marques
Angela P M C
AP
Martinelli
José C
JC
Jorge
Patrick
P
Antonelli
Josiane F A
JF
Neves
Melina E
ME
Whitaker
D002971:Cleft Lip / Q000601:surgery*; D002972:Cleft Palate / Q000601:surgery*; D006801:Humans; D007223:Infant; D010159:Palate / Q000601:surgery*; D011446:Prospective Studies; D019651:Plastic Surgery Procedures / Q000379:methods*; D016896:Treatment Outcome