title: Repair of submucous cleft palate with Furlow palatoplasty.
abstract: OBJECTIVE
  Submucous cleft palate is a congenital anomaly caused by abnormal insertion of the levator veli palatini muscles to the posterior border of the hard palate, normally these muscles unite together to form the levator sling. Velopharyngeal insufficiency (VPI) may occur in about 10% of cases, our previous treatment protocol was pharyngeal flap that may result in obstructive breathing. Furlow technique seems to be a more physiologic solution as it reconstructs the levator sling. The aim of this study was to determine the efficacy of Furlow palatoplasty in treatment of submucous cleft palate cases presented with VPI.
  
  
  METHODS
  This prospective study was conducted on 15 children with symptomatic submucous cleft palate. All cases were treated by Furlow double opposing Z-plasty technique for repositioning of levator muscles, preoperative and postoperative speech evaluation was done using auditory perceptual assessment and nasometry, while velopharyngeal closure was assessed with flexible nasopharyngoscopy.
  
  
  RESULTS
  Significant improvement of speech and overall nasalance score were achieved. Flexible nasopharyngoscopy showed complete velopharyngeal closure of 13 cases (86.7%), while one case needed secondary pharyngoplasty for correction of residual VPI and the parents of the other case refused secondary surgery as the speech improvement of their child was satisfactory.
  
  
  CONCLUSIONS
  Furlow palatoplasty technique is an effective method in treatment of VPI in cases of submucous cleft palate as it has high success rate with no morbidity.
authors.affiliation: Department of Otolaryngology, Faculty of Medicine, Cairo University, Cairo, Egypt. mosabeez@yahoo.com
authors.forename: Mosaad
authors.initials: M
authors.lastname: Abdel-Aziz
authors.forename: Hassan
authors.initials: H
authors.lastname: El-Hoshy
authors.forename: Nader
authors.initials: N
authors.lastname: Naguib
authors.forename: Nassim
authors.initials: N
authors.lastname: Talaat
mesh_terms: D002648:Child; D002675:Child, Preschool; D002972:Cleft Palate / Q000150:complications / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D011446:Prospective Studies; D013524:Surgical Flaps; D016896:Treatment Outcome; D014681:Velopharyngeal Insufficiency / Q000209:etiology / Q000601:surgery