title: Evaluation of two palate repair techniques for the surgical management of velopharyngeal insufficiency.
abstract: BACKGROUND
  The Furlow palatoplasty is commonly used for the correction of velopharyngeal insufficiency in cleft patients. An alternative procedure is introduced involving a single Z-plasty with overlapping intravelar veloplasty (Woo palatoplasty). This study compared the results of both techniques in the correction of velopharyngeal insufficiency.
  
  
  METHODS
  After institutional review board approval, a retrospective chart review was performed of all patients who had undergone secondary palatoplasty for the correction of velopharyngeal insufficiency. All nonsyndromic patients with imaging data were evaluated. Data elements included preoperative and postoperative velopharyngeal gap size and perceptual speech examination results.
  
  
  RESULTS
  Fifty-two subjects were included: 30 subjects had undergone Furlow palatoplasty and 22 underwent Woo palatoplasty. Overall, a larger proportion of Woo (95 percent) than Furlow subjects (63 percent) did not require secondary surgery (p = 0.005). However, mean presurgery closure was significantly different between groups (p = 0.042). For a more refined assessment, only those with 80 percent or greater preoperative closure were evaluated. Successful results were achieved in 67 percent (10 of 15) in Furlow and in 100 percent (19 of 19) in Woo. Again, this finding was significant (p = 0.005). Linear regression analysis suggested a significant effect of cleft type (β = 2.3, p = 0.013) on closure after repair, with decreased closure in cases with isolated cleft palate.
  
  
  CONCLUSIONS
  The Woo palatoplasty compared favorably with Furlow palatoplasty for correction of velopharyngeal insufficiency. The technique appears to be a viable alternative for palatal re-repair, especially in circumstances when Furlow palatoplasty cannot be performed.
  
  
  METHODS
  Therapeutic, III.
authors.affiliation: St. Louis, Mo. From the Division of Plastic and Reconstructive Surgery, Washington University in St. Louis School of Medicine; and the Cleft Palate-Craniofacial Institute, St. Louis Children's Hospital.
authors.forename: Albert S
authors.initials: AS
authors.lastname: Woo
authors.forename: Gary B
authors.initials: GB
authors.lastname: Skolnick
authors.forename: Neil S
authors.initials: NS
authors.lastname: Sachanandani
authors.forename: Lynn M
authors.initials: LM
authors.lastname: Grames
mesh_terms: D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D013517:Otorhinolaryngologic Surgical Procedures / Q000379:methods; D010160:Palate, Soft / Q000601:surgery*; D012189:Retrospective Studies; D014681:Velopharyngeal Insufficiency / Q000601:surgery*