An Modified Furlow Palatoplasty Technique In Primary Cleft Palate Repair

To evaluate the surgical and functional outcomes following a modified Furlow technique. All modified Furlow palatoplasty reconstructions involved posterior-based myomucosal flaps incised at a 70 to 80 degrees in the mid and posterior regions of the soft palate to achieve a 5- to 10-mm limb, as well as anterior-based mucosal flaps incised at a 70 to 80 degrees to achieve a corresponding 5- to 10-mm limb, with muscle overlapping. Adjust the size of the Z-flap based on the required lengthening of the soft palate. This primarily aims at the reconstruction of the levator palatini muscle slings and ensures a tension-free wound closure later in the procedure. This retrospective study analyzed 106 cleft palate patients treated with modified Easy Furlow technique (2013-2023). Outcomes assessed included oronasal fistula (ONF), secondary surgery for velopharyngeal insufficiency (VPI) and speech parameters [intelligibility, stimulability, percentage of correct consonants (PCC) and percentage of non-oral cleft speech characteristics (PNCSC)]. Among 106 patients, the overall incidence rates of ONF and secondary surgery for VPI were 12.3% and 19.8%, respectively. Median scores were: intelligibility 88.6% (23.4-98.7%), stimulability 90.5% (19.1-100%), PCC 87.9% (18.8-98.7%), and PNSCS 0% (0-61.9%), with poorer outcomes in extensive clefts (r=-0.27-0.29, p<0.05). This modified palatoplasty using a small double-opposing Z-plasty provided easy acquired procedure, with satisfactory speech outcome.