Evaluation of Two Palate Repair Techniques for the Surgical Management of Velopharyngeal Insufficiency

@article{Woo2014EvaluationOT,
  title={Evaluation of Two Palate Repair Techniques for the Surgical Management of Velopharyngeal Insufficiency},
  author={Albert S. Woo and Gary B. Skolnick and Neil S Sachanandani and Lynn Marty Grames},
  journal={Plastic and Reconstructive Surgery},
  year={2014},
  volume={134},
  pages={588e–596e}
}
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… 
View on Wolters Kluwer
smiletrain.org
24 Citations
Highly Influential Citations
2
Background Citations
6
Methods Citations
2
Results Citations
1

24 Citations

Citation Type

Citation Type

A Comparison of the Need for Speech Therapy After 2 Palatal Repair Techniques
TLDR
Patients with nonsyndromic cleft palate who underwent either primary Kriens or overlapping intravelar veloplasty before 18 months of age were significantly less likely to need cleft-related speech therapy compared with patients who received KRIens intraVELar enveloplasty at 3 years of age.
A Comparative Study Evaluating Speech Outcomes in Classic versus Occult Submucous Cleft Palate Using a Primary Furlow Palatoplasty Technique
TLDR
The extended indication criteria of Furlow palatoplasty provided adequate velopharyngeal insufficiency management with a low complication rate and satisfactory speech outcome.
Outcome of Palate Re-repair with Radical Repositioning of the Levator Muscle Sling as a First-Line Strategy in Postpalatoplasty Velopharyngeal Incompetence Management Protocol
TLDR
This large series study provides confirmatory evidence of the effectiveness and safety of the re-repair procedure in all velopharyngeal incompetence cases with abnormally oriented levator muscles regardless of gap size, even if the primary operation included prior muscle dissection.
Square-root Palatoplasty: Comparing a Novel Modified-Furlow Double-opposing Z-palatoplasty Technique to Traditional Straight-line Repair
TLDR
After adjusting for Veau classification, age, and gender in nonsyndromic children, SRP is associated with significantly less speech delay/deficits, NAE, articulation errors, and need for secondary speech surgery when compared to children who underwent SLR.
Progressive Tightening of the Levator Veli Palatini Muscle Improves Velopharyngeal Dysfunction in Early Outcomes of Primary Palatoplasty
TLDR
Speech resonance outcomes at 3 years of age are improved and need for secondary velopharyngeal dysfunction management is reduced with more aggressive levator dissection and reconstruction during primary one-stage palatoplasty.
Age and Preoperative Velar Closure Ratio Are Significantly Associated With Surgical Outcome of Furlow Double-Opposing Z-Plasty in Palatal Re-Repair.
Surgical Approaches and 30-D Complications of Velopharyngeal Insufficiency Repair Using American College of Surgeons National Surgical Quality Improvement Program-Pediatric.
A Comparative Study to Evaluate the Functional Effect of Unilateral Uvuloplasty after Primary Palatoplasty
TLDR
It is observed that the use of unilateral uvuloplasty for uvular reconstruction reduces the velopharyngeal space and the frequency of hypernasality in patients with bilateral cleft palate.
The Effectiveness of Palate Re-Repair for Treating Velopharyngeal Insufficiency: A Systematic Review and Meta-Analysis
TLDR
A systematic review and meta-analysis concluded that palate re-repair achieves normal speech resonance in many but not all patients with VPI, and further research is needed to identify the specific examination and imaging findings that predict successful correction of VPI with re- repair.
Reply: Progressive Tightening of the Levator Veli Palatini Muscle Improves Velopharyngeal Dysfunction in Early Outcomes of Primary Palatoplasty.
TLDR
In a limited number of cases where the overlapping intravelar veloplasty was performed without the oral Z-plasty, it was noted that the linear contraction of the incision line with healing can serve to tether the levator muscle anteriorly, potentially resulting in a higher rate of velopharyngeal insufficiency.
...
1
2
3
...

References

SHOWING 1-10 OF 29 REFERENCES
The Correction of Velopharyngeal Insufficiency by Furlow Palatoplasty in Patients Older than 3 Years Undergoing Veau-Wardill-Kilner Palatoplasty: A Prospective Clinical Study
TLDR
It is suggested that Furlow palatoplasty performed in later years improves not only speech but also velopharyngeal closure by reorienting the levator veli palatini muscle and augmenting the velum.
Furlow Palatoplasty for Management of Velopharyngeal Insufficiency: A Prospective Study of 148 Consecutive Patients
TLDR
Speech outcomes in a large series of patients undergoing Furlow palatoplasty were described and preoperative velopharyngeal gap size, as determined with nasendoscopy, was significantly associated with postoperative envelope insufficiency severity, and small gap size is associated with a greater likelihood of resolution.
Correction of Secondary Velopharyngeal Insufficiency in Cleft Palate Patients with the Furlow Palatoplasty
TLDR
The results showed that a Furlow palatoplasty can satisfactorily correct velopharyngeal insufficiency in carefully selected patients.
Correction of velopharyngeal insufficiency with furlow palatoplasty.
TLDR
Furlow palatoplasty is a useful technique for the correction of velopharyngeal insufficiency in selected patients and exhibited good palate closure and marked improvement in speech.
Submucous Cleft Palate: A Grading System and Review of 40 Consecutive Submucous Cleft Palate Repairs
  • B. Sommerlad, C. Fenn, +5 authors Adrian Barnett
  • Medicine
    The Cleft palate-craniofacial journal : official publication of the American Cleft Palate-Craniofacial Association
  • 2004
TLDR
Severity of the SMCP did not correlate with the degree of preoperative speech abnormality but was a significant predictor of outcome of surgery, with the less severe patients having less satisfactory end results and lesser degrees of improvement.
A Technique for Cleft Palate Repair
TLDR
Evidence from independent assessment of speech results in palate re-repair and submucous cleft palate repair suggests that this more radical muscle dissection improves velar function.
Velopharyngeal insufficiency and secondary palatal management. A new look at an old problem.
Anatomic Basis of Cleft Palate and Velopharyngeal Surgery: Implications from a Fresh Cadaveric Study
TLDR
The findings of an anatomic study of the levator veli palatini, palatopharyngeus, and superior constrictor muscles in 18 fresh cadaveric specimens of normal adults are applied to analyze current controversies in velopharyngeal function and cleft palate surgery.
Influence of Palatal Fistulas on Velopharyngeal Movements: A Cineradiographic Study
TLDR
It is indicated that patients with both velopharyngeal incompetence and an additional fistula will need covering of the fistula, and a combination of velopHaryngeAL flap surgery and fistula covering ought to be performed to normalize the velopelygeal activity and speech and resonance.
Cleft palate re-repair--a clinical and radiographic study of 32 consecutive cases.
...
1
2
3
...