From von Langenbeck to Furlow palatoplasty: A 16-year review of cleft palate repair

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Abstract

Aim:

In the past, von Langenbeck palatoplasty was the technique adopted for cleft palate repair at our institution. Since 2002, Furlow palatoplasty has become the technique of choice. The present study aims to compare the outcome of cleft palate repair in children using the two different techniques.

Patients and Methods:

All children who underwent primary cleft palate repair at our institution from January 1996 to December 2011 were studied. The sex, type of cleft palate, age at operation and the presence of associated syndromes were recorded. Postoperative outcome, including the incidence of oronasal fistula (ONF) and pharyngoplasty, were studied.

Results:

A total of 230 children were included in this study. There were 120 boys and 110 girls. Ninety-five children had cleft palate associated with cleft lip; 135 children had cleft palate only. Twenty-eight children were syndromic. The mean age at operation was 19 ± 20 months (range: 10–150 months). A total of 112 children underwent von Langenbeck repair, and 118 children underwent Furlow repair. There was no statistical different in the sex, age at operation and associated syndromes between the two groups. More children had isolated cleft palate in the Furlow group (P < 0.05). Nineteen children developed ONF after surgery (Langenbeck : Furlow, 13:6; P = 0.072). Twenty one of 112 (19 per cent) children required pharyngoplasty to correct velopharyngeal insufficiency after von Langenbeck repair. No child in the Furlow group required pharyngoplasty (P < 0.05).

Conclusions:

The frequency of ONF after palatoplasty was 11.6 per cent after von Langenbeck repair, and 5.1 per cent after Furlow's palatoplasty. Compared with von Langenbeck repair, Furlow palatoplasty appeared to have a superior outcome, with no child requiring pharyngoplasty.

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