Palatoplasty: Furlow's double reversing z-plasty versus intravelar veloplasty

Objective: To evaluate the efficacy of Furlow's double reversing z-plasty ( Furlow) versus intravelar veloplasty with longitudinal closure including pa latal muscle reorientation (IVV), Design: Retrospective, single-institution, single-surgeon comparison. Patients: One hundred nineteen consecutive cleft palate patients were enrol led; 34 syndromic and 9 language-impaired patients were removed from speech and reoperation analysis, Furlow and IVV groups were similar with respect to sex and mean age at primary repair, Interventions: One surgeon performed all surgery and one of two speech path ologists conducted language and speech evaluations at 3 years of age withou t prior knowledge of the surgical technique utilized. Outcome Measures: Outcome measures included frequency of palatal fistulae, speech abnormalities, and need for secondary pharyngoplasty procedures, Results: Patients who had undergone IVV demonstrated a 34% higher incidence of hoarseness, nasal escape, and hypernasality at 3 years of age than did Furlow patients. These same patients likewise required significantly more s econdary pharyngoplasty procedures, No significant difference was noted bet ween fistulae frequencies, Conclusions: These findings suggest that Furlow palatoplasty may provide a better clinical outcome than intravelar veloplasty.