This prospective comparative study was designed to evaluate and compare the surgical
outcome of Von Langenbeck and Furlow's techniques for repair of primary cleft palate. The study
included 30 patients; 17 males and 13 females with mean age of 14.8±2.3 months. Patients were
allocated into 2 equal groups according to the procedure; Group V underwent Von 1,angenbeck
procedure and Group F underwent Furlow's procedure. Intraoperative data as regards width of the
cleft at the junction between soft and hard palates, length increase in the soft palate, length of Zpla::
ty, the frequency of the need for hamulus fracture, duration of suitery and hitt:toper:the blood
loss were recorded. The postoperative distance between last molar tooth and the uvula was
determined and compared versus preoperative one. There was a non-significant (p0.05) difference
between studied patients as regards the width of the cleft and the preoperative length of the distance
between the last molar and uvula. Postoperative length of the distance between the last molar and
uvula was significantly (p<0.05) longer in group F (3.814.42; range: 2.9-4.3 mm) and group V
(3.29±0.42; 2.4-4 mm) compared to their preoperative length with a significantly (p<0.05) longer
length in group F compared to group V. The mean increase of velar length was significantly (p<0.05)
higher in group F (31.5±16.8%) compared to mean length in group V (10.1±16.3%). Mean
postoperative increase in length of soft palate was significantly (p<0.05) longer in group F
(1.31±0.18; range: 1-1.6 mm) compared to group V (0.6±0.18; range: 1-1.6 mm). Ali patients in
group V required relaxing incision to tension-free competent wound closure irrespective of the
preoperative cleft width; while only 2 of patients in group F required relaxing incision with a
significant difference in favor of group F, (X2=5.39, p<0.05). These 2 patients required relaxing
incision in group F had a preoperative cleft width of 1.5 mm. Mean length of Z-plasty incision
required in group F was 1.52±0.18; range: 1.2-1.8 mm. Mean operative time was significantly
(p<0.05) shorter in group V (75±I3; range: 55-95 min) compared to group F (84.3±8.2; range: 70-
100 mm). Furthermore, Furlow's procedure was associated with significantly more blood loss
(49±12.7; range: 15-65 ml) compared to Von Langenbeck procedure (67±15.4; range: 20-90 min).
Only one patient in group F had small fistula, but no patient had wound dehiscence; while in group
V, one patient had wound dehiscence and another had oronasal fistula. It could be concluded that
Furlow's palatoplasty is appropriate surgical procedure for closure of isolated cleft palate irrespective
of cleft width and provides significant lengthening of the uvula with few postoperative complications
Key words : cleft palate , Furlow , palatoplasty |
