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Surgical Furlow procedure: report of 30 cases

C. Fran├žois-Fiquet, R. Le Pendeven, V . Martinot, P. Pellerin

Reference Center for Rare Craniomaxillofacial Malformations, Lille, France

 

ABSTRACT

Aim: This retrospective study was to evaluate the clinical, orthophonic and aerophonoscopic results of the Furlow technique in the treatment of the velopharyngeal incompetence.

Material and methods: 30 patients with average age of 5.4 years (mini 10 months - maximum 24 years and median at 3,6 years) were operated, between 2003 and 2007, in the center of reference for rare cranio-maxillofacial malformations. In 83% of the cases, Furlow technique was proposed in first intention for submucosal division, palate gap, and more rarely for isolated velopharyngeal incompetence.

Results: 20% of our patients had complications: 1 bleeding, 4 scar disunions and 1 oro-nasal communication. No obstructive apnoea was found. 72% of our patients obtained a velopharyngeal competence, 7% had insufficient results leading to a new intervention, 21% are in close follow-up. Phonation difficulties were found in 4 patients (from which 3 preoperatory severe velopharyngeal insufficiencies). The aerophonoscopy identified 12 postoperatory nasal air losses (7 not significant). This underlines the great sensitivity of this examination.

Conclusion: After discussion in accordance with the literature, we can conclude that Furlow technique, in spite of the longer learning curve, has many advantages for the treatment of velar division, but also in certain indications of velopharyngeal incompetence. The complications are very rare and the orthophonic results are very satisfactory in primary surgery and often allow a good improvement of the situation in the secondary surgery. The absence of dissection at the level of the hard palate appears tempting because of the facial growth conservation. This could be evaluated only after a few years.

 

Key words: Furlow technique, velopharyngeal incompetence, palatine division, pediatric plastic surgery, orthophonic evaluation