From the Division of Plastic Surgery, Lurie Children's Hospital of Northwestern Feinberg School of Medicine.
Plast Reconstr Surg. 2019 Apr;143(4):1179-1183. doi: 10.1097/PRS.0000000000005430.
Furlow palatoplasty is increasingly used both for primary palatoplasty and for secondary correction of velopharyngeal insufficiency. Although Furlow palatoplasty offers the advantage of lengthening the palate, the most tenuous component of the oral mucosal repair is anterior transposition of the oral mucosal Z-plasty flap, with superficial separation of the oral mucosa observed in up to 53 percent of cases of secondary Furlow palatoplasty. To mitigate this problem, the authors prophylactically placed pedicled buccal fat pad flaps to provide an additional vascular layer to promote healing of the overlying oral mucosal Z-plasty flap. The authors report their experience comprising seven patients who underwent Furlow palatoplasty with buccal fat flap augmentation. Four of these patients had secondary Furlow palatoplasty procedures; one of them experienced oral mucosal separation that healed uneventfully. No patients developed an oronasal fistula. The authors' experience suggests that buccal fat flaps may minimize vascular compromise and dehiscence of the oral mucosal Z-plasty following Furlow palatoplasty. CLINICAL QUESTION/LEVEL OF EVIDENCE:: Therapeutic, IV.
Furlow 腭裂修补术越来越多地用于初次腭裂修补术和腭咽闭合不全的二次矫正。尽管 Furlow 腭裂修补术具有延长腭部的优势，但口腔黏膜修复中最脆弱的部分是口腔黏膜前移位 Z 成形瓣，在二次 Furlow 腭裂修补术中多达 53%的病例中观察到口腔黏膜浅层分离。为了解决这个问题，作者预防性地放置带蒂颊脂垫瓣，为覆盖的口腔黏膜 Z 成形瓣提供额外的血管层，以促进愈合。作者报告了他们的经验，包括 7 名接受 Furlow 腭裂修补术和颊脂垫瓣增强术的患者。其中 4 名患者接受了二次 Furlow 腭裂修补术；其中 1 名患者出现口腔黏膜分离，但愈合顺利。没有患者发生口鼻瘘。作者的经验表明，颊脂垫瓣可能会最小化 Furlow 腭裂修补术后口腔黏膜 Z 成形瓣的血管受压和裂开。临床问题/证据水平：治疗，IV。
