From the State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases and Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University.
Plast Reconstr Surg. 2023 Jul 1;152(1):145-154. doi: 10.1097/PRS.0000000000010230. Epub 2023 Jan 24.
A modified palatoplasty was established by incorporating the designs of both Sommerlad and Furlow techniques in addition to a novel incision on the medial pterygoid plate's surface, named the Sommerlad-Furlow modified technique. Thus, this study aimed to evaluate the clinical and functional outcomes of the Sommerlad-Furlow modified technique against an accepted standard, the Furlow technique.
A retrospective review was conducted for 212 consecutive nonsyndromic cleft palate patients who underwent Sommerlad-Furlow ( n = 106) and Furlow ( n = 106) repairs without relaxing incision on the hard palate between 2011 and 2016. The success of surgical procedures was estimated by the rate of postoperative fistula, speech outcomes, and velopharyngeal insufficiency (VPI)-related quality of life. The demographic and surgical data, including sex, age, cleft type, cleft width, and follow-up period were recorded.
There was no statistically significant difference between the two treatment groups regarding demographic and surgical data, except the cleft width ( P < 0.001). The incidence of the fistula was 7.5% and 6.6% after the Sommerlad-Furlow and Furlow procedures, respectively. The two groups showed no significant differences in speech outcomes, and adequate velopharyngeal function was found in 84% and 82.1% in Sommerlad-Furlow and Furlow procedures, respectively. Besides, the rate of severe VPI was slightly lower in Sommerlad-Furlow (0.9%) than in Furlow (2.8%) procedures. Moreover, an adequate VPI-related quality of life was found in 80.4% of the Sommerlad-Furlow group and 78.6% of the Furlow group.
The Sommerlad-Furlow technique has obtained acceptable postoperative outcomes and could be a choice for cleft palate repair, especially in wider clefts.
CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, III.
在 Sommerlad 技术和 Furlow 技术的设计基础上，我们增加了对翼内板表面的新型切口，从而建立了改良的腭裂修复术，我们将其命名为 Sommerlad-Furlow 改良技术。因此，本研究旨在评估 Sommerlad-Furlow 改良技术与公认的 Furlow 技术相比的临床和功能结果。
对 2011 年至 2016 年间接受 Sommerlad-Furlow（n = 106）和 Furlow（n = 106）修复术但未行硬腭松弛切口的 212 例非综合征性腭裂患者进行回顾性研究。通过术后瘘管发生率、语音结果和与咽腔闭锁不全（VPI）相关的生活质量来评估手术的成功率。记录人口统计学和手术数据，包括性别、年龄、腭裂类型、腭裂宽度和随访时间。
除了腭裂宽度（P < 0.001），两组在人口统计学和手术数据方面无统计学差异。Sommerlad-Furlow 和 Furlow 手术后瘘管的发生率分别为 7.5%和 6.6%。两组的语音结果无显著差异，Sommerlad-Furlow 和 Furlow 手术后分别有 84%和 82.1%的患者具有足够的咽腔闭锁功能。此外，Sommerlad-Furlow 组（0.9%）的严重 VPI 发生率略低于 Furlow 组（2.8%）。此外，Sommerlad-Furlow 组有 80.4%和 Furlow 组有 78.6%的患者具有足够的 VPI 相关生活质量。
Sommerlad-Furlow 技术获得了可接受的术后效果，可作为腭裂修复的选择，尤其是在较宽的腭裂中。
临床问题/证据水平：治疗性，III 级。
