Tageldeen Mohamed Abdellatif, Mohamed Wesam, Wishahy Ahmed Mohamed Kadry, Farag Heba Mahmoud, Bahaaeldeen Khaled H K
Department of Paediatric Surgery, Cairo University Specialized Paediatric Hospital, Cairo University, Cairo, Egypt.
Department of ENT, Phoniatrics Unit, Cairo University, Cairo, Egypt.
J Indian Assoc Pediatr Surg. 2025 May-Jun;30(3):343-350. doi: 10.4103/jiaps.jiaps_266_24. Epub 2025 Mar 3.
A cleft palate is caused by the failure of fusion of the palatal shelves of the maxillary processes, resulting in a cleft of the hard and/or soft palates. This study aims to evaluate the various outcomes of cleft palate surgery, using Furlow's technique and rotational flap technique, with special emphasis on postoperative velopharyngeal competence through early assessment by nasoendoscopy.
This randomized clinical trial was conducted on 64 cleft palate children at the pediatric surgical unit, in a tertiary pediatric hospital, from February 2022 to February 2024. Patients were randomized into Group A: Furlow Z-plasty technique and Group B: rotational flap palatoplasty. Operative details, outcomes, and complications were recorded and compared between both study groups.
The ratio of males to females in both groups was 1:1, with a mean age of 10 months among study participants. Our results showed no difference between both groups regarding immediate postoperative complications, as well as the rate of fistula and dehiscence. Both techniques provide comparable outcomes in low-grade clefts regarding velopharyngeal competence. For higher-grade clefts, adding buccinator flaps with Furlow improves velopharyngeal valve (VPV) competence with notable differences in palatal mobility and lateral pharyngeal wall mobility scores, yet these are not statistically significant. However, it is at the expense of statistically longer operative time.
On short-term follow-up, both techniques, Furlow and rotation palatoplasty, offer comparable results regarding VPV function on low-grade clefts (Veau I). Moreover, in higher-grade clefts, the addition of buccal flaps has a considerable effect on VPV competence.
腭裂是由上颌突腭突融合失败引起的，导致硬腭和/或软腭出现裂隙。本研究旨在评估采用弗洛技术（Furlow's technique）和旋转皮瓣技术进行腭裂手术的各种结果，特别强调通过鼻内镜早期评估术后腭咽功能。
本随机临床试验于2022年2月至2024年2月在一家三级儿科医院的小儿外科对64例腭裂患儿进行。患者被随机分为A组：弗洛Z成形术（Furlow Z-plasty technique）和B组：旋转皮瓣腭成形术（rotational flap palatoplasty）。记录并比较两组的手术细节、结果和并发症。
两组男女比例均为1:1，研究参与者的平均年龄为10个月。我们的结果显示，两组在术后即刻并发症以及瘘管和裂开发生率方面没有差异。两种技术在低级别腭裂的腭咽功能方面提供了可比的结果。对于高级别腭裂，在弗洛技术中添加颊肌瓣可改善腭咽瓣（VPV）功能，在腭部活动度和咽侧壁活动度评分方面有显著差异，但这些差异无统计学意义。然而，这是以统计学上更长的手术时间为代价的。
在短期随访中，弗洛技术和旋转腭成形术这两种技术在低级别腭裂（韦氏I级，Veau I）的VPV功能方面提供了可比的结果。此外，在高级别腭裂中，添加颊肌瓣对VPV功能有相当大的影响。
