دورية أكاديمية
Double-Opposing Z-Plasty for Secondary Surgical Management of Velopharyngeal Insufficiency Following Primary Furlow Palatoplasty.
| العنوان: | Double-Opposing Z-Plasty for Secondary Surgical Management of Velopharyngeal Insufficiency Following Primary Furlow Palatoplasty. |
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| المؤلفون: | Gosain AK; 1 Division of Pediatric Plastic Surgery, Lurie Children's Hospital of Northwestern University Feinberg School of Medicine, Chicago, IL, USA., Chim H; 2 Division of Plastic Surgery, University of Miami Miller School of Medicine, Miami, FL, USA., Sweeney WM; 1 Division of Pediatric Plastic Surgery, Lurie Children's Hospital of Northwestern University Feinberg School of Medicine, Chicago, IL, USA. |
| المصدر: | The Cleft palate-craniofacial journal : official publication of the American Cleft Palate-Craniofacial Association [Cleft Palate Craniofac J] 2018 May; Vol. 55 (5), pp. 706-710. Date of Electronic Publication: 2018 Feb 28. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: SAGE Publications in Association with American Cleft Palate-Craniofacial Association Country of Publication: United States NLM ID: 9102566 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1545-1569 (Electronic) Linking ISSN: 10556656 NLM ISO Abbreviation: Cleft Palate Craniofac J Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: 2018- : [Thousand Oaks, CA] : SAGE Publications in Association with American Cleft Palate-Craniofacial Association Original Publication: Pittsburgh, PA : The Association, [1991- |
| مواضيع طبية MeSH: | Cleft Palate/*surgery , Postoperative Complications/*surgery , Plastic Surgery Procedures/*methods , Velopharyngeal Insufficiency/*surgery, Adolescent ; Child ; Child, Preschool ; Endoscopy/methods ; Female ; Fluoroscopy ; Humans ; Male ; Phonation ; Postoperative Complications/diagnostic imaging ; Reoperation ; Retrospective Studies ; Surgical Flaps ; Treatment Outcome ; Velopharyngeal Insufficiency/diagnostic imaging |
| مستخلص: | Objective: The present study investigates the efficacy of performing a "palate rerepair" utilizing a double-opposing z-palatoplasty (DOZ) following primary Furlow palatoplasty. Design: Retrospective study. Setting: Tertiary referral academic center for craniofacial surgery. Patients: 15 consecutive patients who presented with velopharyngeal insufficiency (VPI) after primary Furlow palatoplasty. Main Outcome Measures: All subjects were evaluated using the perceptual speech assessment (PSA) scale. Criteria for inclusion in the study were (1) velopharyngeal gap size on phonation of 7 mm or less and (2) lateral wall motion at least 40% normal. Results: Mean PSA score was 7.13 + 3.31 (range 3-13) preoperatively, and decreased to 1.80 + 2.83 (range 0-11; P < .001 vs baseline) 3 months or more after surgery. A sphincter pharyngoplasty was performed as a tertiary procedure in 2 patients due to persistent nasal air emission. There was no symptomatic airway compromise following secondary or tertiary management in all patients. Presence of a cleft lip, lateral wall motion, and velopharyngeal gap size did not impact outcomes. Conclusions: We have demonstrated that a DOZ performed secondarily is anatomically possible following Furlow palatoplasty and can restore function of the levator muscle despite significant scarring following primary repair. This approach respects anatomic principles of palatoplasty without eliminating the possibility for extrapalatal procedures should velopharyngeal competence not be achieved. |
| فهرسة مساهمة: | Keywords: Furlow; double opposing z-plasty; perceptual speech assessment; redo palatoplasty; velopharyngeal incompetence |
| تواريخ الأحداث: | Date Created: 20180301 Date Completed: 20190918 Latest Revision: 20221207 |
| رمز التحديث: | 20231215 |
| DOI: | 10.1177/1055665618756072 |
| PMID: | 29490148 |
| قاعدة البيانات: | MEDLINE |
Full Text Finder | تدمد: | 1545-1569 |
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| DOI: | 10.1177/1055665618756072 |