Ｆｕｒｌｏｗ法による口蓋形成術 第１報 術中，術後経過について

Abstract

Cleft palate repair using Furlow double opposing Z-plasty was performed in 31 patients between 1990 and 1994. To determine the advantages and disadvantages of this technique, Furlow palatoplasty was compared with the pushback procedure. Twenty-seven patients undergoing palatal closure with the pushback technique, performed by the same surgeon during the same period, served as controls. Nineteen of the 31 patients in the Furlow group had cleft palate, nine had submucosal cleft palate, and three had cleft lip and palate. Mean age at Furlow palatoplasty was 2.4 years. In the pushback group, 17 of the 27 patients had cleft palate, three had submucosal cleft palate, and seven had cleft lip and palate. Mean age at pushback palatoplasty was 2.1 years. Operating time and blood loss in the Furlow group were 83.9±14.9 minutes and 28.3±28.8ml, respectively, while the corresponding values in the pushback group were 66.3±17.2 minutes and 39.9±38.5ml. Although operating time in the Furlow group was longer than in the pushback group, blood loss was significantly less. Intraoperative results were favorable, with acceptable operating time and blood loss. No postoperative complications occurred in the Furlow group, and adequate oral intake was achieved immediately after palatoplasty. The maximum body temperature and duration of postoperative fever in the Furlow group were 37.8±0.4°C and 37.0±21.0 hours, respectively, while the corresponding values in the pushback group were 38.3±0.5°C and 76.1±29.7 hours. The rise in body temperature in the Furlow group was significantly lower, and the postoperative course was satisfactory. Oronasal fistulas did not develop.