Early Two-Stage Palatoplasty Using Modified Furlow's Veloplasty

Abstract

To achieve sufficient velopharyngeal function and maxillary growth for patients with unilateral cleft lip and palate (UCLP), the authors have designed a new treatment protocol for palate closure involving early two-stage palatoplasty with modified Furlow veloplasty. Details of the surgical protocol and the outcomes of the dental occlusion of patients at 4 years of age are presented. This was an institutional retrospective study. Seventy-two UCLP patients were divided into two groups based on their treatment protocols: patients treated using the early two-stage palatoplasty protocol (ETS group; n = 30) and patients treated using Wardill-Kilner pushback palatoplasty performed at 1 year of age (PB group; n = 42). The features of the ETS protocol are as follows: The soft palate is repaired at 12 months of age using a modified Furlow technique. The residual cleft in the hard palate is closed at 18 months of age.Lip repair is carried out at 3 months of age with a modified Millard technique for all subjects. The ETS group showed a significantly better occlusal condition than the PB group.The incidence of normal occlusion at the non-cleft side central incisor was 7.1% in the PB group; whereas, it was 66.7% in the ETS group. The results indicate that the early two-stage protocol is advantageous for UCLP children in attaining better dental occlusion at 4 years of age.