Evaluation of Results of the Furlow’s Modified Technique in the Management of Cleft Palate in the Teaching Hospital of Conakry

Oumar Raphiou Diallo,Alpha Oumar Diallo,Karamoko Alpha Diallo,Alhassane Conde,Gary Parker,Thierno Abdourahmane Balde

doi:10.4236/ojst.2021.111003

Abstract

Introduction: Cleft palate (CP) is a congenital dysmorphosis that results from a failure of the palatal processes of the maxillary buds and nasal septum to merge. The objectives of this study were to determine the frequency of complications of the modified Furlow technique and to evaluate its anatomical and functional outcomes. Materials and Method: This was a retrospective study that took place over a period of 4 years (from January 1st, 2015 to December 31th, 2018) in the Department of Odontostomatology and Maxillofacial Surgery at the National Hospital of Donka (Conakry, Guinea). Data retrieval consisted of records from patients operated on for cleft palate according to Furlow’s modified technique only. The operative technique consisted of marginal incisions of the cleft according to the technique of the double Z-plasty of Furlow. Subsequently, the defect created between the 2 flaps and the anterior edge of the cleft was filled by two fat masses of Bichat sutured to each other with Vicryl 3-0. Four years after surgery, the patients were recalled for an evaluation of the anatomical and functional results. Results: 13 patients underwent surgical loading according to the modified Furlow technique. The average age of the patients was 6.9 years with an age range of 7 months and 17 years. Females were the most affected, with 61.54% of cases and a sex ratio of 0.62. The primary repair rate was 84.61% of cases. Immediate operative follow-up was simple with epithelialization of the flaps in all patients. Four (4) years after the surgeries, 12 patients were reevaluated (92.30%), among them one case (8.33%) of fistula complication was noted. The mobility of the veil and the phonation were good in 85.71% and 60% respectively. Articular disorders with nasonation were found in 2 patients (16.67%). Swallowing was normal in 85.72% of cases. Conclusion: The modified Furlow technique is an important contribution to cleft palate surgery significantly reducing the occurrence of postoperative complications. However, the delay of the surgical operation remains a real obstacle for obtaining a normal phonation.

Highlights

Cleft palate (CP) is a congenital dysmorphosis that results from a failure of the palatal processes of the maxillary buds and nasal septum to merge
Cleft palates (CP) are common congenital dysmorphosis. They result from failure of the palatal processes of the maxillary buds and the nasal septum to merge [1]
We included in this study, record of patients operated for CP according to Furlow’s modified technique with or without a cheiloplasty

Summary

Introduction

Cleft palate (CP) is a congenital dysmorphosis that results from a failure of the palatal processes of the maxillary buds and nasal septum to merge. In the case of wide clefts, the tension-free closure of the sutures is difficult to achieve at the hard-soft palate junction increasing the fistula rate [7] To overcome this difficulty, the authors made several modifications to the initial technique described by Leonard Furlow such as using Bichat fat or Bichat flap by Levi et al [8], a vestibular flap, VY plasty, and combination of CP with Langhenbeck technique [3] [7]. The Maxillofacial Department at Donka Hospital uses the modified Furlow technique combined to the Bichat fat pad

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