Comparison of palatal lengthening and perioperative outcomes of Furlow's Z-plasty versus von Langenbeck's palatoplasty in children with complete, non-syndromic cleft palate: a randomized controlled trial in India

印度一项随机对照试验比较了Furlow Z成形术与von Langenbeck腭成形术治疗完全性非综合征型腭裂患儿的腭延长术及围手术期疗效。

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Abstract

BACKGROUND: Cleft palate results from incomplete fusion of the palatine shelves during embryonic development and varies in severity. It affects speech, hearing, and feeding, often leading to complications such as nasal regurgitation and recurrent infections. The condition is common worldwide and frequently coexists with cleft lip. Surgery remains the primary treatment, aiming to restore both palatal length and function. In this study, Furlow's double Z-plasty and von Langenbeck palatoplasty have been compared for their effectiveness in minimizing complications and improving outcomes. METHODS: This study included 22 children aged 6 to 18 months with non-syndromic complete cleft palates, randomly assigned into two groups. Group A underwent von Langenbeck's palatoplasty with intravelar veloplasty, while Group B underwent Furlow's double opposing Z-plasty. RESULTS: Preoperative palatal measurements were comparable between the two groups. Cleft width did not significantly affect surgical outcomes, and both techniques effectively achieved tension-free closure. Von Langenbeck's repair with intravelar veloplasty was as effective as Furlow's palatoplasty in achieving palatal lengthening, while offering the additional advantage of being an anatomically based repair associated with lower fistula rates. CONCLUSION: Von Langenbeck's repair with intravelar veloplasty is as effective as Furlow's palatoplasty in achieving palatal lengthening and provides the advantage of an anatomically sound repair with a reduced fistula rate.

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