Palatal Measurements Pre- and Post-Furlow Cleft Palate Repair: Analysis of Palatal Lengthening and Comparison Within Cleft Types

Abstract

Objective: The purpose of this study was to characterize intraoperative palatal lengthening with the modified Furlow cleft palatal repair and to determine whether lengthening correlated with preoperative cleft width, cleft type, or operating surgeon. Design: Retrospective study. Setting: Academic tertiary care pediatric hospital. Patients: One hundred eighty pediatric patients undergoing primary or secondary palatoplasty using the Furlow technique. Interventions: Cleft and palatal lengths and widths were measured pre- and post-Furlow cleft palatal repair. Main Outcome Measures: Immediate postoperative percentage change in surface palate length, straight palate length, and soft palate length. Results: The average cleft widest width and width at the hard–soft palate junction were 10.2 and 9.5 mm, respectively, and varied with Veau cleft type. Following Furlow palatoplasty, lengths of the curved, straight, and soft palate increased by 7.5%, 15.8%, and 30.6%, respectively. Degree of palatal lengthening varied among surgeons and Veau cleft type but was not related to cleft width. Seven (4.0%) patients developed postoperative oronasal fistulas. Patients with a Veau IV cleft and larger cleft widths were at an increased risk for fistula formation. Conclusions: This study demonstrates that overall palatal lengthening occurs with the modified Furlow technique. Long-term follow-up studies are needed to determine the clinical relevance of these findings.