Document Detail

Prospective clinical trial comparing outcome measures between Furlow and von Langenbeck Palatoplasties for UCLP.
MedLine Citation:
PMID:  21042188     Owner:  NLM     Status:  MEDLINE    
The goal of this prospective randomized clinical trial was to compare 2 cohorts of standardized cleft patients with regard to functional speech outcome and the presence or absence of palatal fistulae. The 2 cohorts are randomized to undergo either a conventional von Langenbeck repair with intravelar velarplasty or the double-opposing Z-plasty Furlow procedure. A prospective 2 × 2 × 2 factorial clinical trial was used in which each subject was randomly assigned to 1 of 8 different groups: 1 of 2 different lip repairs (Spina vs. Millard), 1 of 2 different palatal repair (von Langenbeck vs. Furlow), and 1 of 2 different ages at time of palatal surgery (9-12 months vs. 15-18 months). All surgeries were performed by the same 4 surgeons. A cul-de-sac test of hypernasality and a mirror test of nasal air emission were selected as primary outcome measures for velopharyngeal function. Both a surgeon and speech pathologist examined patients for the presence of palatal fistulae. In this study, the Furlow double-opposing Z-palatoplasty resulted in significantly better velopharyngeal function for speech than the von Langenbeck procedure as determined by the perceptual cul-de-sac test of hypernasality. Fistula occurrence was significantly higher for the Furlow procedure than for the von Langenbeck. Fistulas were more likely to occur in patients with wider clefts and when relaxing incisions were not used.
William N Williams; M Brent Seagle; Maria Ines Pegoraro-Krook; Telma V Souza; Luis Garla; Marcos L Silva; José S Machado Neto; Jeniffer C R Dutka; John Nackashi; Steve Boggs; Jonathan Shuster; Jacquelyn Moorhead; William Wharton; Maria I G Graciano; Maria C Pimentel; Mariza Feniman; Silvia H A Piazentin-Penna; Joseph Kemker; Maria C Zimmermann; Cristina Bento-Gonçalvez; Hilton Borgo; Ilza L Marques; Angela P M C Martinelli; José C Jorge; Patrick Antonelli; Josiane F A Neves; Melina E Whitaker
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Publication Detail:
Type:  Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, N.I.H., Extramural    
Journal Detail:
Title:  Annals of plastic surgery     Volume:  66     ISSN:  1536-3708     ISO Abbreviation:  Ann Plast Surg     Publication Date:  2011 Feb 
Date Detail:
Created Date:  2011-01-13     Completed Date:  2011-05-26     Revised Date:  2013-10-02    
Medline Journal Info:
Nlm Unique ID:  7805336     Medline TA:  Ann Plast Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  154-63     Citation Subset:  IM    
Craniofacial Center, College of Dentistry, University of Florida, Gainesville, FL, USA. williams
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MeSH Terms
Cleft Lip / surgery*
Cleft Palate / surgery*
Palate / surgery*
Prospective Studies
Reconstructive Surgical Procedures / methods*
Treatment Outcome
Grant Support
Comment In:
Ann Plast Surg. 2011 Jun;66(6):679   [PMID:  21558840 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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