Our Summary

The research paper describes a study that looked at the effectiveness and complications of a specific surgical procedure called Furlow Z-plasty, used to treat a condition called submucous cleft palate (SMCP). This condition, which affects the roof of the mouth, can cause problems with speech and swallowing and sometimes requires surgery for treatment.

The researchers analyzed medical records of 40 patients who received this surgery between 2008 and 2017, and found that the procedure was successful in 83% of cases, including those who had no problems or only minor issues with a part of the throat called the velopharyngeal function (VPF), which is important for speech. Only 10% of patients needed a second surgery, and only 5% experienced complications. They also found that the procedure was equally effective in patients with and without other related conditions (syndromic and nonsyndromic patients). Furthermore, none of the children who underwent the surgery developed obstructive sleep apnea, a common sleep disorder, afterwards.

In summary, the Furlow Z-plasty procedure was found to be safe and effective for treating symptomatic SMCP, with a high success rate and a low rate of complications.

FAQs

  1. What is the preferred method of surgical repair for symptomatic submucous cleft palate at the Helsinki cleft center?
  2. What was the success rate of the Furlow Z-plasty in the treatment of symptomatic SMCP according to the study?
  3. Were there any complications or secondary surgeries needed after the Furlow Z-plasty procedure based on the study?

Doctor’s Tip

A helpful tip a doctor might tell a patient about z-plasty is to follow post-operative care instructions carefully to ensure optimal healing and minimize the risk of complications. This may include keeping the surgical site clean and dry, avoiding strenuous activities that could disrupt the healing process, and attending follow-up appointments as scheduled. Additionally, the patient should communicate any concerns or changes in symptoms to their healthcare provider promptly.

Suitable For

Patients with symptomatic submucous cleft palate (SMCP) are typically recommended Furlow Z-plasty. This procedure is particularly effective for nonsyndromic patients, although it can also be successful for syndromic patients. The procedure is safe and has a high success rate, with only a small percentage of patients requiring secondary surgery for residual velopharyngeal insufficiency. Overall, Furlow Z-plasty is a recommended treatment for patients with symptomatic SMCP.

Timeline

Before Z-plasty:

  • Patient is diagnosed with symptomatic submucous cleft palate (SMCP)
  • Patient undergoes preoperative evaluation by speech pathologists to assess velopharyngeal function (VPF)
  • Surgery is scheduled for Furlow Z-plasty
  • Patient is typically around 4.8 years old at the time of surgery

After Z-plasty:

  • Patient undergoes postoperative evaluation by speech pathologists to assess VPF
  • Overall success rate of 83% is achieved, with 10% requiring secondary surgery for residual velopharyngeal insufficiency
  • Success rate is similar in both nonsyndromic and syndromic patients
  • Complications arise in only 5% of patients, with no cases of obstructive sleep apnea postoperatively.

What to Ask Your Doctor

  1. What is the success rate of Furlow Z-plasty in treating symptomatic SMCP?
  2. Are there any potential complications or risks associated with the procedure?
  3. How long is the recovery process after undergoing a Furlow Z-plasty?
  4. Will additional surgery be needed in the future for residual velopharyngeal insufficiency?
  5. How will the patient’s speech and velopharyngeal function be assessed before and after the procedure?
  6. What is the typical age range for patients undergoing Furlow Z-plasty for SMCP?
  7. How experienced is the surgeon in performing Furlow Z-plasty for SMCP?
  8. Will the patient require any post-operative therapy or follow-up care after the procedure?
  9. Are there any specific lifestyle changes or precautions that the patient should take after undergoing Furlow Z-plasty?
  10. Are there any alternative treatment options available for symptomatic SMCP, and why is Furlow Z-plasty preferred in this case?

Reference

Authors: Pitkänen V, Szwedyc A, Alaluusua S, Geneid A, Vuola P, Saarikko A. Journal: J Craniofac Surg. 2023 Oct 1;34(7):2066-2070. doi: 10.1097/SCS.0000000000009385. Epub 2023 May 24. PMID: 37221637