Our Summary

This research paper talks about a surgical technique to correct a condition called velopharyngeal insufficiency, which affects speech because the soft part of the roof of the mouth doesn’t properly close off the nasal cavity, leading to a nasal sounding voice.

One common surgical method, called Furlow double-opposing Z-plasty (DOZ), lengthens the soft palate but can create tension in the tissue, limiting its use. To tackle this, the study combined the DOZ method with a technique using a flap of fat from inside the cheek (buccal fat pad or BFP) to help lengthen the palate and reposition the muscles.

The study looked at patients who had surgery between December 2016 and February 2019, and excluded certain groups such as those under 4 years old or with certain types of cleft palate. They measured the speech outcomes and the gap between the uvula (the dangly bit at the back of your throat) and the back wall of the throat, before and after surgery.

The results showed that the use of a BFP helped improve the nasal sounding voice and also extended the palate further than just using the DOZ method alone. This suggests that combining these two techniques can improve the results of surgery for people with velopharyngeal insufficiency.

FAQs

  1. What is the Furlow double-opposing Z-plasty (DOZ) surgical method?
  2. How does the use of a buccal fat pad (BFP) improve the results of the DOZ method?
  3. Who were the participants of the study and what were the key findings?

Doctor’s Tip

A doctor might tell a patient undergoing z-plasty surgery for velopharyngeal insufficiency to follow post-operative care instructions carefully, including keeping the surgical site clean and dry, avoiding strenuous activities, and attending follow-up appointments to monitor healing progress. They may also recommend speech therapy to help improve speech outcomes after surgery.

Suitable For

Patients who are typically recommended for z-plasty surgery include those with velopharyngeal insufficiency, cleft palate, or other conditions affecting the soft palate and nasal cavity. These patients may experience speech difficulties, nasal sounding voice, or other related issues that can be improved with z-plasty surgery.

Timeline

Before the surgery:

  1. Patient is diagnosed with velopharyngeal insufficiency affecting their speech.
  2. Patient consults with a surgeon to discuss treatment options.
  3. Surgeon recommends Furlow double-opposing Z-plasty (DOZ) combined with buccal fat pad (BFP) technique.
  4. Patient undergoes pre-operative evaluations and tests to assess their condition.

During the surgery:

  1. Surgeon performs Furlow double-opposing Z-plasty (DOZ) combined with buccal fat pad (BFP) technique to lengthen the soft palate and reposition the muscles.
  2. Surgery is completed successfully with the combined techniques.

After the surgery:

  1. Patient undergoes post-operative care and recovery.
  2. Speech outcomes and the gap between the uvula and the back wall of the throat are measured to assess the effectiveness of the surgery.
  3. Results show improvement in the nasal sounding voice and extension of the palate compared to using the DOZ method alone.
  4. Patient experiences improved speech and overall quality of life post-surgery.

What to Ask Your Doctor

  1. What is z-plasty and how does it relate to my condition of velopharyngeal insufficiency?

  2. Can you explain the Furlow double-opposing Z-plasty (DOZ) technique and how it works in lengthening the soft palate?

  3. What are the potential risks and complications associated with the DOZ technique?

  4. How does the addition of a buccal fat pad (BFP) in conjunction with the DOZ technique help improve outcomes for patients with velopharyngeal insufficiency?

  5. Can you explain the surgical procedure in detail, including the steps involved in combining the DOZ technique with the use of a BFP?

  6. What are the expected outcomes and recovery time following this combined surgical technique?

  7. Are there any specific eligibility criteria or contraindications for undergoing this surgery?

  8. How will you monitor my progress post-surgery, and what follow-up care will be needed?

  9. Are there any alternative treatment options available for velopharyngeal insufficiency, and how does this combined technique compare to other surgical methods?

  10. Can you provide me with information on the success rates and long-term effects of this combined surgical approach for velopharyngeal insufficiency?

Reference

Authors: Park H, Choi JM, Oh TS. Journal: Cleft Palate Craniofac J. 2022 Dec;59(12):1445-1451. doi: 10.1177/10556656211047139. Epub 2021 Oct 12. PMID: 34636625