Submucous Cleft Palate Repair: Furlow Double-Opposing Z-Palatoplasty

Furlow Double-Opposing Z-Palatoplasty

Submucous cleft palate, velopharyngeal insufficiency

Any medical conditions that preclude using general anesthesia. Patients with airway conditions or syndromes, such as Pierre Robin sequence, retrognathia, may need to be addressed before palatoplasty.

Dingman mouth gag, 6700 beaver blade, Dandy trigeminal scissor, Stevens tenotomy scissors

General otolaryngology set up including Dingman mouth gag, 6700 beaver blade, Dandy trigeminal scissor, Stevens tenotomy scissors, 0.25% Marcaine with epinephrine.

Feeding/speech therapy, medical clearance, consideration for concurrent myringotomy tubes, preoperative parental counseling

Variable severity of a bifid uvula, zona pellucida, and bony indentation in the posterior edge of the hard palate can be seen in patient with a submucous cleft palate. A submucous cleft palate may involve only the secondary palate or both the primary and secondary palate. The palate is divided into primary and secondary palates by the incisive foramen, where the primary palate is anterior to the foramen and the secondary palate is posterior to it.

Palatal fistula formation (rare), scarring, bleeding, infection

None

1. Ravishanker R. Furlow's Palatoplasty for Cleft Palate Repair. Med J Armed Forces India. 2006;62(3):239-242. doi:10.1016/S0377-1237(06)80010-9.
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