Comparison of two-flap palatoplasty plus intravelar veloplasty technique with and without double-layer Z-plasty on the s
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ORIGINAL ARTICLE
Comparison of two-flap palatoplasty plus intravelar veloplasty technique with and without double-layer Z-plasty on the soft palate length in children with cleft palate Shahin Abdollahi Fakhim 1
&
Masoud Nouri-Vaskeh 2,3
&
Faezeh Amiri 1 & Nikzad Shahidi 1
Received: 29 March 2020 / Accepted: 7 July 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Purpose Velopharyngeal failure occurs as a result of a nasopharyngeal gap following inadequate velopharyngeal closure for structural or functional cause. We aimed to compare the soft palate length in two-flap palatoplasty with intravelar veloplasty (IVV) and two-flap palatoplasty with IVV plus double-layer Z-plasty combination in patients with cleft palate. Methods This clinical trial was conducted on infants aged 9 to 12 months with cleft palate in two groups. The method of two-flap palatoplasty with IVV technique and two-flap palatoplasty with IVV plus double-layer Z-plasty was compared in terms of soft palate length which was measured during operation and short-term complications. Results This study was conducted on 62 infants including 30 patients in two-flap palatoplasty with IVV group and 32 patients in two-flap palatoplasty with IVV plus double-layer Z-plasty group. The soft palate length in two-flap palatoplasty and IVV with and without Z-plasty groups before surgery was 17.56 ± 2.05 and 17.68 ± 1.88 mm, respectively (P = 0.561). After surgery, the soft palate length was significantly higher in two-flap palatoplasty with IVV plus Z-plasty group (22.43 ± 2.73 mm vs. 20.56 ± 2.42 mm) (P = 0.032). Conclusion The two-flap palatoplasty with IVV plus Z-plasty technique is a suitable method for increasing the palatal length in infants with cleft palate. On the other hand, the addition of Z-plasty method could increase the length of the palate. Moreover, the complications are very low and further trials for development of this method on patients with cleft palate are recommended. Trial registration number (TRN) IRCT2017032423559N11 Keywords Cleft length . Cleft palate . Cleft lip . Palatoplasty . Velopharyngeal function
Introduction Velopharyngeal insufficiency (VPI) is characterized by nasal congestion, nasal emission, and non-speech related symptoms, such as nasal regurgitation. Velopharyngeal failure occurs as a result of a gap that is associated with inadequate velopharyngeal closure due to structural or functional cause
* Nikzad Shahidi [email protected] 1
Department of Otorhinolaryngology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
2
Immunology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
3
Network of Immunity in Infection, Malignancy and Autoimmunity (NIIMA), Universal Scientific Education and Research Network (USERN), Tehran, Iran
[1, 2]. Velopharyngeal failure often occurs in children with cleft palate in 20 to 30% after initial palatoplasty and significant progress has been made in the outcomes of the primary palate surgeries in developing countries [3,
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