Nasoendoscopic findings after primary palatal surgery: can the Furlow technique result in a smaller velopharyngeal gap?

Abstract

Introduction: The surgical technique for primary repair of cleft palate might be less invasive as possible to reduce scar in order to promote velopharyngeal function for speech. The nasoendoscopic exam allows the visualization of the velopharyngeal structures during speech and therefore can help to define the diagnostic and treatment of the velopharyngeal dysfunction. Since the Furlow technique can provide a longer velum extension by means of the repositioning of the soft palate muscles fibers, this study brings the following hypothesis: Do the patients who have undergone palatal surgery by the Furlow technique who remained with velopharyngeal insufficiency (VPI) present smaller velopharyngeal gap than those operated by the von Langenbeck technique? Objective: Compare the nasoendoscopic findings between patients who received the Furlow technique and those who received the von Langenbeck technique for the primary palatal repair. Material and Methods: Date will be collected from the bank of nasoendoscopic exam recordings of the Projeto Florida/HRAC/USP. The sample will be composed by the minimum of 10 patients for each technique with VPI who have undergone nasoendoscopic exam between the ages of 5 and 10 years. The selected images will be edited in a DVD in a randomized sequency to be judged by three experienced speech pathologists, who shall judge: the movement and displacement of the soft palate; maximum movement and displacement of lateral pharyngeal walls, movement of the posterior pharyngeal wall, presence of Passavant´s pad, and size and type of velopharyngeal gap. (AU)