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Videofluoroscopic findings after primary palatal surgery: does the Furlow technique provide longer palate extension?

Grant number: 13/08356-9
Support Opportunities:Scholarships in Brazil - Master
Effective date (Start): September 01, 2013
Effective date (End): February 28, 2015
Field of knowledge:Health Sciences - Speech Therapy
Principal Investigator:Maria Inês Pegoraro Krook
Grantee:Ana Flávia Rodrigues da Silva
Host Institution: Hospital de Reabilitação de Anomalias Craniofaciais (HRAC). Universidade de São Paulo (USP). Bauru , SP, Brazil


Videofluoroscopy allows assessment of velopharyngeal function due to velopharyngeal view through dynamic radiographic images during speech. Since Furlow technique (F) favors a greater extent of the soft palate through the repositioning of the fibers of the soft palate muscles, this study raises the following questions: do patients operated by the F technique who remained with velopharyngeal insufficiency (VPI) after primary palatal surgery have the same depth of the nasopharynx, greater extent and thickness of the soft palate and lower ratio between the depth of the nasopharynx and extent of the soft palate than those operated by the von Langenbeck (vL) who also remained with VPI? Objectives: a) compare videofluoroscopy findings among patients who received the F technique and those who received the VL technique in the primary palatal surgery, and b) compare the videofluoroscopic findings of the present study with the ones obtained by Subtelny (1957) in normal individuals. Methods: Patients were selected from an analysis of the recordings bank of videofluoroscopy exams of the Florida Project / HRAC/USP. The sample consisted of 90 videofluoroscopic images taken in lateral view during physiologic rest obtained from 27 patients who received the F technique and 63 who received the vL in the primary palatal surgery. The patients of both genders, remained with VPI after surgery and underwent videofluoroscopy to define the best treatment to correct VPI, between the ages of 3 and 14 years. The images were edited in random order on a CD and measurements of nasopharyngeal structures were performed by three experienced speech pathologists which were later compared with the measures proposed by Subtelny (1957) for normal individuals. Results: The results have shown statistically significant differences when comparing the surgical techniques only to the extension of the soft palate measures (means = 26.51 mm for the F patients and 24.25 mm for the vL patients; p=0.042). The comparison with the normal values proposed by Subtelny (1957) revealed statistically significant measures only for the ratio between depth of the nasopharynx and extension of the soft palate, showing 96% of F patients and 73% of vL patients with measures outside the normal range (p=0.025). Conclusion: The surgical technique used in primary palatoplasty can influence the size of the nasopharyngeal structures even in those patients who remained with VPI. (AU)

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Academic Publications
(References retrieved automatically from State of São Paulo Research Institutions)
SILVA, Ana Flávia Rodrigues da. Videofluoroscopic findings of velopharyngeal structures after primary palatal surgery. 2015. Master's Dissertation - Universidade de São Paulo (USP). Faculdade de Odontologia de Bauru (FOB/SDB) Bauru.

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