The Children's Hospital of Philadelphia modification of the Furlow double-opposing z-palatoplasty: Long-term speech and growth results

The goal of palatoplasty is to restore a mechanism for normal speech production without impairing normal facial growth. The surgeon is faced with a constellation of deficits and anatomic variations that can affect the final outcome. These include the severity of the cleft and the deficiency of maxillary bone and palatal mucosa and muscle; the angle and position of the cranial base relative to the soft palate; the size and activity of the muscles of the velopharyngeal sphincter; syndromes; and impediments, such as intellectual capacity, learning ability, hearing loss, and variations in soft tissue healing. Surgery can potentially compensate for some, but not all, of these variables. We describe our results with the Children's Hospital of Philadelphia modification of the Furlow double opposing z-palatoplasty.