Abstract
Objectives; The aim of this study was to determine the optimal timing of hard palate closure with low surgical damage and to assess the difficulty in achieving early acquisition of normal articulation using Furlow's palatoplasty (F-group), which provides earlier velopharyngeal competence than by Perko's method (P-group).
Subjects and Methods;
1. Serial study cast models of the F-group (unilateral cleft lip and palate, N=47) were used to evaluate the reduction in the residual cleft size in the hard palate.
2. The surgical results of the F-group, such as the maximum cleft width, operation time, blood loss and fistula rate were compared with those of the P-group.
3. The surgical damage and difficulty of hard palate closure in the F-group was also subjectively evaluated by inspecting randomly-selected cast models at four years of age and at the time of hard palate closure.
Results;
1. The anterior cleft width showed a significant reduction by two years of age.
2. The posterior cleft width also showed a significant reduction by three years of age. On the other hand, the posterior alveolar width showed a significant increase by four years of age.
3. The maximum cleft width and the blood loss in the F-group and P-group were 4.06 mm and 15.3 g, and 6.02 mm and 34.6 g, respectively (p < 0.001). There was no difference in the operation time or the fistula rate.
4. The subjective evaluation of the surgical damage and difficulty in achieving hard palate closure in the F-group was low. The agreement between the evaluations at four years of age and at the time of hard palate closure was high.
Conclusion; This study showed that the hard palate could be closed at 4 years of age with low surgical damage and little difficulty by applying Furlow's method.
