Comparative Evaluation of Modified Furlow Palatoplasty and Intravelar Veloplasty in Cleft Palate Repair

Introduction: The purpose of this study was to comparatively assess the two techniques of cleft palate repair i.e. Kriens intravelar veloplasty (IVV) and modified Furlow Palatoplasty (MFP) for post-operative fistula formation, wound dehiscence at suture line, nasal regurgitation, velopharyngeal insufficiency, soft palate lengthening and speech. Method: This prospective study was conducted on 60 patients having primary cleft palate.  They were assigned either to IVV group or MFP group randomly so that both the groups consisted of 30 patients each. The two groups were operated under general anesthesia. Measurements at the time of operation were made with the help of soft ruler and Castroviejo caliper. Follow up of patient's was done 1 week, 1 month, 3 month, 6 months and complication is present was noted. Five year post operatively speech was recorded and assessed by the speech language pathologist. Post-operative Nasoendoscopy was also performed to assess the velopharyngeal insufficiency. Result: The MFP group showed more percentage elongation of the soft palate and less incidence of post-operative palatal fistula formation than IVV group. Total speech scores were superior in MFP patients but the differences were less robust. Velopharyngeal incompetence was present in both groups but was less severe in MFP group than the IVV group.  Conclusion: The MFP group showed comparatively superior results than the IVV group but required an increased surgical time. Therefore MFP can be used as an alternative technique for cleft palate repair.