Sommerlad–Furlow modified palatoplasty vs Sommerlad palatoplasty: A retrospective study

The purpose of palatoplasty is to close the cleft of the palate, whilst improving postsurgical speech and avoiding maxillofacial growth inhibition (Bessell et al., 2013; Fitzpatrick et al., 2020; Losee and Kirschner, 2016). Factors affecting postsurgical speech include levator veli palatini reconstruction, the length of the soft palate, the volume of the pharyngeal cavity, and age at surgery (Shi and Losee, 2015). Bone denudation after relaxing incision could be one factor associated with the inhibition of maxillofacial growth2–6. Therefore, avoiding a conventional relaxing incision on the hard palate, reconstructing the palatal muscle, and lengthening the soft palate to decrease the pharyngeal cavity have been proposed as the three main principles for an effective palatoplasty.

The Sommerlad technique, with minimal hard palate dissection and radical muscle reconstruction, has been shown to restore the function of the soft palate (Bruneel et al., 2018; Sommerlad, 2003). The Furlow double-opposing Z-plasty technique has been shown to significantly lengthen the soft palate (Chen et al., 1994, 1996; Furlow, 1986; Kwon et al., 2018). Both the Furlow and Sommerlad techniques emphasized the importance of raising the mucoperiosteal flaps on the hard palate without lateral relaxing incisions, but how to avoid the relaxing incisions still required further modification.

For a palatoplasty to achieve the forementioned principles, the concepts of both the original Furlow and Sommerlad techniques were combined in a modified palatoplasty, called the Sommerlad–Furlow modified technique (S–F palatoplasty). In addition, a novel incision on the medial pterygoid plate's surface was designed to complete this combination, by harvesting abundant tissues for closing the cleft and avoiding the conventional relaxing incision on the hard palate.

Our study aimed to demonstrate the surgical process of S–F palatoplasty and compare its postsurgical outcomes with the Sommerlad (S) technique.

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