A Systematic Review Comparing Furlow Double - Opposing Z - Plasty and Straight - Line Intravelar

1014 The primary goal of palatoplasty is anatomical reconstruction of an intact palate to allow for development of normal speech while minimizing the incidence of oronasal fistula and ensuring long-term harmonious facial growth. Kriens1 first drew attention to the muscular anatomy of the soft palate, describing the abnormal positioning of the levator veli palatini muscle and loss of integrity of the supporting structures as the primary causes for impairment of speech production following palate repair. Therefore, he advocated for release and reorientation of the levator muscles.1 This method, termed intravelar veloplasty, became an inherent component of the most commonly used cleft palate repair techniques, including von Langenbeck palatoplasty, Veau-Wardill-Kilner pushback palatoplasty, and the Bardach two-flap palatoplasty.2 All of these techniques produce a straight-line closure of the soft palate and are often grouped under the single designation of “straight-line” repairs. In 1976, in an attempt to improve the speech results following palate repair while allowing adequate maxillary growth, Furlow3 devised the double-opposing Z-plasty method for the repair of clefts involving the soft palate. This technique has the advantages of lengthening the velum, avoiding overlap between the oral and nasal mucosal