Results of Furlow Z-Plasty in Patients With Velocardiofacial Syndrome

DʼAntonio, Linda L.; Davio, Michael; Zoller, Kristyn; Punjabi, Anil P.; Hardesty, Robert A.

doi:10.1097/00006534-200104010-00033

Cited by 25 publications

(21 citation statements)

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“…25 Antonio et al used Furlow Z-plasty for treating VPI; they divided patients into three groups: nonsyndromic, VCFS, and syndromic. 9 Furlow Z-plasty produced excellent results in the nonsyndromic group, varied results in the syndromic group, and poor results in the VCFS group. The majority of patients in the three groups showed similar patterns of velopharyngeal function evidenced by perceptual, aerodynamic, endoscopic, and cephalometric studies preoperatively; therefore, VCFS patients may be poor candidates for doubleopposing Z-plasty.…”

Section: Discussionmentioning

confidence: 90%

Evaluation of the levator veli palatini muscle thickness in patients with velocardiofacial syndrome using magnetic resonance imaging

Mi-Kyong

Ahn

Jeong

et al. 2015

Journal of Plastic, Reconstructive & Aesthetic Surgery

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Velocardiofacial syndrome (VCFS) is associated with velopharyngeal insufficiency, which occurs in approximately 75% of VCFS patients. Surgical management of velopharyngeal insufficiency in VCFS patients is difficult with a high revision rate due to the anatomic and physiological abnormalities of the velopharynx. The aims of this study were to evaluate the thickness and symmetry of the levator veli palatini (LVP) muscle using magnetic resonance imaging (MRI), and to compare the findings in VCFS patients to those in patients with nonsyndromic submucous cleft palate. We conducted a prospective analysis of 17 VCFS patients (nine boys, eight girls; age range, 4-9 years) and nine patients with submucous cleft palate without VCFS (eight boys, one girl; age range, 4-13 years) who had undergone MRI between March 2009 and August 2013. The thickness of the LVP muscle was measured at six locations in both groups. The symmetry was determined by comparing the values between the average of the left three points and the right three points. The mean LVP muscle thickness was significantly thinner in VCFS patients (2.14 ± 0.73 mm) than in patients without VCFS (3.70 ± 1.08 mm) (p < 0.001). In addition, the difference between the left and right sides of muscle thickness in the VCFS group was larger than that in the nonsyndromic submucous cleft palate group (0.25 and 0.09 mm, respectively). The thinness and asymmetry of the LVP muscle should be considered when determining the surgical management of velopharyngeal insufficiency in VCFS patients.

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Section: Discussionmentioning

confidence: 90%

Evaluation of the levator veli palatini muscle thickness in patients with velocardiofacial syndrome using magnetic resonance imaging

Mi-Kyong

Ahn

Jeong

et al. 2015

Journal of Plastic, Reconstructive & Aesthetic Surgery

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“…Hypernasal speech is a hallmark of VCFS [1] , resulting from a variety of anomalies including cleft palate, submucous cleft palate, palatopharyngeal hypotonia, deep retropharynx, or anterior positioning of the levator palatini [1,4,5] . While hypernasality is often eliminated in patients with nonsyndromic cleft palate with traditional surgical approaches, speech outcomes in the VCFS population have been less than optimal [6][7][8] . Losken et al [8] found that children with VCFS with a larger VP orifice ( 1 30 mm 2 ) were more likely to require additional surgery to reduce hypernasality.…”

Section: Introductionmentioning

confidence: 99%

Structural and Functional Causes of Hypernasality in Velocardiofacial Syndrome

Baylis

Watson

Moller

2009

Folia Phoniatr Logop

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Objective: Hypernasality in velocardiofacial syndrome (VCFS) is more severe, persistent, and difficult to manage compared to other populations with cleft palate or velopharyngeal (VP) dysfunction. This pilot study investigated why children with VCFS have more severe hypernasality. Methods: Pressure-flow methodology indirectly measured VP orifice size and VP closure timing during speech in a group of 5 children with VCFS, 5 children with cleft palate, and 6 normal children. Results: Children with VCFS demonstrated significant differences in VP closure timing and hypernasality. There were no significant group differences in VP orifice size. Duration of nasal airflow was the strongest predictor of judgments of hypernasality. Conclusion: This study provides preliminary evidence that VP closure timing may account for the more severe hypernasality in children with VCFS, compared to structural factors alone.

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“…Un estudio publicado el año 2000 puso en evidencia que los pacientes con FSM y SVCF tenían resultados poco exitosos con cierre de paladar empleando la técnica de Furlow, ya que ninguno de los pacientes con el síndrome logró un cierre velofaríngeo adecuado, en oposición al 78% de cierre del EVF en el grupo control de pacientes con FSM no sindrómicos (3) . La experiencia en nuestro medio es similar, ninguno de los pacientes de una serie de 8, con SVCF operados en la Fundación Gantz y el Hospital Roberto del Río, lograron corregir la IVF, utilizando para el cierre Las técnicas quirúrgicas tradicionales para lograr el cierre del EVF en pacientes con IVF, no son efectivas en pacientes SVCF (31,32) dado el tamaño reducido de adenoides, la hiperplasia de amígdalas, la platibasia, hipotonía de la musculatura faríngea, la posición de las carótidas y la hipernasalidad severa.…”

Section: Aspectos Quirúrgicosunclassified

“…Las manifestaciones clínicas que presentan estos pacientes son diversas, incluyendo características faciales típicas, anomalías cardíacas, fisura palatina, así como dificultades de índole fonoaudiológico, pedagógico y psicológico-psiquiátrico, que deben ser atendidas y requieren de una estrategia de intervención especializada (2)(3)(4) , y de un equipo profesional interdisciplinario.…”

Section: Introductionunclassified

Descripción de características clínicas del síndrome velocardiofacial

Alvarez¹,

Palomares²,

Villena³

2012

Revista Chilena De Fonoaudiología

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RESUMENUno de los síndromes más frecuentes asociados a fisura palatina es el Síndrome Velocardiofacial. Sus características involucran aspectos faciales, cardiológicos, psicológicos, lingüísticos y de aprendizaje, que deben ser abordados por equipos multiprofesionales. Internacionalmente el estudio de este síndrome se ha ido masificando en forma progresiva. En nuestro país son escasos los grupos que manejan e intervienen en esta población. En este contexto es que se hace necesaria una revisión bibliográfica actualizada, que resuma los hallazgos clínicos y algunos aspectos de manejo multiprofesional, desde una perspectiva fonoaudiológica.Palabras clave: Síndrome Velocardiofacial, Fisura Palatina, Insuficiencia Velofaríngea, Faringoplastía. ABSTRACTVelo-Cardio-Facial syndrome (VCFS) is one of the most frequently associated syndromes to cleft palate. It comprises facial, cardiological, psychological, and linguistic disorders as well as learning difficulties which all must be addressed by a multi-professional team. The study of this syndrome has been systematically carried out around the world. In Chile, however, there are only few health-related professionals who work with this patient population. The present article aims at providing an up-to-date review, from a speech pathology point of view, on the clinical findings and on some aspects involved in the clinical management of VCFS.

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Results of Furlow Z-Plasty in Patients With Velocardiofacial Syndrome

Cited by 25 publications

References 0 publications

Evaluation of the levator veli palatini muscle thickness in patients with velocardiofacial syndrome using magnetic resonance imaging

Evaluation of the levator veli palatini muscle thickness in patients with velocardiofacial syndrome using magnetic resonance imaging

Structural and Functional Causes of Hypernasality in Velocardiofacial Syndrome

Descripción de características clínicas del síndrome velocardiofacial

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