Furlow palatoplasty to restore velopharyngeal competence following tonsillectomy avulsion of a pharyngeal flap

Arun K. Gosain*, Daniel Remmler

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

2 Scopus citations

Abstract

Objective: We report the successful use of a Furlow palatoplasty to salvage velopharyngeal competence following Latrogenic avulsion of a pharyngeal flap that had been previously established to treat velopharyngeal insufficiency associated with a submucous cleft palate. Intervention: A tonsillectomy, conducted by a surgeon unaffiliated with a cleft palate team, was used to remove enlarged tonsils that had developed after pharyngeal flap surgery and extended into the lateral ports causing nasal obstruction and hypernasality because of mechanical interference with port closure. A posttonsillectomy evaluation revealed avulsion of the pharyngeal flap, which was successfully treated using a Furlow palatoplasty. Conclusions: To our knowledge, this is the first report of latrogenic avulsion of a pharyngeal flap caused by tonsillectomy. Based on a review of the literature and this case experience, we would conclude that tonsillectomy should not be regarded as a routine procedure in patients previously treated with a pharyngeal flap. If required, it should be performed by a skilled otolaryngologist, preferably one affiliated with a multidisciplinary cleft palate team who is familiar with pharyngoplasty surgery. Finally, our experience would suggest that the Furlow palatoplasty is sufficiently robust to be used as a secondary salvage procedure to restore velopharyngeal sufficiency following iatrogenic avulsion of a pharyngeal flap.

Original languageEnglish (US)
Pages (from-to)84-88
Number of pages5
JournalCleft Palate-Craniofacial Journal
Volume38
Issue number1
DOIs
StatePublished - Jan 1 2001

Keywords

  • Furlow palatoplasty
  • Pharyngeal flap
  • Postoperative complications
  • Velopharyngeal insufficiency

ASJC Scopus subject areas

  • Oral Surgery
  • Otorhinolaryngology

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