Comparison of palatal lengthening and perioperative outcomes of Furlow’s Z-plasty versus von Langenbeck’s palatoplasty in children with complete, non-syndromic cleft palate - a randomized controlled trial in India

Sep 30, 2026

Randomized controlled trial evaluates palatal lengthening and perioperative outcomes in 22 infants with complete, non-syndromic cleft palate. Children were assigned to von Langenbeck palatoplasty with intravelar veloplasty or to Furlow’s double opposing Z-plasty under uniform clinical conditions. Preoperative palatal measurements were similar and cleft width did not significantly influence outcomes. Both techniques achieved tension-free closure and produced comparable palatal lengthening. Von Langenbeck repair provided an anatomically based approach associated with lower fistula rates.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages11

Reading Time28 min

AccessFree to download

Introduction

Methods

Results

Conclusion

Or ig ina l Article Archives of Craniofacial Surgery Arch Craniofac Surg Vol.26 No.6, 244-254 [https://doi.org/10.7181/acfs.2026.0013](https://doi.org/10.7181/acfs.2026.0013) Comparison of palatal lengthening and perioperative outcomes of Furlow’s Z-plasty versus von Langenbeck’spalatoplastyin children with complete, non-syndromiccleft palate: a randomized controlled trial in India Nishank Manohar1, Altaf Mir1, N Nasida Fathima1, Madhubari Vathulya1, Akshay Kapoor1, Sudipta Bera2, Taruna Singh1, Debarati Chattopadhyay1 1Department of Burns and Plastic Surgery, All India Institute of Medical Sciences (AIIMS), Rishikesh, India 2Department of Burns and Plastic Surgery, Banaras Hindu University, Varanas, India Background: Cleft palate results from incomplete fusion of the palatine shelves during embryonic development and varies in severity. It affects speech, hearing, and feeding, often leading to complications such as nasal regurgitation and recurrent infections. The condition is common worldwide and frequently coexists with cleft lip. Surgery remains the primary treatment, aiming to restore both palatal length and function. In this study, Furlow’s double Z-plasty and von Langenbeck palatoplasty have been compared for their effectiveness in minimizing complications and improving outcomes. Methods: This study included 22 children aged 6 to 18 months with non-syndromic complete cleft palates, randomly assigned into two groups. Group A underwent von Langenbeck’s palatoplasty with intravelar veloplasty, while Group B underwent Furlow’s double opposing Z-plasty. Results: Preoperative palatal measurements were comparable between the two groups. Cleft width did not significantly affect surgical outcomes, and both techniques effectively achieved tension-free closure. Von Langenbeck’s repair with intravelar veloplasty was as effective as Furlow’s palatoplasty in achieving palatal lengthening, while offering the additional advantage of being an anatomically based repair associated with lower fistula rates. Conclusion: Von Langenbeck’s repair with intravelar veloplasty is as effective as Furlow’s palatoplasty in achieving palatal lengthening and provides the advantage of an anatomically sound repair with a reduced fistula rate. Keywords: Cleft palate / India / Speech / Therapeutic effectiveness Correspondences: Debarati Chattopadhyay Department of Burns and Plastic Surgery, All India Institute of Medical Sciences (AIIMS), Virbhadra Road, Rishikesh 249203, India [E-mail: debarati.psurg@aiimsrishikesh.edu.in](E-mail: debarati.psurg@aiimsrishikesh.edu.in) N Nasida Fathima Department of Burns and Plastic Surgery, All India Institute of Medical Sciences (AIIMS), Virbhadra Road, Rishikesh 249203, India [E-mail: nasidafathima@gmail.com](E-mail: nasidafathima@gmail.com) How to cite this article: Manohar N, Mir A, Fathima NN, Vathulya M, Kapoor A, Bera S, Singh T, Chattopadhyay D. Comparison of palatal lengthening and perioperative outcomes of Furlow’s Z-plasty versus von Langenbeck’s palatoplasty in children with complete, non-syndromic cleft palate: a randomized controlled trial in India. Arch Craniofac Surg 2025;26(6):244-254. [https://doi.org/10.7181/acfs.2026.0013](https://doi.org/10.7181/acfs.2026.0013) [Received April 10](Received April 10), [2025 / Revised September 11](2025 / Revised September 11), [2025 / Accepted December 3](2025 / Accepted December 3), [2025](2025) INTRODUCTION Surgical options for cleft palate closure have historically ranged from simple apposition to the use of buccal flaps, aiming to achieve both optimal structural integrity and functional outcomes. To meet these goals, two well-established surgical procedures are widely performed: Furlow’s double opposing Zplasty and von Langenbeck’s palatoplasty with intravelar veloplasty. Numerous studies have compared speech outcomes and complication rates between these methods. While Furlow’s © 2025 Korean Cleft Palate-CraniofacialAssociati

FAQs

What was the main objective of the randomized controlled trial?

To assess intraoperative palatal lengthening and compare perioperative outcomes between Furlow’s Z-plasty and von Langenbeck’s palatoplasty in children with complete, non-syndromic cleft palate.

How were the children assigned to surgical groups?

Twenty-two children aged 6 to 18 months were randomly assigned to two groups: Group A received von Langenbeck palatoplasty with intravelar veloplasty, and Group B received Furlow’s double opposing Z-plasty.

Did cleft width affect surgical outcomes?

Cleft width did not significantly affect surgical outcomes in the study, and both procedures achieved tension-free closure.

Which technique was associated with lower fistula rates?

Von Langenbeck’s repair with intravelar veloplasty offered the additional advantage of lower fistula rates while achieving palatal lengthening comparable to Furlow’s palatoplasty.

Sep 30, 2026

Uploaded by Genevieve