Comparison of intravelar veloplasty and Furlow palatoplasty in submucous cleft palate: a meta-analysis.

The submucous cleft palate is a known entity. The two most common techniques are intravelar veloplasty and Furlow palatoplasty. However, a standard technique has not yet been defined and, to our knowledge, there are no systematic reviews on the topic. This study therefore was undertaken to compare these two surgical techniques in terms of improvements in speech and velopharyngeal closure. We used Google Scholar, PubMed Central, Medline, and Cochrane databases. Reference checking and citation searching was done to identify studies to be included. Outcomes measured were speech improvement, objective improvement in velopharyngeal insufficiency, and adverse effects (wound dehiscence, palatal fistula, sleep apnoea, or hyponasal speech).Results were synthesised for each outcome using meta-analysis where possible (inverse variance with random effects analysis model). Four studies were included in the meta-analysis with a total of 170 participants. The comparison between intravelar veloplasty and Furlow palatoplasty in terms of speech was in favour of Furlow palatoplasty (odds ratio: 1.32; 95% confidence interval (CI): 0.55 to 3.18). For velopharyngeal closure, the result was in favour of Furlow palatoplasty (odds ratio: 2.11; 95% CI: 0.54 to 8.23). The rate of fistula formation was lower with intravelar veloplasty (odds ratio: 0.54; 95% CI: 0.11 to 2.71). Furlow palatoplasty may reduce the risk of incomprehensible speech and velopharyngeal insufficiency in comparison with intravelar veloplasty. There is less risk of fistula formation after intravelar veloplasty.