Functional and speech outcomes of superiorly based flap pharyngoplasty combined with radical intravelar veloplasty

Abstract

Objective The aim of this study was to evaluate functional and speech outcomes of superiorly based pharyngeal flap (SBF) pharyngoplasty combined with radical intravelar veloplasty (RIVVP) for the management of velopharyngeal insufficiency (VPI) following surgically repaired cleft palate. Design A case series with chart review. The study was conducted in academic tertiary care medical centre. Patients and Methods Fifteen patients with VPIs following surgically repaired cleft palate were managed between May 2011 and August 2014, with SBF pharyngoplasty combined with RIVVP. Results We found that the speech defects improved by a success rate of 93.4%; the VP function became normal (circular pattern of closure) in 80% of patients and the postoperative overall success rate of VP competence grades was 93.4%. Moreover, we found that the overall incidence of complications were 33.3%. Conclusion By doing SBF pharyngoplasty combined with RIVVP the surgical procedure was satisfactory in both functional and speech outcomes.

Filling the Void: Use of the Interpositional Buccal Fat Pad to Decrease Palatal Contraction and Fistula Formation

“…Over the past few decades, many techniques and procedures have been described and/or revised to address VPI. [14][15][16][17][18][19][20][21][22] Few of these papers postulate an underlying mechanism that pre-disposes a patient to velopharyngeal insufficiency, 3,4,19,20,23 and often the complication is associated with failure to adequately address the levator sling at the time of primary palatoplasty. 19,20 Given the increased burden of care that prolonged speech therapy can impose on families and the relatively high potential for additional speech operations, it would seem prudent to address the concern for VPI at the time of initial repair, particularly in those difficult cases where there is a high likelihood of a poor outcome.…”

Spaltbildungen und deren Therapie

“…Ebenso wie bei den LS-Korrekturen und der NAM-Therapie finden sich in der Literatur auch in Bezug auf die Palatoplastik erhebliche Kontroversen. Alle referierten Techniken weisen Vor-und Nachteile hinsichtlich des Outcomes (Sprache, Wachstumshemmung des Oberkiefers, Häufigkeit von Fisteln[Restlöchern] sowie Tubenfunktion) auf[26][27][28]. Die Unterschiede hinsichtlich der Langzeitergebnisse sind insgesamt jedoch eher gering, sodass eine Vielzahl von Verfahren weiterhin ihre Berechtigung hat[16].…”

Função velofaríngea após cirurgia de retalho faríngeo: influência do tipo de fissura labiopalatina

“…Considerando que o retalho faríngeo é a técnica cirúrgica mais utilizada para a correção da IVF, é de interesse da população científica o estudo acerca dos seus resultados relacionados aos aspectos de fala e respiração (ARMOUR et al, 2005;DAILEY et al, 2006;ABDEL-AZIZ, 2007;MULLIKEN, 2010;CAMPOS et al, 2015;EZZAT et al, 2015).…”

“…Pretende-se alcançar consistência e uniformidade nas classificações, parâmetros universais e treinamento de profissionais (HENNINGSSON et al, 2008;SELL et al, 2009;OLIVEIRA, 2014;BAYLIS et al, 2015;MEDEIROS, 2015). Em função desses fatores, a complementação dos resultados de fala utilizando avaliação instrumental é sempre recomendada (DOTEVALL et al, 2002; BRUNNEGÅRD; LOHMANDER; VAN DOORN, 2012 MULLIKEN, 2010;COLLINS et al, 2012;PATEL et al, 2012;BARBOSA et al, 2013;NYBERG;PETERSON;LOHMANDER, 2014;EZZAT et al, 2015;SETABUTR et al, 2015). Abdel-Aziz (2007) CARDIA et al, 2011;CAMPOS et al, 2015;EZZAT et al, 2015).…”

“…Em função desses fatores, a complementação dos resultados de fala utilizando avaliação instrumental é sempre recomendada (DOTEVALL et al, 2002; BRUNNEGÅRD; LOHMANDER; VAN DOORN, 2012 MULLIKEN, 2010;COLLINS et al, 2012;PATEL et al, 2012;BARBOSA et al, 2013;NYBERG;PETERSON;LOHMANDER, 2014;EZZAT et al, 2015;SETABUTR et al, 2015). Abdel-Aziz (2007) CARDIA et al, 2011;CAMPOS et al, 2015;EZZAT et al, 2015). Por outro lado, estudo recente de Campos et al (2015), mostrou, por meio da polissonografia, que a apneia obstrutiva do sono é um achado frequente entre adultos de meia-idade com fissura palatina reparada e que o tratamento da IVF com a CRF pode não ser o fator ocasional.…”