Nasometric and Aerodynamic Outcome Analysis of Pharyngeal Flap Surgery for the Management of Velopharyngeal Insufficiency

Abstract

Pharyngeal flap surgery was shown to be effective in reducing nasalance scores and velopharyngeal area during speech for a significant number of patients. Complete resolution was observed in smaller number of cases. Age at surgery and postoperative speech therapy were relevant factors for treatment success.

Influência das consoantes de alta e baixa pressão intraoral sobre a nasalidade e nasalância da fala em pacientes com fissura de palato reparada

“…Nasality was rated using a 4-point scale, where 1=absent hypernasality, 2=mild hypernasality, 3=moderate hypernasality, 4=severe hypernasality (11) . The examiners individually received the samples in two distinct stages, with a 32-day interval between each of the stages.…”

“…However, the use of instrumental assessment complements the subjective analysis, verifying treatment outcomes more thoroughly, and its use is highly recommended (8,9,10,11) . Nasometry is one of the methods used to confirm nasality judgment and complement speech diagnosis (10,11,12,13) . The technique estimates the velopharyngeal function indirectly, by measuring nasalance, a physical magnitude that corresponds to the relative amount of nasal acoustic energy during production of oral sounds (14) , according to the spoken language.…”

“…Thus, it is considered gold standard in the analysis of speech disorders in individuals with cleft lip and palate (7) . However, the use of instrumental assessment complements the subjective analysis, verifying treatment outcomes more thoroughly, and its use is highly recommended (8,9,10,11) . Nasometry is one of the methods used to confirm nasality judgment and complement speech diagnosis (10,11,12,13) .…”

Comparação entre duas abordagens diferentes de tratamento cirúrgico da insuficiência velofaríngea

“…Several surgical techniques have been described for that purpose, the most common of which are the achievement of pharyngeal flaps and sphincteroplasty, which are well reported in the literature, and secondary palatoplasty with intravelar veloplasty, which has been used more recently for correction of VPI (7,8,9,10,11) . In general, selection of the surgical technique is based on the structural and functional conditions of the velopharynx determined on preoperative evaluation, including the extent and mobility of the palatal vault, movement of pharyngeal walls and type of velopharyngeal closure (7,12) . The pharyngeal flap surgery comprises creation of a myomucous tissue bridge between the posterior pharyngeal wall and the soft palate, determining two lateral orifices.…”

Correlação entre nasalância e nasalidade em crianças com hipernasalidade

“…Other studies reported measures of nasalance in patients with operated cleft palate in order to investigate the conditions of the velopharyngeal mechanism after the performed surgical procedures [25][26][27][28] , even after adapting a palatal prosthesis 29 . While these studies have contributed greatly to information about nasalance in individual PB speakers, data on the correlation between the values of nasalance and perceptual findings in BP-speaking children are limited.…”