Outcomes of Sphincter Pharyngoplasty and Palatal Lengthening for Velopharyngeal Insufficiency<subtitle>A 10-Year Experience</subtitle>

Abstract

Sphincter pharyngoplasty is an effective procedure for the management of VPI, with a success rate of 87% when using need for surgical revision as the primary outcome measure. This number improved to 100% after a single revision, with elimination of VPI in all revision cases. Concomitant FP and SP may improve outcomes compared with SP alone. Further prospective studies are needed to elucidate this relationship.

Outcomes of Combined Furlow Palatoplasty and Sphincter Pharyngoplasty for Velopharyngeal Insufficiency

“…11 The combined procedure addresses the potentially multifactorial pathophysiology of velopharyngeal insufficiency with velar musculature repositioning, soft palatal lengthening, lateral pharyngeal constriction, and an overall decrease in velopharyngeal gap size. Restoring all of these physiologic components of the velopharyngeal sphincter mechanism might theoretically result in improved speech outcomes.…”

Age-Related Changes Between the Level of Velopharyngeal Closure and the Cervical Spine

“…19-21 Riski et al 22 observed the primary cause of failed pharyngoplasty was insertion of the flap below the point of optimal velopharyngeal closure. Studies have emphasized the importance of placement of the pharyngoplasty as it relates to speech outcome 20,23,24 , suggesting placement at or above the level of velopharyngeal closure 20,22,24 . However, clinical methods tend to be less prescriptive indicating placement should be “as high as possible.” The first cervical vertebra (C1) or the level of velopharyngeal closure have been recommended as landmarks for identifying placement of the pharyngoplasty prior to and during surgery in order to ensure the pharyngoplasty is at an optimal level for normal resonance postsurgically.…”

Furlow palatoplasty for previously repaired cleft palate with velopharyngeal insufficiency

“…A c c e p t e d M a n u s c r i p t 4 The aim of this study was to assess the efficacy of performing Furlow double opposing Z-plasty for patients presented with post-palatoplasty VPI.…”

“…It can be used as a single procedure for treatment of VPI, and may be combined with another method as sphincter pharyngoplasty in severe cases[4, 22].…”