Posterior Pharyngeal Wall Augmentation With Muscular Flap Versus Musculomucosal Flap for Correction of Velopharyngeal Incompetence

Abstract

This study was aimed to evaluate and compare the posterior pharyngeal wall augmentation using muscular flap versus musculomucosal flap for correction of velopharyngeal incompetence (VPI).Patients and methods: this study was conducted on twenty children (13 males and 7females) complaining from VPI with age ranging between 6.5 and 13 years with a mean of age 8.7 years. All patients were treated surgically using posterior pharyngeal wall augmentation. Patients were classified into two equal groups according to the type of flap technique used for posterior pharyngeal wall augmentation. Group I included10 patients (7 males and 3 females) were treated by muscular flap. Group II included10 patients (6 males and 4 females) were treated by musculomucosal flap. The preoperative and postoperative assessments for patients with VPI included clinical examination of the voice, nasopharyngoscopy and computed tomography (CT) scans. Results:Regarding clinical presentation (hypernasality and nasal regurgitation of fluid), all patients in both groups had no nasal regurgitation of fluid or food which represents 100%. As regard the overall nasalance results (Nasal sentence) measured by nasometry in both groups there was noticeable improvement. But when comparing overall nasalance results between both groups there was no significant difference .Competence and borderline closure was achieved in 65% for patients of both groups. The VP gap size reduction was achieved in both groups, however there was no significant difference regarding reduction of median VP gap size. Conclusion:At the end, as there no significant difference in the results of both groups: the myomucosal flap technique for posterior pharyngeal wall augmentation is simple and easier than the muscular flap technique and the posterior pharyngeal wall augmentation is a good technique for treatment of VPI KEY WORDS: VPI, Posterior pharyngeal wall augmentation, nasometer.(1230) Mahmoud E. Khalifa, et al.