Salvaging the Failed Pharyngoplasty: Intervention Outcome

Abstract

Rates of primary pharyngeal flap failure are roughly equivalent to rates of primary sphincter pharyngoplasty failure. Pharyngeal flap and sphincter pharyngoplasty failures can be salvaged with revisional surgery, which can provide a velopharyngeal mechanism capable of complete closure. Revisional surgery is usually associated with denasal speech.

Speech prognosis and need of pharyngeal flap for non syndromic vs syndromic Pierre Robin Sequence

“…Surgical procedures include the enlargement of the posterior pharyngeal wall with various injectable materials, the lengthening of the palate by pushback palatoplasty and pharyngeal flap, sphincter pharyngoplasty or pharyngeal flap alone [10,11]. Pharyngeal flaps can be based superiorly, inferiorly, or laterally [12,13]. Indications for surgery must take into account the social impact of the child's speech and the age of the child because the recovery period is quite uncomfortable.…”

“…In the 3 sPRS who underwent pharyngeal surgery, results were also very satisfactory with postoperative scores of 1, 1/2, and 2. Witt et al [13] reported that over a 9-year period, about 15% of patients who underwent pharyngeal flap surgery or sphincter pharyngoplasty for velopharyngeal dysfunction required revision. Surgical failure can be the result of surgical error and/or inadequate lateral pharyngeal wall motion [22].…”

Revisional surgery following the superiorly based posterior pharyngeal wall flap. Historical perspectives and current considerations

“…Barot et al 3 reported similar results, while Witt et al 40 reported a slightly higher percentage (20%) of revisional surgery. Three causes can be identified for the unsatisfactory functional outcome with respect to nasal resonance.…”

“…Successful outcome with respect to nasal resonance of the sphincterpharyngoplasty ranged from 67% to 85% 26 . Both sphincterpharyngoplasty and pharyngeal flap operations require revisional surgery to treat unsatisfactory functional results in about 15-20% 40 .…”

Dimensões nasofaríngeas em indivíduos sem anomalias craniofaciais: dados normativos

“…Pharyngeal flap is a surgical procedure widely applied in the VPI management. This method aims to create a partial mechanical nasopharyngeal obstruction, favoring velopharyngeal closure during the speech (9,10) . Thus, due to the pharyngeal patency reduction caused by the flap, some cases may exhibit respiratory changes resulting from the nasopharyngeal obstruction (11) .…”