Speech and Magnetic Resonance Imaging Results following Autologous Fat Transplantation to the Velopharynx in Patients with Velopharyngeal Insufficiency

Filip, Charles; Matzen, Michael; Aagenæs, Ingegerd; Aukner, Ragnhild; Kjøll, Lillian; Høgevold, Hans Erik; Åbyholm, Frank; Tønseth, Kim Alexander

doi:10.1597/09-161

Cited by 32 publications

(20 citation statements)

References 32 publications

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“…Recently, only one report discussed augmentation that was limited to the soft palate [23]. Furthermore, many reports on velopharyngeal augmentation have found that this treatment did not improve hypernasality in some VPI patients [13,15,18,19,21,23].…”

Section: Discussionmentioning

confidence: 99%

Evaluation of sites of velopharyngeal structure augmentation in dogs for improvement of velopharyngeal insufficiency

et al. 2019

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Background Velopharyngeal structure augmentation methods are used as alternatives to velopharyngeal plasty. Anatomic sites of implantation/injection vary widely due to a lack of standardized criteria. Here, we experimentally investigated optimal sites of velopharyngeal structure augmentation via saline injection in dogs as they naturally exhibit velopharyngeal insufficiency (VPI). Methods Velopharyngeal structure augmentation was performed on 10 beagles (age range: 20–24 months; weight range: 9–12 kg). Saline containing 1/80,000 epinephrine was injected intraorally in 1-mL increments into the nasal mucosa of the soft palate (n = 4), posterior pharyngeal wall (n = 3), or bilateral pharyngeal walls (n = 3) of each dog. Nasal air leakage was measured under rebreathing until velopharyngeal closure was achieved; the measurement was performed using flow meter sensors on both nasal apertures, and the oral cavity was filled with alginate impression material to prevent oral air leakage. Results Pre-injection, the dogs exhibited an average of 0.455 L/s air leakage from the nasal cavity. The dogs with saline injected into the nasal mucosa of the soft palate achieved steady augmentation, and nasal air leakage disappeared under rebreathing following 6-mL saline injection. Conversely, nasal air leakage remained in the dogs with saline injected in the posterior pharyngeal wall or bilateral pharyngeal walls. Conclusions During VPI treatment in dogs, augmentation was most effective at the nasal mucosa of the soft palate. Improvement in nasal air leakage was highly dependent on the saline injection volume. Although velopharyngeal structures vary between dogs and humans, velopharyngeal closure style is similar. Thus, our results may aid in the treatment of VPI patients.

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Section: Discussionmentioning

confidence: 99%

Evaluation of sites of velopharyngeal structure augmentation in dogs for improvement of velopharyngeal insufficiency

et al. 2019

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“…Las insuficiencias velo faríngeas se han definido como la incapacidad del velo palatino en la obturación del esfínter velo faríngeo (Filip et al, 2011;Ministerio de Salud;Ysunza et al, 2002) permitiendo el escape del aire hacia la cavidad nasal durante la emisión de los fonemas vocálicos y consonánticos, excepto para m, n y ñ que son por naturaleza nasales (Cortés Araya et al). Se ha propuesto como medida terapéutica para este trastorno la realización de una cirugía secundaria de velo palatino en conjunto con tratamiento fonoaudiológico.…”

Section: Discussionunclassified

Morfología del Velo Palatino en Individuos Fisurados Operados, y su Relación con el Grado de Insuficiencia Velo Faríngea

et al. 2013

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RESUMEN: La fisura labio palatina corresponde a una malformación congénita, caracterizada por la interrupción en la continuidad de los tejidos. La cirugía primaria del velo del paladar permite reconstituir la morfología perdida del velo palatino, sin embargo ésta no siempre considera la devolución de la anatomía del músculo de la úvula, por lo cual, el velo operado adquiere una anatomía anómala impidiendo el cierre óptimo entre cavidad oral y nasal; esta condición se conoce con el nombre de insuficiencia velo faríngea. El objetivo de este trabajo fue asociar la morfología del velo palatino con la insuficiencia velo faríngea en individuos fisurados operados. Se realizó un estudio analítico, teniendo como unidad de muestra al velo del paladar; La muestra se seleccionó entre aquellos pacientes que cumplían con los criterios de inclusión. A los individuos seleccionados se les realizó un examen clínico y un registro fotográfico con el objetivo de clasificar la anatomía del velo del paladar. Posteriormente se les realizó una evaluación fonoaudiológica para determinar el grado de insuficiencia velo faríngea. Los datos obtenidos fueron tabulados y evaluados estadísticamente. La clasificación morfológica del velo del paladar determino que el 52% de los velos fueran clasificados como cóncavos, los velos convexos y planos se distribuyeron ambos en un 24%. Según la evaluación velo faríngea, el 12% se presentaron como insuficientes, el 52% como límite insuficiente, el 24% como límite suficiente y tan solo el 8% como suficientes. Al relacionar la morfología del velo del paladar con evaluación velo faríngea se obtuvo un p = 0,3. Existe una variabilidad tanto en la morfología del velo del paladar como en la evaluación de la insuficiencia velo faríngea en individuos fisurados operados, siendo esta ultima desfavorable. No se estableció una relación estadística entre morfología del velo del paladar y la evaluación velo faríngea. PALABRAS CLAVE: Fisura labio palatina; Anatomía velo-palatina; Evaluación velo-faríngea.

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“…Several reports have described another method for treating VPI [8][9][10][11][12][13][14][15][16][17][18][19][20][21][22]. Velopharyngeal structure augmentation is an alternative to pharyngeal flap surgery that utilizes an injectable material implanted into the tissue around the velopharynx.…”

Section: Introductionmentioning

confidence: 99%

“…There have been no reports about the optimal materials for implantation or injection, however. There are various artificial and biological materials that may be used in the velopharyngeal structure, including silicone, Teflon, porous polyethylene, Gore-Tex 1 , calcium hydroxyapatite, auricular or costal cartilage, and autologous fat [8][9][10][11][12][13][14][15][16][17][18][19][20][21][22]. However, when we augment the soft palate, the material needs to be injectable, because it cannot be implanted into the nasal side of the soft palate without damaging the levator veli palatini.…”

Section: Introductionmentioning

confidence: 99%

Endoscopic soft palate augmentation using injectable materials in dogs to ameliorate velopharyngeal insufficiency

et al. 2020

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Background Velopharyngeal structure augmentation methods are used as alternatives to pharyngeal flap operations. Recently, we investigated the sites of velopharyngeal structure augmentation in dogs and reported that the most effective injection location is the soft palate. However, there have been no reports regarding the optimal materials for implantation or injection. In this study, we aimed to investigate the injectable materials used in soft palate augmentation in dogs to ameliorate velopharyngeal insufficiency (VPI). Methods Endoscopic soft palate augmentation (ESPA) was performed in dogs using purified sodium hyaluronate, atelocollagen, or autogenic fat tissue. ESPA is an original technique developed by our group, and this is the first report of its performance. Moreover, we assessed the amount of nasal air leakage during inspiration at rest and during expiration under the rebreathing system at 1, 2, 3, 4, 5, and 6 months after injection of these materials. Results The amount of nasal air leakage during expiration under the rebreathing system was significantly decreased in all dogs injected with the ESPA materials, but neither apnea nor hypopnea was observed. Conclusions We investigated the optimal materials for use in ESPA, such as purified sodium hyaluronate, atelocollagen, or autogenic fat tissue. We found that all of them reduced nasal air leakage and only autogenic fat tissue showed significant histologic differences in dogs at 6 months. This technique may also be useful for the treatment of patients with VPI.

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Speech and Magnetic Resonance Imaging Results following Autologous Fat Transplantation to the Velopharynx in Patients with Velopharyngeal Insufficiency

Cited by 32 publications

References 32 publications

Evaluation of sites of velopharyngeal structure augmentation in dogs for improvement of velopharyngeal insufficiency

Evaluation of sites of velopharyngeal structure augmentation in dogs for improvement of velopharyngeal insufficiency

Morfología del Velo Palatino en Individuos Fisurados Operados, y su Relación con el Grado de Insuficiencia Velo Faríngea

Endoscopic soft palate augmentation using injectable materials in dogs to ameliorate velopharyngeal insufficiency

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