Surgical treatment of velopharyngeal insufficiency

Nam, Seung Min

doi:10.7181/acfs.2018.02082

Cited by 62 publications

(12 citation statements)

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“…For children with cleft palate who have undergone palatoplasty, an algorithm could be developed using an RNN that would use spectral analysis to extract characteristic voice features from a picture pronunciation test or a sentence pronunciation test and extracting characteristic voice features. Cleft palate and velopharyngeal insufficiency are also closely related to speech [ 33 , 34 ]. Although currently not valid for children with cleft palate or velopharyngeal insufficiency, South Korea has a platform that uses AI algorithms to diagnose and conduct rehabilitation of speech disorders ( https://www.talkytalky.kr/ ).…”

Section: Recurrent Neural Network and Speech And Natural Language Processing: Cleft Palate And Velopharyngeal Insufficiencymentioning

confidence: 99%

Potential role of artificial intelligence in craniofacial surgery

Ryu

Chung

Choi

2021

Arch Craniofac Surg

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The field of artificial intelligence (AI) is rapidly advancing, and AI models are increasingly applied in the medical field, especially in medical imaging, pathology, natural language processing, and biosignal analysis. On the basis of these advances, telemedicine, which allows people to receive medical services outside of hospitals or clinics, is also developing in many countries. The mechanisms of deep learning used in medical AI include convolutional neural networks, residual neural networks, and generative adversarial networks. Herein, we investigate the possibility of using these AI methods in the field of craniofacial surgery, with potential applications including craniofacial trauma, congenital anomalies, and cosmetic surgery.

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Section: Recurrent Neural Network and Speech And Natural Language Processing: Cleft Palate And Velopharyngeal Insufficiencymentioning

confidence: 99%

Potential role of artificial intelligence in craniofacial surgery

Ryu

Chung

Choi

2021

Arch Craniofac Surg

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“…Numerous operative techniques exist which have evolved to include modifications and combinations of procedures. The most common techniques include the pharyngeal flap, Furlow palatoplasty (double opposing Z-plasty), and sphincter pharyngoplasty, each with multiple modified versions [ 10 , 11 , 15 , 16 , 20 – 32 ]. Procedure selection is partially based on velopharyngeal closure pattern but is also reliant on factors relating to the surgeon such as training, comfort with each technique, and institutional preference [ 10 – 12 , 15 , 16 , 22 ].…”

Section: Introductionmentioning

confidence: 99%

Surgical interventions in velopharyngeal dysfunction: Comparative perceptual speech and nasometric outcomes for three techniques

Instrum

Dzioba

Dworschak-Stokan

et al. 2022

Journal of Otolaryngology - Head & Neck Surgery

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Background The aim of this study was to evaluate speech outcomes following surgical intervention for velopharyngeal dysfunction (VPD). Perceptual speech outcome data were subsequently analyzed in conjunction with patient factors such as congenital abnormalities, presence of cleft lip and/or palate, and age of repair. We hope to aid in the eventual creation of treatment algorithms for VPD, allowing practitioners to tailor surgical technique selection to patient factors. Methods A retrospective analysis was performed for all patients who underwent surgical correction of VPD at London Health Sciences Centre between the years 2005 and 2018. Two hundred and two consecutive VPD patients (median age 10.6 years) were followed for an average of 20.2 months after having undergone a superiorly based pharyngeal flap (121), Furlow palatoplasty (72), or sphincteroplasty (9). Speech outcomes were measured via the American Cleft Palate-Craniofacial Association (ACPA) perceptual speech assessment, and MacKay-Kummer Simplified Nasometric Assessment Procedures Revised (SNAP-R) was used to measure nasalence. Comparisons of mean preoperative and postoperative outcomes were made, as well as analyses regarding surgical procedure, syndrome, cleft status, and age. Results Mean perceptual scores improved significantly postoperatively (p < .0001), and successful perceptual resonance was identified in 86.1% patients (n = 174). Postoperative perceptual speech scores for three ACPA domains were superior with pharyngeal flap compared to both Furlow palatoplasty and sphincteroplasty ([hypernasality: p < .001, p < .02], [audible nasal emissions: p < .002, p < .05], [velopharyngeal function: p < .001, p < .05]). Success rate was higher in pharyngeal flap (94.2%) than in Furlow palatoplasty (75.0%, p < .001) or sphincter pharyngoplasty (66.7%, p < .001). No significant difference was identified in success rate based on syndrome or cleft status. Conclusion Operative management of VPD is highly effective in improving perceptual speech outcomes. Given proper patient selection, all three procedures are viable treatment options for VPD. For those patients identified as appropriate to undergo a pharyngeal flap, robust improvements in speech outcomes were observed. Graphical abstract

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“…The choice of surgical management procedures among the numerous options available is based on the findings of nasoendoscopic examinations and closure patterns. The pharyngeal flap is generally recommended in cases showing a sagittal closure pattern of the velopharyngeal port, and the sphincter pharyngoplasty is recommended in cases showing a coronal closure pattern 3 . Numerous modifications have been made to the dynamic sphincter pharyngoplasty technique, which has been demonstrated to be a useful surgical method for correcting velopharyngeal insufficiency 4–6 .…”

mentioning

confidence: 99%

“…The pharyngeal flap is generally recommended in cases showing a sagittal closure pattern of the velopharyngeal port, and the sphincter pharyngoplasty is recommended in cases showing a coronal closure pattern. 3 Numerous modifications have been made to the dynamic sphincter pharyngoplasty technique, which has been demonstrated to be a useful surgical method for correcting velopharyngeal insufficiency. [4][5][6] We modified the dynamic sphincter pharyngoplasty technique described by Orticochea 7 by performing overlapping sutures of the palatopharyngeus muscles to further tighten the lateral wall and augmenting the posterior pharyngeal wall using an acellular dermal matrix (AlloDerm; LifeCell, Branchburg, NJ).…”

mentioning

confidence: 99%