Update on surgery for velopharyngeal dysfunction

Abstract

Multiple surgical options exist to assist patients with velopharyngeal dysfunction. The majority of the surgical options can be highly successful. A multispecialty team is critical in providing patients with the most appropriate treatment for their specific situation. Standardized speech and velopharyngeal dysfunction outcome measures are necessary to allow accurate preoperative and postoperative comparisons, intrasurgeon comparisons, and multi-institutional comparisons. Unfortunately, there is a lack of standardization in speech outcome measures among the studies published over the last year. The risk of postoperative obstructive sleep apnea must be assessed and discussed prior to surgery for any patient scheduled to undergo surgery for velopharyngeal dysfunction. Future studies promise to improve our understanding of velopharyngeal dysfunction and provide further guidance as to the best surgical options to assist these patients.

Respiratory failure after superior-based pharyngeal flap for velopharyngeal insufficiency: A rare complication

“…Other common associations are poor speech intelligibility and speech delay [2]. The etiology can be congenital, associated with anatomic, functional, or neuromuscular abnormalities, or acquired during adenoidectomy [1,3]. The precise incidence of congenital VPI has not been reported in the literature but there is a known association between VPI and pediatric syndromes, of note velocardiofacial syndrome, PierreRobin, and cleft palate [1].…”

“…If a patient continues to have hypernasal speech, surgical repair is planned when the child is aged 3 or 4 years [1]. Numerous approaches to the surgical repair of VPI have been reported, including superior-based pharyngeal flap, sphincter pharyngoplasty, Furlow palatoplasty, and augmentation pharyngoplasty, and calcium hydroxylapatite or autologous fat injection [1][2][3][4]. Selection of which procedure(s) best suits each patient is highly individualized, taking into consideration suspected etiology, anatomic gap, age, syndromes, and many other factors.…”

Effects of aging and blood pressure on timing and amplitude of central pulse contour landmarks

“…The result is a patient with hypernasal speech, increased nasal resonance, and in some instances, nasal regurgitation of liquids and solids. The etiology can be congenital, associated with anatomic, functional, or neuromuscular abnormalities, or acquired during adenoidectomy [1,3]. The etiology can be congenital, associated with anatomic, functional, or neuromuscular abnormalities, or acquired during adenoidectomy [1,3].…”

Melanoma gene expression in adhesive-tape sampled lesions is similar in primary tumors and patient-derived xenografts

“…Patients typically undergo a trial of speech therapy for 6 months to determine if they have the compensatory mechanisms necessary to pursue non-operative management. Numerous approaches to the surgical repair of VPI have been reported, including superior-based pharyngeal flap, sphincter pharyngoplasty, Furlow palatoplasty, and augmentation pharyngoplasty, and calcium hydroxylapatite or autologous fat injection [1][2][3][4]. Numerous approaches to the surgical repair of VPI have been reported, including superior-based pharyngeal flap, sphincter pharyngoplasty, Furlow palatoplasty, and augmentation pharyngoplasty, and calcium hydroxylapatite or autologous fat injection [1][2][3][4].…”