scholarly journals POSTERIOR PHARYNGEAL WALL AUGMENTATION WITH MUSCULAR FLAP VERSUS MUSCULOMUCOSAL FLAP FOR CORRECTION OF VELOPHARYNGEAL INCOMPETENCE

2017 ◽  
Vol 63 (2) ◽  
pp. 1229-1238
Author(s):  
Mahmoud Khalifa ◽  
Mohamed Allam ◽  
Mohamed Darwish
Keyword(s):  
Posterior Pharyngeal Wall ◽  
Pharyngeal Wall ◽  
Velopharyngeal Incompetence ◽  
Muscular Flap

Treatment of Stress Velopharyngeal Incompetence With Injection of Hyaluronic Acid

2017 ◽  
Vol 55 (4) ◽  
pp. 615-618 ◽  
Author(s):  
Steven Koprowski ◽  
Michael J. VanLue ◽  
Michael E. McCormick
Keyword(s):  
Hyaluronic Acid ◽  
Posterior Pharyngeal Wall ◽  
Clinical Entity ◽  
Multidisciplinary Management ◽  
Pharyngeal Wall ◽  
Safety And Efficacy ◽  
Velopharyngeal Incompetence ◽  
Acid Compound

Stress velopharyngeal incompetence (VPI) is a challenging clinical entity that can be managed by a variety of surgical and nonsurgical approaches. We describe the case of a clarinetist who presented with nasal air escape while playing. She had successful improvement in her symptoms after targeted injection of a hyaluronic acid compound to her posterior pharyngeal wall. Our objective is to describe the safety and efficacy of this technique, to emphasize the multidisciplinary management of patients with stress VPI, and to review the importance of both nasopharyngoscopy and videofluoroscopy in their evaluation.

Augmentation of Oral Tissues in Rabbit Using Autogenous Fat

1995 ◽  
Vol 32 (1) ◽  
pp. 1-6 ◽  
Author(s):  
John W. Canady ◽  
Sue Ann Thompson ◽  
Jerald B. Moon ◽  
Richard L. Glowacki
Keyword(s):  
Oral Cavity ◽  
Speech Therapy ◽  
Donor Site ◽  
Posterior Pharyngeal Wall ◽  
Donor Site Morbidity ◽  
Speech Disorders ◽  
Pharyngeal Wall ◽  
Synthetic Materials ◽  
Velopharyngeal Incompetence ◽  
The Stability

Patients with mild velopharyngeal incompetence (VPI) may have speech disorders, which are not sufficiently severe to warrant extensive surgical intervention, yet may not be amenable to correction by speech therapy alone. Augmentation of the posterior pharyngeal wall to aid in closure of the velopharyngeal sphincter may be beneficial in establishing better speech patterns, especially when combined with speech therapy. A variety of materials and techniques have been used in the past for this purpose. In this setting, autogenous fat may be transplanted without the risks incurred by augmentation with synthetic materials and involves very little donor site morbidity. The literature is somewhat contradictory, however, regarding the stability of the augmentation achieved using autogenous fat and there are no histologic studies describing the fate of fat injected into tissues of the oral cavity. Prior to introduction of this technique into clinical practice, this study was designed to investigate the fate of autogenous fat injected submucosally in the oropharyngeal region. Autogenous fat was injected into the anterior soft palate using the rabbit as a model. Histologic and gross inspections were performed at 2 days, 1, 2, and 4 weeks after injections. At the end of 4 weeks, at least 50% of the injection sites had visible evidence of augmentation, and 90% had histologic evidence of submucosal fat. In some instances most of the fat was resorbed; however, there were no instances of clinical infection or necrosis of the injection site. We conclude that submucosal injection of autogenous fat is a feasible alternative to using synthetic or other biologic materials for augmentation in the oral cavity.

Velopharyngeal Morphology of Patients with Persistent Velopharyngeal Incompetence following Repushback Surgery for Cleft Palate

2003 ◽  
Vol 40 (6) ◽  
pp. 612-617 ◽  
Author(s):  
Norifumi Nakamura ◽  
Yuko Ogata ◽  
Kyoko Kunimitsu ◽  
Akira Suzuki ◽  
Masaaki Sasaguri ◽  
...  
Keyword(s):  
Cleft Palate ◽  
Cervical Vertebrae ◽  
Posterior Pharyngeal Wall ◽  
Cranial Base ◽  
Normal Children ◽  
Pharyngeal Wall ◽  
Velopharyngeal Incompetence ◽  
Posterior Maxilla ◽  
Dental Hospital ◽  
Pharyngeal Depth

Objective To characterize the velopharyngeal morphology of patients with persistent velopharyngeal incompetence (VPI) following repushback surgery for cleft palate. Participants Seven patients with moderate to severe VPI following repushback surgery for secondary correction of cleft palate, and 14 patients who had already obtained complete velopharyngeal closure function (VPF) were enrolled. Control data were obtained from the longitudinal files of 20 normal children in Kyushu University Dental Hospital. Main Outcome Measures Skeletal landmarks and measurements were derived from tracing of lateral roentgenographic cephalograms. The measurements included velar length, pharyngeal depth, and pharyngeal height and the ratio of velar length to pharyngeal depth. Additionally, the configuration of the upper pharynx (pharyngeal triangle) involving the cranial base, cervical vertebrae, and the posterior maxilla and also the position of posterior pharyngeal wall (PPW) in the pharyngeal triangle were analyzed. Results The VPI group had a significantly shorter velar length and greater pharyngeal depth, resulting in a smaller length/depth ratio than the controls. The points of PPW and cervical vertebrae of the VPI group were located more posteriorly and inferiorly than those in the group with complete VPF after the primary operation and the controls. The positions of cranial base and maxilla were not significantly different. Additionally, the position of PPW in the pharyngeal triangle was located significantly posteriorly and superiorly in the VPI group, compared with the controls. Conclusions The craniopharyngeal morphology of patients with persistent VPI was characterized by a short palate, wide-based and counterclockwise-rotated pharyngeal triangle, and posteriorly and superiorly positioned PPW. These might be contributory factors for the prediction of VPF before repushback surgery for cleft palate.

Surgical Management of Velopharyngeal Incompetence in Velocardiofacial Syndrome

2004 ◽  
Vol 41 (2) ◽  
pp. 124-135 ◽  
Author(s):  
Felicity V. Mehendale ◽  
Malcolm J. Birch ◽  
Louise Birkett ◽  
Debbie Sell ◽  
Brian C. Sommerlad
Keyword(s):  
Posterior Pharyngeal Wall ◽  
Velocardiofacial Syndrome ◽  
Prospective Data ◽  
Pharyngeal Wall ◽  
Velopharyngeal Incompetence ◽  
Staged Approach ◽  
Velopharyngeal Function ◽  
And Function ◽  
Nasal Emission ◽  
Results Of Surgery

Objective To analyze the results of surgery for velopharyngeal incompetence (VPI) in velocardiofacial syndrome. Design Prospective data collection, with randomized, blind assessment of speech and velopharyngeal function on lateral videofluoroscopy and nasendoscopy. Setting Two-site, tertiary referral cleft unit. Patients Forty-two consecutive patients with the 22q11 deletion underwent surgery for symptomatic VPI by a single surgeon. Interventions Intraoral examinations, lateral videofluoroscopy (± nasendoscopy) and intraoperative evaluation of the position of the velar muscles through the operating microscope. Based on these findings, either a radical dissection and retropositioning of the velar muscles (submucous cleft palate [SMCP repair]) or a Hynes pharyngoplasty (posterior pharyngeal wall augmentation pharyngoplasty) was performed. As anticipated, a proportion of patients undergoing SMCP repair subsequently required a Hynes. The aim of this staged approach was to maximize velar function, thereby enabling a less obstructive pharyngoplasty to be performed. Thus, there were three surgical groups for analysis: SMCP alone, Hynes alone, and SMCP+Hynes. Main Outcome Measures Blind perceptual rating of resonance and nasal airflow; blind assessment of velopharyngeal function on lateral videofluoroscopy and nasendoscopy; and identification of predictive factors. Results Significant improvement in hypernasality in all three groups. The SMCP+Hynes group also showed significant improvement in nasal emission. There were significant improvements in the extended and resting velar lengths following SMCP repair and a trend toward increased velocity of closure. Conclusions Depending on velopharyngeal anatomy and function, there is a role for SMCP repair, Hynes pharyngoplasty, and a staged combination of SMCP+Hynes, all of which are procedures with a low morbidity.

Velopharyngeal Incompetence and Persistent Hypernasality after Adenoidectomy in Children without Palatal Defect

1995 ◽  
Vol 32 (6) ◽  
pp. 476-482 ◽  
Author(s):  
Yan-Fang Ren ◽  
Annika Isberg ◽  
Gunilla Henningsson
Keyword(s):  
Posterior Pharyngeal Wall ◽  
Predisposing Factor ◽  
Pharyngeal Wall ◽  
Adenoid Tissue ◽  
Velopharyngeal Incompetence ◽  
Incomplete Removal ◽  
Lateral Cephalometry ◽  
Palatal Defect

Persistent hyper nasal speech after adenoidectomy has been reported In children with palatal deficiency. Hypernasality after adenoidectomy can also occur in children with normal palatal function. The aim of the present study was to identify the cause of velopharyngeal Incompetence and hypernasality after adenoidectomy in children who did not have palatal defect as a predisposing factor. Sixteen children who developed hypernasality after adenoidectomy were included in the present study. Standard lateral cephalometry, videofluoroscopy, and nasopnaryngoscopy were performed to visualize the velopharynx and Its function during speech. The results showed that enlarged tonsils and prominent remaining adenoid tissue on the posterior pharyngeal wall were the causes of hypernasality in these children. Incomplete removal of the adenoid tissue should be avoided and enlarged tonsils should be removed at the time of adenoidectomy to prevent the risk for postoperative hypernasality.

Compensatory Tongue-Palate-Posterior Pharyngeal Wall Relationships in Cleft Palate

1965 ◽  
Vol 30 (2) ◽  
pp. 166-173 ◽  
Author(s):  
Alta R. Brooks ◽  
Ralph L. Shelton ◽  
Karl A. Youngstrom
Keyword(s):  
Cleft Palate ◽  
Posterior Pharyngeal Wall ◽  
Pharyngeal Wall

Management of vasomotor rhinitis patients

2020 ◽  
pp. 24-28
Author(s):  
Konstantin Robertovich Gulyabin
Keyword(s):  
Viral Infection ◽  
Nasal Congestion ◽  
Clinical Manifestations ◽  
Posterior Pharyngeal Wall ◽  
Respiratory Obstruction ◽  
Vasomotor Rhinitis ◽  
Respiratory Viral Infection ◽  
Pharyngeal Wall ◽  
Chronic Rhinitis ◽  
The Subject

There has been a recent obvious trend towards the increased prevalence of chronic rhinitis – 10-20% of the population experiences this disorder. Vasomotor rhinitis, sometimes also called idiopathic rhinitis, is the indisputable leader among various chronic rhinitis forms (allergic, infectious, atrophic, catarrhal and hypertrophic). The term of vasomotor rhinitis has been the subject of experts' repeated criticism because neurovisceral innervation disorders that underlie this condition are found in almost every form of chronic rhinitis. The main clinical manifestations of vasomotor rhinitis include a feeling of nasal congestion and nasal respiratory obstruction, regular abundant discharge of clear mucus and a feeling of its trickling down the posterior pharyngeal wall. A past respiratory viral infection treated by excessive quantities of vasoconstrictor drops triggers the vasomotor rhinitis onset in most cases.

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