scholarly journals Clinical Study on the Prognosis of Pharyngeal Flap Operation for Velopharyngeal Incompetence

1988 ◽  
Vol 42 (1) ◽  
pp. 65-82
Author(s):  
Masahiro Maki
Keyword(s):  
Clinical Study ◽  
Velopharyngeal Incompetence ◽  
Pharyngeal Flap

scholarly journals Clinical Analysis of Velopharyngeal Incompetence in Patients with Folded Pharyngeal Flap

2003 ◽  
Vol 106 (6) ◽  
pp. 700-704 ◽  
Author(s):  
Hiroshi Hoshikawa ◽  
Rieko Goto ◽  
Masayuki Karaki ◽  
Kazunori Miyabe ◽  
Nozomu Mori
Keyword(s):  
Clinical Analysis ◽  
Velopharyngeal Incompetence ◽  
Pharyngeal Flap

scholarly journals Unified velopharyngoplasty for the management of recurrence of velopharyngeal incompetence after pharyngeal flap surgery.

1996 ◽  
Vol 42 (3) ◽  
pp. 320-322 ◽  
Author(s):  
Takashi TACHIMURA ◽  
Hisanaga HARA ◽  
Takeshi WADA ◽  
Seiji IIDA ◽  
Mikihiko KOGO ◽  
...  
Keyword(s):  
Flap Surgery ◽  
Velopharyngeal Incompetence ◽  
Pharyngeal Flap

Comparison of Velopharyngeal Growth Patterns between Cleft Lip and/or Palate Patients Requiring or Not Requiring Pharyngeal Flap Surgery

1994 ◽  
Vol 31 (6) ◽  
pp. 452-460 ◽  
Author(s):  
Mohammad Mazaheri ◽  
Athanasios E. Athanasiou ◽  
Ross E. Long
Keyword(s):  
Cleft Palate ◽  
Soft Palate ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Growth Curves ◽  
Growth Patterns ◽  
Flap Surgery ◽  
Velopharyngeal Incompetence ◽  
Lateral Cephalograms ◽  
Pharyngeal Flap

This investigation compares the patterns of velopharyngeal growth in cleft lip and/or palate patients. Those who had velopharyngeal competence and acceptable speech are compared with those who presented with velopharyngeal incompetence requiring pharyngeal flap surgery or prosthesis later. Lateral cephalograms of 30 cleft palate only (CPO), 35 unilateral cleft lip and palate (UCLP), and 20 bilateral cleft lip and palate (BCLP) children of the Lancaster Cleft Palate Clinic were studied. These records were taken at 6 month intervals during the first 2 postnatal years and annually thereafter up to 6 years of age. Soft tissue landmark points in the velopharyngeal region were digitized. Length and thickness of the soft palate and height and depth of the nasopharynx were measured. Evaluation of the growth curves of these four cephalometric variables indicated only two significant differences between children who later required pharyngeal flap surgery and those who did not. These differences were found in the growth in length of the soft palate of the CPO group and in the growth in depth of the nasopharynx of the BCLP group. Based on the present cephalometric data, it is Impossible to predict at an early age those cleft lip and/or palate patients who will later require pharyngeal flaps.

Stress Velopharyngeal Incompetence: Prevalence, Treatment, and Management Practices

2007 ◽  
Vol 44 (4) ◽  
pp. 424-433 ◽  
Author(s):  
Deonne Malick ◽  
Jerry Moon ◽  
John Canady
Keyword(s):  
Management Practices ◽  
Demographic Data ◽  
Posterior Wall ◽  
Fat Injection ◽  
Speech Language Pathologist ◽  
Velopharyngeal Incompetence ◽  
Management Techniques ◽  
Pharyngeal Flap ◽  
Sphincter Pharyngoplasty ◽  
Typical Treatment

Objective: Stress velopharyngeal incompetence is the unwanted coupling of the oral and nasal cavities while brass and woodwind musicians play their instruments. This study investigated both (1) the prevalence of stress velopharyngeal incompetence in college musicians, delineating symptoms and situations possibly associated with the condition; and (2) physicians’ experiences with musicians exhibiting stress velopharyngeal incompetence, including typical treatment and management techniques. Methods: Questionnaires were distributed to 297 brass or woodwind student musicians at three public universities and to 998 plastic surgeons and otolaryngologists. The musician questionnaire focused on demographic data and identification of symptoms that might indicate the presence of stress velopharyngeal incompetence. The physician questionnaire addressed demographics of the physician and his or her practice, familiarity and experience with stress velopharyngeal incompetence, and treatment and management suggestions for individuals experiencing the condition. Results: Thirty-four percent of the responding musicians reported symptoms of stress velopharyngeal incompetence, most often after 30 minutes of playing. Forty-five percent of the responding physicians reported being familiar with the term stress velopharyngeal incompetence, although only 27% reported ever having seen a patient with the condition. The seven most frequently reported intervention strategies were referral to a speech language pathologist (47.50%), sphincter pharyngoplasty (30.00%), pharyngeal flap (26.88%), referral to a cleft palate team (24.38%), watch and wait (18.75%), posterior wall fat injection (12.50%), and palatal lift (10.00%). Conclusions: Stress velopharyngeal incompetence is a potentially career-ending (or career-preventing) problem that currently may be undertreated and that is in need of more systematic study both in terms of its physiologic underpinnings and its management.

scholarly journals Experience with the Folded Pharyngeal Flap Operation for Velopharyngeal Incompetence

1983 ◽  
Vol 76 (2special) ◽  
pp. 731-735
Author(s):  
Michiaki Hiramoto ◽  
Tadashi Kimura ◽  
Masafumi Tani
Keyword(s):  
Velopharyngeal Incompetence ◽  
Pharyngeal Flap

Long-Term Follow-Up after Division of a Pharyngeal Flap for Severe Nasal Obstruction

1992 ◽  
Vol 29 (1) ◽  
pp. 27-31 ◽  
Author(s):  
Louise Caouette-Laberge ◽  
E. Patricia Egerszegi ◽  
Anne-Marie De Remont ◽  
Ilse Ottenseyer
Keyword(s):  
Nasal Obstruction ◽  
Soft Palate ◽  
Nasal Breathing ◽  
Complete Transection ◽  
Velopharyngeal Incompetence ◽  
Complete Section ◽  
Long Term Follow Up ◽  
Pharyngeal Flap ◽  
Velopharyngeal Function

Between 1965 and 1986, nine patients were noticed to have significant nasal airway obstruction following surgery for velopharyngeal incompetence (VPI). All had a superiorly based pharyngeal flap. Division of the flap was recommended to correct the posterior obstruction. A complete section of the flap was done in seven cases and lateral port enlargement was done in the remaining two. The interval between flap elevation and transection ranged from 5 months to 5 years. Three patients required more than one operation to fully correct the obstruction. All the patients were evaluated 2 to 14 years later to assess nasal breathing and speech and to document velopharyngeal function by nasoendoscopy and videofluoroscopy. One patient presented major symptoms of nasal obstruction at follow-up, while others reported snoring and occasional mouth breathing, although their nasal respiration appeared subjectively adequate. Four patients had normal speech, three were mildly hyponasal, one was moderately hyponasal, and the other was severely hyponasal. Intelligibility was good in all cases but one, although three patients had some articulation errors: two with persistent errors related to early VPI and one from dental malocclusion and tongue protrusion. Videofluoroscopy and nasoendoscopy showed that despite complete transection at the base of the flap in eight cases, five still had evidence of residual tethering. In one patient, the obstruction was almost complete and repeat division of the flap was recommended. Seven patients showed increased thickness of the soft palate in the midline where the flap had been anchored. Velopharyngeal closure was adequate in five cases, marginal in three, and obstructed in one. The review of our cases showed that the velopharyngeal opening in these patients is not large and incompetent, but rather is contracted and the flap often reattaches posteriorly after division. We recommend a closure of all raw surfaces to be done when the flap is sectioned, adding Z-plasties when needed to prevent further V-P obstruction. Even in the presence of recurrent obstruction, the resection of the extra tissue contributed by the flap on the soft palate is not felt to be indicated.

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