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A Comparative Study to Evaluate the Functional Effect of Unilateral Uvuloplasty after Primary Palatoplasty.

Rossell-Perry P, Olivencia-Flores C, Gavino-Gutierrez AM, Caceres-Nano E, Cotrina-Rabanal O - Plast Reconstr Surg Glob Open (2015)

Bottom Line: In addition, postoperative dimensions of the velopharynx were measured by a single-blind examiner using a computed tomography scan.Our comparative study found statistically significant differences between the 2 groups in favor of the unilateral uvuloplasty group.We observed that the use of unilateral uvuloplasty for uvular reconstruction reduces the velopharyngeal space and the frequency of hypernasality in patients with bilateral cleft palate.

View Article: PubMed Central - PubMed

Affiliation: San Martin de Porres University, Lima, Peru; "Outreach Surgical Center Lima Peru," ReSurge Int, Lima, Peru; Plastic Surgery Service, Edgardo Rebagliatti Martins Hospital, Lima, Peru; A.B. PRISMA, Lima, Peru; Universidad Peruana Cayetano Heredia, Lima, Peru; School of Pedagogic Training, Lima, Peru; and ARMONIZAR Foundation, Lima, Peru.

ABSTRACT

Background: The conventional method for uvular repair suturing the 2 hemi-uvulas of the palatal cleft together in the midline does not allow us to obtain a proper anatomical repair. In our hands, the midline straight closure frequently causes retraction of the uvular tissues with the consequent abnormal appearance of the uvula. We described before a method for uvular repair in patients with cleft palate. The technique consists in preserving one of the hemi-uvulas, which is moved to the midline to form the definitive uvula. The purpose of this study was to evaluate the functional effects of the unilateral uvuloplasty for uvular repair in a group of patients with bilateral cleft palate.

Methods: This is a retrospective, single-blinded cohort study between 2 groups of 90 patients with bilateral cleft palate who were operated on using the conventional and unilateral uvuloplasty methods of uvular repair from 2000 to 2009. Data collection was accomplished by physical examination to evaluate the presence of postoperative fistulas and hypernasal speech determined at 6 months to 5 years after surgery. In addition, postoperative dimensions of the velopharynx were measured by a single-blind examiner using a computed tomography scan.

Results: Our comparative study found statistically significant differences between the 2 groups in favor of the unilateral uvuloplasty group.

Conclusions: We observed that the use of unilateral uvuloplasty for uvular reconstruction reduces the velopharyngeal space and the frequency of hypernasality in patients with bilateral cleft palate.

No MeSH data available.


Related in: MedlinePlus

Postoperative view of repaired cleft palate using the unilateral uvuloplasty for uvular repair.
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Figure 3: Postoperative view of repaired cleft palate using the unilateral uvuloplasty for uvular repair.

Mentions: Cleft palate uvular repair and the impact on velopharyngeal function have not been evaluated. The conventional uvular repair method involves suturing the 2 hemi-uvulas of the cleft palate and does not produce a proper anatomical repair. In our hands, this closure method frequently causes retraction of the uvular tissues along with abnormal appearance and function of the uvula. To address this issue, we developed unilateral uvuloplasty. Unilateral uvuloplasty is a new method for uvular repair that is based on the use of one hemi-uvula (Figs. 1–3).1 A similar uvular repair method has been described by Navarro and Bardales.2 The unilateral uvuloplasty technique involves preserving one of the hemi-uvulas and moving it to the midline to form the definitive uvula during cleft closure in patients with cleft palates. Huang et al,3 Kuehn and Kahane,4 and Kuehn et al5 described the function of the uvula, and their findings suggest that the uvula increases the midline bulk and maximizes midline pharyngeal contact.


A Comparative Study to Evaluate the Functional Effect of Unilateral Uvuloplasty after Primary Palatoplasty.

Rossell-Perry P, Olivencia-Flores C, Gavino-Gutierrez AM, Caceres-Nano E, Cotrina-Rabanal O - Plast Reconstr Surg Glob Open (2015)

Postoperative view of repaired cleft palate using the unilateral uvuloplasty for uvular repair.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4494485&req=5

Figure 3: Postoperative view of repaired cleft palate using the unilateral uvuloplasty for uvular repair.
Mentions: Cleft palate uvular repair and the impact on velopharyngeal function have not been evaluated. The conventional uvular repair method involves suturing the 2 hemi-uvulas of the cleft palate and does not produce a proper anatomical repair. In our hands, this closure method frequently causes retraction of the uvular tissues along with abnormal appearance and function of the uvula. To address this issue, we developed unilateral uvuloplasty. Unilateral uvuloplasty is a new method for uvular repair that is based on the use of one hemi-uvula (Figs. 1–3).1 A similar uvular repair method has been described by Navarro and Bardales.2 The unilateral uvuloplasty technique involves preserving one of the hemi-uvulas and moving it to the midline to form the definitive uvula during cleft closure in patients with cleft palates. Huang et al,3 Kuehn and Kahane,4 and Kuehn et al5 described the function of the uvula, and their findings suggest that the uvula increases the midline bulk and maximizes midline pharyngeal contact.

Bottom Line: In addition, postoperative dimensions of the velopharynx were measured by a single-blind examiner using a computed tomography scan.Our comparative study found statistically significant differences between the 2 groups in favor of the unilateral uvuloplasty group.We observed that the use of unilateral uvuloplasty for uvular reconstruction reduces the velopharyngeal space and the frequency of hypernasality in patients with bilateral cleft palate.

View Article: PubMed Central - PubMed

Affiliation: San Martin de Porres University, Lima, Peru; "Outreach Surgical Center Lima Peru," ReSurge Int, Lima, Peru; Plastic Surgery Service, Edgardo Rebagliatti Martins Hospital, Lima, Peru; A.B. PRISMA, Lima, Peru; Universidad Peruana Cayetano Heredia, Lima, Peru; School of Pedagogic Training, Lima, Peru; and ARMONIZAR Foundation, Lima, Peru.

ABSTRACT

Background: The conventional method for uvular repair suturing the 2 hemi-uvulas of the palatal cleft together in the midline does not allow us to obtain a proper anatomical repair. In our hands, the midline straight closure frequently causes retraction of the uvular tissues with the consequent abnormal appearance of the uvula. We described before a method for uvular repair in patients with cleft palate. The technique consists in preserving one of the hemi-uvulas, which is moved to the midline to form the definitive uvula. The purpose of this study was to evaluate the functional effects of the unilateral uvuloplasty for uvular repair in a group of patients with bilateral cleft palate.

Methods: This is a retrospective, single-blinded cohort study between 2 groups of 90 patients with bilateral cleft palate who were operated on using the conventional and unilateral uvuloplasty methods of uvular repair from 2000 to 2009. Data collection was accomplished by physical examination to evaluate the presence of postoperative fistulas and hypernasal speech determined at 6 months to 5 years after surgery. In addition, postoperative dimensions of the velopharynx were measured by a single-blind examiner using a computed tomography scan.

Results: Our comparative study found statistically significant differences between the 2 groups in favor of the unilateral uvuloplasty group.

Conclusions: We observed that the use of unilateral uvuloplasty for uvular reconstruction reduces the velopharyngeal space and the frequency of hypernasality in patients with bilateral cleft palate.

No MeSH data available.


Related in: MedlinePlus