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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

Patient with diagnosis of bilateral cleft lip and palate operated on using the unilateral uvuloplasty. Measurements: velar length (VL), 45 mm; pharyngeal depth (PD), 44 mm; velopharyngeal distance (VPD), 42 mm.
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Figure 12: Patient with diagnosis of bilateral cleft lip and palate operated on using the unilateral uvuloplasty. Measurements: velar length (VL), 45 mm; pharyngeal depth (PD), 44 mm; velopharyngeal distance (VPD), 42 mm.

Mentions: The characteristics of the patients are presented in Table 1. Statistically significant differences were not detected based on sex (P = 0.50), cleft severity (P = 0.77), or age at operation (12–14 months). We found statistically significant differences between the 2 uvuloplasty methods regarding hypernasal speech (P = 0.026) and the blowing ratio (P = 0.008) in favor of group B (Table 2). We did not find differences between the 2 groups regarding the development of postoperative fistulas (8 cases in each group; a rate of 8.88%). All of the fistulas were located in the middle third of the palate. There were statistically significant differences between the 2 groups with regard to the velar length and velopharyngeal distance (P = 0.00001) (Table 3 and Figs. 11 and 12).


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)

Patient with diagnosis of bilateral cleft lip and palate operated on using the unilateral uvuloplasty. Measurements: velar length (VL), 45 mm; pharyngeal depth (PD), 44 mm; velopharyngeal distance (VPD), 42 mm.
© Copyright Policy
Related In: Results  -  Collection

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

Figure 12: Patient with diagnosis of bilateral cleft lip and palate operated on using the unilateral uvuloplasty. Measurements: velar length (VL), 45 mm; pharyngeal depth (PD), 44 mm; velopharyngeal distance (VPD), 42 mm.
Mentions: The characteristics of the patients are presented in Table 1. Statistically significant differences were not detected based on sex (P = 0.50), cleft severity (P = 0.77), or age at operation (12–14 months). We found statistically significant differences between the 2 uvuloplasty methods regarding hypernasal speech (P = 0.026) and the blowing ratio (P = 0.008) in favor of group B (Table 2). We did not find differences between the 2 groups regarding the development of postoperative fistulas (8 cases in each group; a rate of 8.88%). All of the fistulas were located in the middle third of the palate. There were statistically significant differences between the 2 groups with regard to the velar length and velopharyngeal distance (P = 0.00001) (Table 3 and Figs. 11 and 12).

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