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Postoperative evaluation of the folded pharyngeal flap operation for cleft palate patients with velopharyngeal insufficiency.

Yoshimasu H, Sato Y, Mishimagi T, Negishi A - Ann Maxillofac Surg (2015 Jan-Jun)

Bottom Line: Velopharyngeal function is very important for patients with cleft palate to acquire good speech.The cases included 61 males and 36 females, ranging in age from 7 to 50 years.Approximately 95% of patients showed improved velopharyngeal function.

View Article: PubMed Central - PubMed

Affiliation: Department of Oral Care for Systemic Health Support, Graduate School, Tokyo Medical and Dental University, Tokyo, Japan.

ABSTRACT

Background: Velopharyngeal function is very important for patients with cleft palate to acquire good speech. For patients with velopharyngeal insufficiency, prosthetic speech appliances and speech therapy are applied first, and then pharyngeal flap surgery to improve velopharyngeal function is performed in our hospital. The folded pharyngeal flap operation was first reported by Isshiki and Morimoto in 1975. We usually use a modification of the original method.

Purpose: The purpose of this research was to introduce our method of the folded pharyngeal flap operation and report the results.

Materials and methods: The folded pharyngeal flap operation was performed for 110 patients with velopharyngeal insufficiency from 1982 to 2010. Of these, the 97 whose postoperative speech function was evaluated are reported. The cases included 61 males and 36 females, ranging in age from 7 to 50 years. The time from surgery to speech assessment ranged from 5 months to 6 years. In order to evaluate preoperative velopharyngeal function, assessment of speech by a trained speech pathologist, nasopharyngoscopy, and cephalometric radiography with contrast media were performed before surgery, and then the appropriate surgery was selected and performed. Postoperative velopharyngeal function was assessed by a trained speech pathologist.

Results: Of the 97 patients who underwent the folded pharyngeal flap operation, 85 (87.6%) showed velopharyngeal competence, 8 (8.2%) showed marginal velopharyngeal incompetence, and only 2 (2.1%) showed velopharyngeal incompetence; in 2 cases (2.1%), hyponasality was present. Approximately 95% of patients showed improved velopharyngeal function.

Conclusions: The folded pharyngeal flap operation based on appropriate preoperative assessment has been shown to be an effective method for the treatment of cleft palate patients with velopharyngeal insufficiency.

No MeSH data available.


Related in: MedlinePlus

Examination of velopharyngeal function by cephalogram with contrast medium
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Figure 3: Examination of velopharyngeal function by cephalogram with contrast medium

Mentions: In order to evaluate preoperative velopharyngeal function, assessment of speech by a trained speech pathologist, nasopharyngoscopy, and cephalometric radiography with contrast media were performed before surgery. For evaluation of velopharyngeal function, a test battery proposed by the Committee on Cleft Palate Speech of the Japan Society of Logopedics and Phoniatrics,[4] was used. The distance between the soft palate and the posterior pharyngeal wall was also measured in a cephalometric radiograph taken during phonation of ā€œiā€ [Figure 3]. The type of FPF was selected based on Table 2. Type I was performed in three patients, type II was performed in 45, and type III was performed in 36, while the FPF with palatal push back operation (PB) was performed in 13 [Table 3].


Postoperative evaluation of the folded pharyngeal flap operation for cleft palate patients with velopharyngeal insufficiency.

Yoshimasu H, Sato Y, Mishimagi T, Negishi A - Ann Maxillofac Surg (2015 Jan-Jun)

Examination of velopharyngeal function by cephalogram with contrast medium
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4555951&req=5

Figure 3: Examination of velopharyngeal function by cephalogram with contrast medium
Mentions: In order to evaluate preoperative velopharyngeal function, assessment of speech by a trained speech pathologist, nasopharyngoscopy, and cephalometric radiography with contrast media were performed before surgery. For evaluation of velopharyngeal function, a test battery proposed by the Committee on Cleft Palate Speech of the Japan Society of Logopedics and Phoniatrics,[4] was used. The distance between the soft palate and the posterior pharyngeal wall was also measured in a cephalometric radiograph taken during phonation of ā€œiā€ [Figure 3]. The type of FPF was selected based on Table 2. Type I was performed in three patients, type II was performed in 45, and type III was performed in 36, while the FPF with palatal push back operation (PB) was performed in 13 [Table 3].

Bottom Line: Velopharyngeal function is very important for patients with cleft palate to acquire good speech.The cases included 61 males and 36 females, ranging in age from 7 to 50 years.Approximately 95% of patients showed improved velopharyngeal function.

View Article: PubMed Central - PubMed

Affiliation: Department of Oral Care for Systemic Health Support, Graduate School, Tokyo Medical and Dental University, Tokyo, Japan.

ABSTRACT

Background: Velopharyngeal function is very important for patients with cleft palate to acquire good speech. For patients with velopharyngeal insufficiency, prosthetic speech appliances and speech therapy are applied first, and then pharyngeal flap surgery to improve velopharyngeal function is performed in our hospital. The folded pharyngeal flap operation was first reported by Isshiki and Morimoto in 1975. We usually use a modification of the original method.

Purpose: The purpose of this research was to introduce our method of the folded pharyngeal flap operation and report the results.

Materials and methods: The folded pharyngeal flap operation was performed for 110 patients with velopharyngeal insufficiency from 1982 to 2010. Of these, the 97 whose postoperative speech function was evaluated are reported. The cases included 61 males and 36 females, ranging in age from 7 to 50 years. The time from surgery to speech assessment ranged from 5 months to 6 years. In order to evaluate preoperative velopharyngeal function, assessment of speech by a trained speech pathologist, nasopharyngoscopy, and cephalometric radiography with contrast media were performed before surgery, and then the appropriate surgery was selected and performed. Postoperative velopharyngeal function was assessed by a trained speech pathologist.

Results: Of the 97 patients who underwent the folded pharyngeal flap operation, 85 (87.6%) showed velopharyngeal competence, 8 (8.2%) showed marginal velopharyngeal incompetence, and only 2 (2.1%) showed velopharyngeal incompetence; in 2 cases (2.1%), hyponasality was present. Approximately 95% of patients showed improved velopharyngeal function.

Conclusions: The folded pharyngeal flap operation based on appropriate preoperative assessment has been shown to be an effective method for the treatment of cleft palate patients with velopharyngeal insufficiency.

No MeSH data available.


Related in: MedlinePlus