Objective: To compare surgical outcomes between pharyngeal flap, sphincter pharyngoplasty, and combined Furlow palatoplasty and sphincter pharyngoplasty in the management of pediatric velopharyngeal insufficiency.
Study Design: Case series with chart review.
Setting: Tertiary care pediatric hospital.
Subjects And Methods: After exclusion of children with velocardiofacial syndrome, 96 patients who underwent surgical intervention between 2008 and 2012 were identified. Surgical interventions were categorized as pharyngeal flap, sphincter pharyngoplasty, and combined Furlow palatoplasty and sphincter pharyngoplasty. Main outcome measures included perceptual speech analyses, complications, and surgical revision rates.
Results: Of the 96 reviewed patients, 38 (39.6%) underwent pharyngeal flap, 20 (20.8%) sphincter pharyngoplasty, and 38 (39.6%) combined Furlow palatoplasty and sphincter pharyngoplasty. Choice of surgical intervention was based on patient characteristics, observed palatal length, and formal speech assessments. There were no differences in patient demographics or preoperative perceptual speech analysis scores among the 3 surgical groups. The mean speech improvement was significantly greater in both the pharyngeal flap (P = .031) and combined procedure (P = .013) compared with sphincter pharyngoplasty alone, but no differences were observed between the pharyngeal flap and combined procedure (P = .797). There were no differences in complications among the 3 surgical interventions (P = .220). The combined procedure required significantly less surgical revisions than the pharyngeal flap (P = .019).
Conclusion: Combined Furlow palatoplasty and sphincter pharyngoplasty is an effective procedure for the management of pediatric velopharyngeal insufficiency and may result in superior speech outcomes and lower revision rates than sphincter pharyngoplasty and pharyngeal flap, respectively.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1177/0194599813513715 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Management of velopharyngeal insufficiency by a new modification of sphincter pharyngoplasty technique in cleft palate patients, clinical and radiographical prospective study.
Ann Med Surg (Lond)
November 2024
Oral and Maxillofacial Surgery Department, Faculty of Dentistry, Tishreen University, Lattakia, Syria.
Background: This study was designed to investigate the effectiveness and outcome of a new modification of the sphincter pharyngoplasty technique in the treatment of velopharyngeal insufficiency patients, with the determination of a specific dimension of velopharyngeal port and velum length of no hypernasality, snoring, and nasal regurgitation potential.
Materials And Methods: The study included 10 patients, who were suffering from consistent hypernasal speech after failure of conservative speech therapy. Clinical and radiographic measurements of the velopharyngeal port and velum length before and after surgery were done, with clinical patient follow-up to assess snoring and nasal regurgitation after surgery for 1, 6, and 12 months.
Efficacy of Expansion Pharyngoplasty without Drug-induced Sleep Endoscopy Screening in Obstructive Sleep Apnea.
Int Arch Otorhinolaryngol
October 2024
Department of Otolaryngology, Head and Neck Surgery, Hospital Universitario Costa del Sol, Marbella, Spain.
Expansion sphincter pharyngoplasty has been shown to be a good alternative to continuous pressure devices in patients with moderate to severe obstructive sleep apnea. On the other hand, drug-induced sleep endoscopy provides information on the pattern of collapse in obstructive sleep apnea, although it is unclear whether this information improves the surgical outcomes. To evaluate the success rate obtained when performing expansion sphincter pharyngoplasty on a group of patients diagnosed with moderate to severe obstructive sleep apnea who were not previously selected by drug-induced sleep endoscopy.
View Article and Find Full Text PDFDistribution of Specialties Providing Surgical Management of Cleft-Related Speech Disorders in Children 3 years of Age and Older: 2004 to 2021.
J Craniofac Surg
October 2024
Division of Plastic Surgery, Ann and Robert H. Lurie Children's Hospital, Northwestern University Feinberg School of Medicine, Chicago, IL.
Article Synopsis
- The study analyzed the types of surgical specialties involved in secondary correction of velopharyngeal incompetence (VPI) from 2004 to 2021 using data from 45 hospitals.
- A total of 7,090 VPI procedures were examined, with plastic surgeons performing the majority (67%), followed by otolaryngologists (31%) and oral and maxillofacial surgeons (12%).
- It was found that the choice of procedure varied by specialty, with otolaryngologists favoring sphincter pharyngoplasty, which saw a decline in performance by plastic surgeons from 2017 to 2021.
Efficacy of Posterior Pharyngeal Wall Injection for Velopharyngeal Dysfunction in Adults.
Laryngoscope
September 2024
Department of Otolaryngology-Head and Neck Surgery, University of California San Francisco School of Medicine, San Francisco, California, U.S.A.
Objective(s): Posterior pharyngeal wall (PPW) injection is often employed to treat velopharyngeal deficiency (VPD). We sought to analyze the impact of PPW injection on severity of dysphagia and dysphonia.
Methods: Retrospective chart review was conducted of patients undergoing PPW injection from 2018 to 2023 at a tertiary laryngology center.
Reasonable Risk Ratio of Palate Surgery: A New Critical Analysis.
J Otolaryngol Head Neck Surg
September 2024
Otolaryngology, Western University, London, ON, Canada.
Objective.: A new critical complication risk analysis, the reasonable risk ratio (RRR or R) for palate surgeries in obstructive sleep apnea patients.
Methods.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!