Location of the levator veli palatini insertion following levator retropositioning, palatal pushback, and pharyngeal flap procedures.
A long-term cineradiographic follow-up study of twenty patients with velo-pharyngeal incompetence fails to demonstrate predictable retrodisplacement of the levator insertion following combined levator retropositioning, pushback, and pharyngeal flap procedures. Simple levator retropositioning gave posterior displacement in the two patients evaluated. Patients with normal or posterior levator insertions pre-operatively all demonstrated post-operative anterior displacement following pharyngeal flap procedures, either alone or in combination with pushback. Anterior levator displacement may be the result of scar contraction or division of the levator sling (during insetting of a pharyngeal flap). Pre-operative and post-operative speech evaluation demonstrated substantial improvement in all except 3 patients; 2 of the poor speech results were patients with demonstrated levator retrodisplacement on post-operative cineradiography.
D000293:Adolescent; D002648:Child; D006801:Humans; D009132:Muscles / Q000033:anatomy & histology / Q000601:surgery; D010159:Palate / Q000033:anatomy & histology* / Q000601:surgery; D010614:Pharynx / Q000601:surgery