title: A comparison of speech results after the pharyngeal flap and the dynamic sphincteroplasty procedures.
abstract: Eighty-five patients underwent surgery to reduce velopharyngeal incompetence with either a pharyngeal flap (n = 75) or a dynamic sphincteroplasty (n = 10) performed between April 1958 and August 1989, and were evaluated preoperatively and postoperatively by a plastic surgeon, speech pathologist, and otolaryngologist. Improvement in speech was noted in 75% (n = 56) of the patients with pharyngeal flaps and 70% (n = 7) of the patients with dynamic sphincteroplasties postoperatively. Thirty percent of the patients in both groups showed no improvement postoperatively in speech. Three patients (4%) who underwent pharyngeal flap procedures developed sleep apnea postoperatively. Persistent velopharyngeal incompetence may be treated effectively with either a pharyngeal flap or a dynamic sphincteroplasty. Either procedure appears to result in improved speech in most patients.
authors.affiliation: Division of Plastic Surgery, Children's Memorial Hospital, Chicago, IL 60614.
authors.forename: J M
authors.initials: JM
authors.lastname: Pensler
authors.forename: D S
authors.initials: DS
authors.lastname: Reich
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D006801:Humans; D011183:Postoperative Complications; D013065:Speech Intelligibility; D013524:Surgical Flaps; D013514:Surgical Procedures, Operative / Q000379:methods; D014681:Velopharyngeal Insufficiency / Q000601:surgery*