Velopharyngeal insufficiency in hemifacial microsomia: analysis of correlated factors.
OBJECTIVE
To investigate the incidence of unilateral hypodynamic palate (UHP) and velopharyngeal insufficiency (VPI) in hemifacial microsomia (HFM), and to determine the dysmorphic manifestations having significant associations with UHP/VPI in HFM.


METHODS
This was a nonrandomized study of 48 patients with unilateral HFM without cleft palate. The correlation between each anomaly and UHP/VPI was analyzed statistically. In addition, we observed 4 HFM patients with cleft palate to examine the influence on cleft palate speech.


RESULTS
The incidence of UHP in HFM was 50.0% and that of VPI was 14.6%. All the VPI patients had UHP. Severe micrognathia and soft tissue deficiency, macrostomia, and mental retardation were significant risk factors for developing VPI in HFM. Moreover, UHP exacerbated speech in HFM with cleft lip and palate.


CONCLUSIONS
Significant correlations were detected between VPI and HFM. This finding should be helpful in the overall management of HFM.
Funayama
Emi
E
Department of Plastic and Reconstructive Surgery, Hokkaido University Graduate School of Medicine, Sapporo, Japan. emi-f@bc.iij4u.or.jp
Igawa
Hiroharu H
HH
Nishizawa
Noriko
N
Oyama
Akihiko
A
Yamamoto
Yuhei
Y
D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D002972:Cleft Palate / Q000150:complications / Q000503:physiopathology; D005146:Facial Asymmetry / Q000145:classification / Q000150:complications* / Q000503:physiopathology; D006801:Humans; D008875:Middle Aged; D011446:Prospective Studies; D014681:Velopharyngeal Insufficiency / Q000145:classification / Q000209:etiology* / Q000503:physiopathology