[Velopharyngeal sequels in labial-alveolar-velopalatine clefts. Veloplasty and pharyngoplasty using an inferior or superior pedicle pharyngeal flap].
Velopharyngeal insufficiency remains a sequel of labial-alveolar-velopalatine clefts. It may occur despite a good quality primary repair. A surgical management must be considered as soon as speech therapy is no longer efficient or before any irreversible compensatory speech pattern appears. Thus, surgery should be decided on after consultation between the surgeon and the speech pathologist or speech therapist, when considering that speech therapy has failed. Several surgical techniques are discussed: intravelar veloplasty, Furlow double-opposing Z-plasty, pharyngoplasty using an inferior or superior pedicle flap. Superior pedicle flap surgery is currently the most commonly used technique. For the past twenty years we have used this technique as described by Petit and modified by Malek, because of the excellent speech results. The drawbacks are known and can be contained by a preventive management.
Service de chirurgie maxillofaciale et chirurgie plastique, hôpital d'enfants Armand-Trousseau, APHP, 75012 Paris, France. marie-paule.vazquez@trs.aphp.fr
M-P
MP
Vazquez
V
V
Soupre
H
H
Bénateau
J-B
JB
Seigneuric
H
H
Martinez
M-F
MF
Taieb
C
C
Trichet-Zbinden
A
A
Picard
D002971:Cleft Lip / Q000150:complications* / Q000601:surgery; D002972:Cleft Palate / Q000150:complications* / Q000601:surgery; D006801:Humans; D010160:Palate, Soft / Q000601:surgery*; D010609:Pharyngeal Muscles / Q000637:transplantation; D010614:Pharynx / Q000601:surgery*; D017286:Polysomnography; D019651:Plastic Surgery Procedures / Q000379:methods; D013060:Speech / Q000502:physiology; D013070:Speech Therapy; D013524:Surgical Flaps; D014068:Tonsillectomy; D014681:Velopharyngeal Insufficiency / Q000209:etiology* / Q000473:pathology / Q000601:surgery