title: The modified Honig velopharyngoplasty - a new technique to treat hypernasality by palatal lengthening.
abstract: BACKGROUND
  Palatal lengthening by pushback with a pharyngeal flap is a commonly used operative technique for the treatment of velopharyngeal insufficiency. The conventional Honig velopharyngoplasty uses full thickness mucoperiosteal flaps for the oral lining of the defect.
  
  
  OBJECTIVE
  A modification is described using only mucosal flaps, thus preserving the periosteum and the palatine arteries. Vascularisation of the hard palate is preserved and bone is not exposed, avoiding potential detrimental scar formation overlying the hard palate, which may affect normal outgrowth of the maxilla.
  
  
  METHODS
  Eight patients with persisting hypernasality were included. Velopharyngeal closure was evaluated by nasendoscopy, nasometry and a Dutch speech test for cleft patients.
  
  
  RESULTS
  Hypernasality was corrected in all cases. One patient developed a light hyponasality. In four patients the overall speech normalised and in the remaining four cases small errors persisted, but speech was well understandable.
  
  
  CONCLUSIONS
  The procedure yields satisfactory speech results in this preliminary study, comparable to the conventional Honig velopharyngeaplasty. Long term follow up regarding maxillary growth and comparative studies with other operative techniques are now warranted.
authors.affiliation: UMCU, Department of Pediatric Plastic Surgery, Utrecht, The Netherlands.
authors.forename: Aebele B
authors.initials: AB
authors.lastname: Mink van der Molen
authors.forename: Karlijn
authors.initials: K
authors.lastname: Janssen
authors.forename: Tom F J M C
authors.initials: TF
authors.lastname: Specken
authors.forename: Bart M
authors.initials: BM
authors.lastname: Stubenitsky
mesh_terms: D002648:Child; D002675:Child, Preschool; D002972:Cleft Palate / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D009061:Mouth Mucosa / Q000601:surgery; D021362:Palate, Hard / Q000601:surgery; D010160:Palate, Soft / Q000601:surgery; D013065:Speech Intelligibility; D013068:Speech Production Measurement; D013524:Surgical Flaps; D014681:Velopharyngeal Insufficiency / Q000150:complications / Q000601:surgery*; D014832:Voice Disorders / Q000209:etiology / Q000601:surgery*; D014833:Voice Quality