Long-term effects of pharyngeal flaps on the upper airways of subjects with velopharyngeal insufficiency.
OBJECTIVE
To investigate the long-term effects of pharyngeal flap surgery (PFS) on nasal and nasopharyngeal dimensions of patients with velopharyngeal insufficiency (VPI) and to correlate the findings with the onset of respiratory complaints after surgery.


METHODS
Prospective study in 58 nonsyndromic patients with repaired cleft palate and VPI, evaluated 2 days before and 5 months (POST1) and 1 year (POST2) after PFS, on average. Patients were divided into two groups: one consisting of patients with postoperative respiratory complaints (RC group) and the other without complaints (NRC group).


METHODS
Superiorly based PFS.


METHODS
Respiratory complaints (self reports of mouth breathing, snoring, and other sleep obstructive events) assessed at POST1 and POST2, and minimum nasal (NCSA) and nasopharyngeal (NPA) cross-sectional areas assessed by rhinomanometry at POST2.


RESULTS
Respiratory complaints were reported by 55% and 36% of the patients evaluated at POST1 and POST2, respectively. Posterior rhinomanometry showed a significant postoperative reduction of mean NCSA in the RC and NRC groups (p < .05), to subnormal levels in some of them. The decrease was more pronounced in the RC group. No significant changes in NCSA were observed by anterior rhinomanometry. Similar results were obtained when NPA was assessed by modified anterior rhinomanometry.


CONCLUSIONS
In the long-term, PFS yielded a significant reduction in upper airways dimensions beyond what should be expected and associated with persistent respiratory complaints in some cases.
Yamashita
Renata Paciello
RP
Laboratory of Physiology, Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, Bauru, Brazil. rezeyama@usp.br
Trindade
Inge Elly Kiemle
IE
D000293:Adolescent; D000328:Adult; D002648:Child; D002972:Cleft Palate / Q000150:complications / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009058:Mouth Breathing / Q000209:etiology / Q000473:pathology; D015508:Nasal Obstruction / Q000209:etiology* / Q000473:pathology; D009305:Nasopharynx / Q000473:pathology; D009666:Nose / Q000473:pathology; D019647:Oral Surgical Procedures / Q000009:adverse effects*; D011446:Prospective Studies; D019651:Plastic Surgery Procedures / Q000009:adverse effects*; D025363:Rhinomanometry; D012913:Snoring / Q000209:etiology / Q000473:pathology; D013524:Surgical Flaps; D014681:Velopharyngeal Insufficiency / Q000150:complications / Q000209:etiology / Q000601:surgery*