Velopharyngoplasty for noncleft velopharyngeal insufficiency: results in relation to 22q11 microdeletion.
OBJECTIVE
To evaluate the results of velopharyngoplasty for velopharyngeal insufficiency (VPI) in relation to 22q11 deletion or nonsyndromic VPI.


METHODS
Retrospective study.


METHODS
Academic medical center.


METHODS
Eleven of 45 patients with 22q11 microdeletion (group 1) and 9 patients without 22q11 microdeletion (group 2) with noncleft VPI (hypoplastic velum or hypodynamic velopharynx and deep pharynx) underwent velopharyngoplasty (midline pharyngeal flap with superior pedicle). Exclusion criteria included cleft palate, submucous cleft palate, all syndromic cases, and all associated malformations (except those related to 22q11 microdeletion in patients with DiGeorge syndrome).


METHODS
Speech assessment before surgery using the Borel-Maisonny scale and at 9 months and 24 months after surgery. Velopharyngeal insufficiency was classified as normal, inconsistent, mild, moderate, and severe.


RESULTS
Before surgery, in group 1, 3 patients had mild and 8 had severe VPI, and in group 2, 1 had mild and 8 had severe VPI. Postoperative outcomes at 9 months showed that in group 1, 2 patients had excellent results (normal and inconsistent) and 9 had mild VPI, while in group 2, 6 patients had excellent results and 3 had mild VPI (P = .03). Postoperative outcomes at 24 months showed that in group 1, 10 patients had excellent results and 1 had mild VPI, while in group 2, 8 patients had excellent results and 1 had mild VPI.


CONCLUSIONS
Surgical treatment of noncleft VPI by pharyngoplasty was efficient in 10 of the 11 patients (91%) in the 22q11 group and in 8 of the 9 patients (89%) in the nonsyndromic group. Postoperative remission took longer for patients with the 22q11 microdeletion than for the control group. However, long-term results following surgical treatment were equally good in the 2 groups.
Rouillon
Isabelle
I
Service d'Otorhinolaryngologie et de Chirurgie Cervico-Faciale, Hôpital d'Enfants Armand-Trousseau, APHP and UPMC Univ Paris 6, 26 avenue Arnold Netter, 75571 Paris Cedex 12, France. isabelle.rouillon@trs.ap-hop-paris.fr
Leboulanger
Nicolas
N
Roger
Gilles
G
Maulet
Michel
M
Marlin
Sandrine
S
Loundon
Natalie
N
Portnoï
Marie France
MF
Denoyelle
Francoise
F
Garabédian
Erea Noel
EN
D002648:Child; D002675:Child, Preschool; D002872:Chromosome Deletion; D002892:Chromosomes, Human, Pair 22; D005260:Female; D006801:Humans; D008297:Male; D010614:Pharynx / Q000601:surgery*; D016896:Treatment Outcome; D014681:Velopharyngeal Insufficiency / Q000235:genetics* / Q000601:surgery*; D055158:Velopharyngeal Sphincter / Q000601:surgery*