title: Treatment of velopharyngeal insufficiency by autologous fat injection.
abstract: Velopharyngeal insufficiency (VPI) is a structural or functional trouble, which causes hypernasal speech. Velopharyngeal flaps, speech therapy and augmentation pharyngoplasty, using different implants, have all been used to address this trouble. We hereby present our results following rhinopharyngeal autologous fat injection in 18 patients with mild velopharyngeal insufficiency (12 soft palate clefts, 4 functional VPI, 2 myopathy). 28 injections were carried out between 2004 and 2007. The degree of hypernasal speech was evaluated pre- and postoperatively by a speech therapist and an ENT specialist and quantified by an acoustic nasometry (Kay Elemetrics). All patients were exhaustively treated with preoperative speech therapy (average, 8 years). The mean value of the nasalance score was 37% preoperatively and 23% postoperatively (p = 0.015). The hypernasality was reduced postoperatively in all patients (1-3 degrees of the Borel-Maisonny score). There were no major complications, two minor complications (one hematoma, one cervical pain). The autologous fat injection is a simple, safe, minimally invasive procedure. It proves to be efficient in cases of mild velopharyngeal insufficiency or after a suboptimal velopharyngoplasty.
authors.affiliation: Department of Otolaryngology, University Hospital Centre of the Canton of Vaud (CHUV), 1011 Lausanne, Switzerland. igor.leuchter@hcuge.ch
authors.forename: Igor
authors.initials: I
authors.lastname: Leuchter
authors.forename: Valérie
authors.initials: V
authors.lastname: Schweizer
authors.forename: Judith
authors.initials: J
authors.lastname: Hohlfeld
authors.forename: Philippe
authors.initials: P
authors.lastname: Pasche
mesh_terms: D000273:Adipose Tissue / Q000637:transplantation*; D000293:Adolescent; D000328:Adult; D002648:Child; D002972:Cleft Palate / Q000601:surgery; D004062:DiGeorge Syndrome / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010699:Phonation / Q000502:physiology; D011183:Postoperative Complications / Q000209:etiology; D013018:Sound Spectrography; D013065:Speech Intelligibility; D014681:Velopharyngeal Insufficiency / Q000209:etiology / Q000601:surgery*; D014832:Voice Disorders / Q000209:etiology / Q000601:surgery; D014833:Voice Quality / Q000502:physiology; D055815:Young Adult