title: Treatment of velopharyngeal insufficiency by pharyngeal and velar fat injections.
abstract: The aim of this prospective study was to evaluate the effectiveness of fat injections in the treatment of velopharyngeal insufficiency (VPI). The study involved 10 patients (6 adults aged 19-48 years and 4 children aged 5-13 years) with mild/moderate VPI who were injected with 3.5 to 8 mL of fat in the posterior, lateral pharyngeal walls and soft palate under general anaesthesia. A second fat-grafting procedure was performed in 2 patients to achieve further improvement. Nasoendoscopy revealed a reduction in the closure gap in all patients, and the perceptual evaluation demonstrated improved speech intelligibility and resonance and reduced nasal air leakage in all cases (P < .005). The aerodynamic assessment showed a significant reduction in nasal airflow during phonation (P < .05). Follow-up was 6 to 23 months. In conclusion, fat injections improved voice resonance and reduced nasal air escape in all treated cases and can be a promising alternative to major procedures, such as velopharyngoplasties, for the treatment of mild/moderate VPI.
authors.affiliation: Otolaryngology Department, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy. giovanna.cantarella@policlinico.mi.it
authors.forename: Giovanna
authors.initials: G
authors.lastname: Cantarella
authors.forename: Riccardo F
authors.initials: RF
authors.lastname: Mazzola
authors.forename: Mario
authors.initials: M
authors.lastname: Mantovani
authors.forename: Giovanna
authors.initials: G
authors.lastname: Baracca
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Pignataro
mesh_terms: D000273:Adipose Tissue / Q000637:transplantation*; D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D005500:Follow-Up Studies; D006801:Humans; D015552:Injections, Intralesional; D007828:Laryngoscopy / Q000379:methods; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D019651:Plastic Surgery Procedures / Q000379:methods*; D018570:Risk Assessment; D012720:Severity of Illness Index; D018709:Statistics, Nonparametric; D020858:Tissue and Organ Harvesting; D016896:Treatment Outcome; D014681:Velopharyngeal Insufficiency / Q000175:diagnosis* / Q000601:surgery*; D055815:Young Adult