title: Surgical outcome of pharyngeal flap surgery and intravelar veloplasty on the velopharyngeal function.
abstract: OBJECTIVE
  To investigate the postoperative outcomes of pharyngeal flap surgery (PF) and secondary palatoplasty with intravelar veloplasty (IV) in the velopharyngeal insufficiency management regarding nasalance scores and velopharyngeal area.
  
  
  METHODS
  Seventy-eight patients with cleft palate±lips submitted to surgical treatment for velopharyngeal insufficiency, for 14 months on an average, were evaluated: 40 with PF and 38 with IV, of both genders, aged between 6 and 52 years old. Hypernasality was estimated by means of nasalance scores obtained by nasometry with a cutoff score of 27%. The measurement of velopharyngeal orifice area was provided by the pressure-flow technique and velopharyngeal closure was classified as: adequate (0.000-0.049 cm²), adequate/borderline (0.050-0.099 cm²), borderline/inadequate (0.100-0.199 cm²), and inadequate (≥0.200 cm²).
  
  
  RESULTS
  Absence of hypernasality was observed in 70% of the cases and adequate velopharyngeal closure was observed in 80% of the cases, in the PF group. In the IV group, absence of hypernasality was observed in 34% and adequate velopharyngeal closure was observed in 50% of the patients. Statistically significant differences were obtained between the two techniques for both evaluations.
  
  
  CONCLUSIONS
  PF was more efficient than the secondary palatoplasty with IV to reduce hypernasality and get adequate velopharyngeal closure.
authors.forename: Daniela Aparecida
authors.initials: DA
authors.lastname: Barbosa
authors.forename: Rafaeli Higa
authors.initials: RH
authors.lastname: Scarmagnani
authors.forename: Ana Paula
authors.initials: AP
authors.lastname: Fukushiro
authors.forename: Inge Elly Kiemle
authors.initials: IE
authors.lastname: Trindade
authors.forename: Renata Paciello
authors.initials: RP
authors.lastname: Yamashita
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002972:Cleft Palate / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009296:Nasal Cavity / Q000503:physiopathology; D019647:Oral Surgical Procedures / Q000379:methods*; D010614:Pharynx / Q000503:physiopathology / Q000601:surgery*; D025363:Rhinomanometry; D013524:Surgical Flaps; D016896:Treatment Outcome; D014681:Velopharyngeal Insufficiency / Q000503:physiopathology / Q000601:surgery*; D055815:Young Adult