title: Posterior Pharyngeal Flap for Velopharyngeal Insufficiency Patients: A New L-Shaped Flap.
abstract: OBJECTIVE
  To describe and assess the results of central inset L-shaped posterior pharyngeal flap (PF) for treatment of velopharyngeal incompetence.
  
  
  METHODS
  This study included 12 patients who were diagnosed as persistent velopharyngeal insufficiency. L-shaped central inset superiorly based PF was harvested from oropharynx and inserted into the soft palate through a transverse full-thickness palatal incision 1 cm behind the posterior margin of the hard palate, then the flap was spread 1 cm horizontally and 1 cm in the anteroposterior direction in soft palate. Before and after surgery, patients were assessed by examination, video: nasoendoscopy, and speech assessment.
  
  
  RESULTS
  Postoperative speech assessment showed significant improvement in the nasal emission, resonance, intraoral pressure, and articulation defects. Grade 4 velopharyngeal valve closure (complete closure) could be achieved in all patients. No patients showed dehiscence (partial or total) of the flap and no obstructive sleep apnea reported.
  
  
  CONCLUSIONS
  The new used L-shaped PF could properly correct velopharyngeal functions (closure and speech) in patients with persistent velopharyngeal insufficiency with no reported complication.
authors.affiliation: Otorhinolaryngology-Head and Neck Surgery Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt.
authors.forename: Ezzeddin
authors.initials: E
authors.lastname: Elsheikh
authors.forename: Mohammad Waheed
authors.initials: MW
authors.lastname: El-Anwar
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D004724:Endoscopy / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006085:Graft Survival; D006801:Humans; D008297:Male; D009960:Oropharynx / Q000601:surgery; D021362:Palate, Hard / Q000601:surgery; D010160:Palate, Soft / Q000502:physiology / Q000601:surgery; D010614:Pharynx / Q000502:physiology / Q000601:surgery*; D011312:Pressure; D011446:Prospective Studies; D013060:Speech / Q000502:physiology; D013524:Surgical Flaps / Q000637:transplantation*; D060053:Transplant Donor Site / Q000601:surgery; D016896:Treatment Outcome; D014681:Velopharyngeal Insufficiency / Q000601:surgery*; D014741:Video Recording; D014831:Voice / Q000502:physiology