title: Modified Superior-Based Pharyngeal Flap Is Effective in Treatment of Velopharyngeal Insufficiency Regardless of the Preoperative Closure Pattern.
abstract: Velopharyngeal insufficiency (VPI) is certainly one of the most important problems confronted after cleft palate repairs. In this study, it was aimed to evaluate the preoperative and postoperative speaking results of patients who underwent modified superior-based pharyngeal flap. Sixty-six children who underwent modified superiorly based pharyngeal flap for treatment of VPI between 2005 and 2013 were retrospectively reviewed. The study population was evaluated in 2 distinctive groups depending on their preoperative velopharyngeal closure pattern as: coronal closure pattern or noncoronal closure patterns (ie, circular, sagittal with or without the presence of a Passavant ridge). The speech outcome of the patients was evaluated using the objective assessment tools of nasopharyngoscopy and nasometer. Coronal closure pattern was determined in 24 patients (36.4%) and noncoronal closure pattern in 42 patients (63.6%). The mean follow-up period was 14.67 ± 3.90 and 13.74 ± 3.53 months in the coronal and noncoronal groups, respectively. The results demonstrated that the postoperative nasalance scores of all syllables except (m) and (n) were found to be significantly lower compared to those of the preoperative period (P < 0.001). However, no significant difference between the preoperative and postoperative results was observed in means of closure pattern. The surgical approach of modified superior-based pharyngeal flap for treatment of VPI appears to be effective regardless of the preoperatively determined closure pattern.
authors.affiliation: *Department of Plastic Reconstructive and Aesthetic Surgery, Hacettepe University Faculty of Medicine †Plastic and Reconstructive Surgery Clinic, Ordu State Hospital ‡Department of Otolaryngology, Audiology and Speech Pathology Unit, Hacettepe University Faculty of Medicine §Department of Otolaryngology, Hacettepe University Faculty of Medicine, Ankara, Turkey.
authors.forename: Omer
authors.initials: O
authors.lastname: Ekin
authors.forename: Mert
authors.initials: M
authors.lastname: Calis
authors.forename: Mavis Emel
authors.initials: ME
authors.lastname: Kulak Kayikci
authors.forename: Mehtap
authors.initials: M
authors.lastname: Icen
authors.forename: Riza Onder
authors.initials: RO
authors.lastname: Gunaydin
authors.forename: Figen
authors.initials: F
authors.lastname: Ozgur
mesh_terms: D002675:Child, Preschool; D002972:Cleft Palate / Q000601:surgery*; D004724:Endoscopy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D019647:Oral Surgical Procedures / Q000009:adverse effects / Q000379:methods; D010043:Outcome and Process Assessment, Health Care; D010614:Pharynx / Q000601:surgery; D011183:Postoperative Complications / Q000601:surgery*; D012189:Retrospective Studies; D013524:Surgical Flaps; D016896:Treatment Outcome; D014681:Velopharyngeal Insufficiency / Q000209:etiology / Q000601:surgery; D055158:Velopharyngeal Sphincter / Q000601:surgery; D058106:Wound Closure Techniques