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Management of velopharyngeal insufficiency by augmentation of posterior pharyngeal wall with bone graft | ||
| IRAQI JOURNALOF COMMUNITY MEDICINE | ||
| Article 1, Volume 20, Issue 2, 2007, Pages 369-374 | ||
| Author | ||
| Ali I. Albayati | ||
| Abstract | ||
| ABSTRACT Objectives: This study is aiming at evaluation of the surgical treatment of velopharyngeal insufficiency (VPI) by augmentation of the posterior pharyngeal wall by bone grafts to aid the proper closure of the velopharyngeal sphincter on backwards movement of the soft palate during speech and swallowing, with the preservation of a patent airway. Methodology: Eight patients with VPI due to different causes (mainly repaired cleft palate and paralytic conditions of the soft palate) were evaluated by approximate measurements of the gap left opened in the velopharyngeal sphincter during phonation and swallowing. They all underwent surgery of augmentation of the posterior pharyngeal wall by bone grafts from the iliac crest to close the gap left in the velopharyngeal sphincter while functioning. Follow up and post-operative evaluation periods extended from 4-8 years. Results: The results obtained by this surgical procedure were encouraging where 87.5% of the patients suffering from nasal escape in speech or hepernasality had a good to complete improvement; only one patient had a poor improvement. In the 6 patients with regurgitation of fluids during swallowing, 5 of them (81.5%) had got a complete improvement. All the patients suffering from regurgitation of solid food (4 patients) got fully improved. All the patients post-operatively remained breathing satisfactorily, no post-operative snoring, nor any upper airway breathing difficulties. Conclusions: This surgical procedure is recommended as one of the first line treatment of VPI for its simplicity as no restrictions to be put that the surgery should be performed by highly skilled hands only, the easy way of estimation of the condition, and almost no morbidity and no danger to affect the airway, on the other hand it is not highly recommended in the larger gaps of the velopharyngeal sphincter as the results were not as encouraging as in the smaller and medium gaps. Key words: Velopharyngeal insufficiency, Velopharyngeal incompetence, Rhinolalia aperta | ||
| Keywords | ||
| Velopharyngeal insufficiency; Velopharyngeal incompetence; Rhinolalia aperta | ||
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