PRACTICA OTO-RHINO-LARYNGOLOGICA
Vol. 100 No. 4 April 2007
Pharyngeal Flap Construction Surgery for
Velopharyngeal Incompetence
Kensei Naito, Tomoko Horibe and Seiji Horibe
(Fujita Health University, School of Medicine)
Pharyngeal flap construction surgery is a treatment for velopharyngeal incompetence in cleft palate children. Velopharyngeal incompetence is a major cause of dysphemia. In our department, we assessed velopharyngeal competence in 382 cases from 1992 to 2006 by inspection of the soft palate length or movement, lateral view of X-ray, aerodynamic study, nasometry and naso-pharyngeal fiberscopic examination, and evaluated incompetence in 88 cases. In 22 of the 88, we perfomed pharyngeal flap construction because of failed speech therapy. Usually, palatal re-push back was combined with pharyngeal flap construction and we had a satisfactory postoperative course. We should pay attention to the conceivable complications of the operation, such as mouth breathing, snoring, obstructive sleep apnea, bradycardia, cardiac arrest, underdevelopment and otitis media with effusion. Speech therapy has to be still required although these patients have received surgery for velopharyngeal incompetence.
Key words : pharyngeal flap, velopharyngeal incompetence, cleft palate, articulation, dysphemia, hypernasality