Arch Craniofac Surg.  2020 Feb;21(1):22-26. 10.7181/acfs.2019.00731.

Outcomes of a superiorly-based pharyngeal flap for the correction of velopharyngeal dysfunction

• Lee YW
• Bae YC
• Park SM
• Nam SB
• Seo HJ
• Kim GW

• KMID: 2501083
• DOI: http://doi.org/10.7181/acfs.2019.00731

Abstract

Background
This study investigated the outcomes of pharyngeal flap surgery in Asian patients with velopharyngeal dysfunction (VPD), with a focus on postoperative improvements in speech articulation and complications. Additionally, this study explored whether the cause of VPD and the timing of surgery affected outcomes in terms of speech improvement.
Methods
A retrospective review was conducted of the medical records of 72 Asian VPD patients who underwent pharyngeal flap surgery performed by a single surgeon from 1996 to 2014. Operative complications were analyzed for all 72 patients, and preoperative and postoperative speech articulation tests were compared for the subset of 43 patients in whom such testing was possible. The relationships of age at surgery and the cause of VPD with the extent of improvement in speech articulation were also investigated.
Results
Nine of the 72 patients (13%) experienced wound-related complications. Furthermore, 34 patients (47%) reported persistent snoring lasting for over 3 months, and 16 (22%) reported snoring for over 1 year. Three patients (4%) underwent reoperation. Speech articulation scores significantly improved postoperatively across all groups. Younger age at surgery was associated with greater improvements in speech outcomes, but no significant relationship was found between the cause of VPD and the extent of the postoperative improvement in speech outcomes.
Conclusion
Speech outcomes improved after pharyngeal surgery in Asian patients with VPD. Early surgery was associated with favorable speech outcomes, but no association was found between the cause of VPD and postoperative speech outcomes.

Keyword

Cleft palate; Speech; Surgery; Surgical flap; Velopharyngeal Insufficiency