Archives of Craniofacial Surgery (대한두개안면성형외과학회지)

Korean Cleft Palate-Craniofacial Association (대한두개안면성형외과학회)
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Surgical treatment of velopharyngeal insufficiency

  • Nam, Seung Min (Department of Plastic and Reconstructive Surgery, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine)
  • Received : 2018.08.19
  • Accepted : 2018.09.19
  • Published : 2018.09.20
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Abstract

Velopharyngeal insufficiency (VPI) is a common complication after primary palatoplasty. Although the several surgical treatments of VPI have been introduced, there is no consensus guide to select the optimal surgical treatment for VPI patients. The selection of surgical treatment for VPI depends on a multimodal patient evaluation, such as perceptual speech evaluation, nasometery and nasoendoscopy. We can provide more adequate treatment for VPI through the deeper understanding of anatomy and physiology in VPI.

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References

  1. Gart MS, Gosain AK. Surgical management of velopharyngeal insufficiency. Clin Plast Surg 2014;41:253-70. https://doi.org/10.1016/j.cps.2013.12.010
  2. Ahmed M. Cleft lip and palate care in the United Kingdom: the Clinical Standards Advisory Group (CSAG) study. Cleft Palate Craniofac J 2002;39:656. https://doi.org/10.1597/1545-1569(2002)039<0656:LTTE>2.0.CO;2
  3. Padgett EC. The repair of cleft palates after unsuccessful operations with special reference to cases with an extensive loss of palatal tissue. Int J Orthodontia Oral Surg Radiogr 1930;16: 1299-316. https://doi.org/10.1016/S0099-6963(30)90042-7
  4. Hogan VM. A clarification of the surgical goals in cleft palate speech and the introduction of the lateral port control (l.p.c.) pharyngeal flap. Cleft Palate J 1973;10:331-45.
  5. Shprintzen RJ, Lewin ML, Croft CB, Daniller AI, Argamaso RV, Ship AG, et al. A comprehensive study of pharyngeal flap surgery: tailor made flaps. Cleft Palate J 1979;16:46-55.
  6. Hynes W. Pharyngoplasty by muscle transplantation. Br J Plast Surg 1950;3:128-35. https://doi.org/10.1016/S0007-1226(50)80020-6
  7. Jackson IT, Silverton JS. The sphincter pharyngoplasty as a secondary procedure in cleft palates. Plast Reconstr Surg 1977;59: 518-24. https://doi.org/10.1097/00006534-197759040-00007
  8. Riski JE, Serafin D, Riefkohl R, Georgiade GS, Georgiade NG. A rationale for modifying the site of insertion of the orticochea pharyngoplasty. Plast Reconstr Surg 1984;73:882-94. https://doi.org/10.1097/00006534-198406000-00003
  9. Orticochea M. Construction of a dynamic muscle sphincter in cleft palates. Plast Reconstr Surg 1968;41:323-7. https://doi.org/10.1097/00006534-196804000-00005
  10. Chen PK, Wu JT, Chen YR, Noordhoff MS. Correction of secondary velopharyngeal insufficiency in cleft palate patients with the Furlow palatoplasty. Plast Reconstr Surg 1994;94:933-41. https://doi.org/10.1097/00006534-199412000-00005
  11. Lewin ML, Croft CB, Shprintzen RJ. Velopharyngeal insufficiency due to hypoplasia of the musculus uvulae and occult submucous cleft palate. Plast Reconstr Surg 1980;65:585-91. https://doi.org/10.1097/00006534-198005000-00008
  12. Yoshida H, Michi K, Ohsawa T. Prosthetic treatment for speech disorders due to surgically acquired maxillary defects. J Oral Rehabil 1990;17:565-71. https://doi.org/10.1111/j.1365-2842.1990.tb01427.x
  13. Finkelstein Y, Shifman A, Nachmani A, Ophir D. Prosthetic management of velopharyngeal insufficiency induced by uvulopalatopharyngoplasty. Otolaryngol Head Neck Surg 1995; 113:611-6. https://doi.org/10.1177/019459989511300514
  14. Conley SF, Gosain AK, Marks SM, Larson DL. Identification and assessment of velopharyngeal inadequacy. Am J Otolaryngol 1997;18:38-46. https://doi.org/10.1016/S0196-0709(97)90047-8
  15. Shifman A, Finkelstein Y, Nachmani A, Ophir D. Speech-aid prostheses for neurogenic velopharyngeal incompetence. J Prosthet Dent 2000;83:99-106. https://doi.org/10.1016/S0022-3913(00)70094-1
  16. Hubbard BA, Rice GB, Muzaffar AR. Adenoid involvement in velopharyngeal closure in children with cleft palate. Can J Plast Surg 2010;18:135-8. https://doi.org/10.1177/229255031001800402
  17. Rilo B, Fernandez-Formoso N, da Silva L, Pinho JC. A simplified palatal lift prosthesis for neurogenic velopharyngeal incompetence. J Prosthodont 2013;22:506-8. https://doi.org/10.1111/jopr.12024
  18. Henningsson G, Kuehn DP, Sell D, Sweeney T, Trost-Cardamone JE, Whitehill TL, et al. Universal parameters for reporting speech outcomes in individuals with cleft palate. Cleft Palate Craniofac J 2008;45:1-17. https://doi.org/10.1597/06-086.1
  19. Landis JR, Koch GG. The measurement of observer agreement for categorical data. Biometrics 1977;33:159-74. https://doi.org/10.2307/2529310
  20. Kao DS, Soltysik DA, Hyde JS, Gosain AK. Magnetic resonance imaging as an aid in the dynamic assessment of the velopharyngeal mechanism in children. Plast Reconstr Surg 2008; 122:572-7. https://doi.org/10.1097/PRS.0b013e31817d54d5
  21. Silver AL, Nimkin K, Ashland JE, Ghosh SS, van der Kouwe AJ, Brigger MT, et al. Cine magnetic resonance imaging with simultaneous audio to evaluate pediatric velopharyngeal insufficiency. Arch Otolaryngol Head Neck Surg 2011;137:258-63. https://doi.org/10.1001/archoto.2011.11
  22. Fletcher SG, Bishop ME. Measurement of nasality with tonar. Cleft Palate J 1970;7:610-21.
  23. Fletcher SG. "Nasalance" vs. listner judgements of nasality. Cleft Palate J 1976;13:31-44.
  24. Karnell MP. Instrumental assessment of velopharyngeal closure for speech. Semin Speech Lang 2011;32:168-78. https://doi.org/10.1055/s-0031-1277719
  25. Furlow LT Jr. Cleft palate repair by double opposing Z-plasty. Plast Reconstr Surg 1986;78:724-38. https://doi.org/10.1097/00006534-198678060-00002
  26. Furlow LT Jr. Flaps for cleft lip and palate surgery. Clin Plast Surg 1990;17:633-44.
  27. Woo AS, Skolnick GB, Sachanandani NS, Grames LM. Evaluation of two palate repair techniques for the surgical management of velopharyngeal insufficiency. Plast Reconstr Surg 2014;134:588e-596e. https://doi.org/10.1097/PRS.0000000000000506
  28. Jackson P, Whitaker LA, Randall P. Airway hazards associated with pharyngeal flaps in patients who have the Pierre Robin syndrome. Plast Reconstr Surg 1976;58:184-6. https://doi.org/10.1097/00006534-197608000-00007
  29. Kravath RE, Pollak CP, Borowiecki B, Weitzman ED. Obstructive sleep apnea and death associated with surgical correction of velopharyngeal incompetence. J Pediatr 1980;96:645-8. https://doi.org/10.1016/S0022-3476(80)80730-X
  30. Thurston JB, Larson DL, Shanks JC, Bennett JE, Parsons RW. Nasal obstruction as a complication of pharyngeal flap surgery. Cleft Palate J 1980;17:148-54.
  31. Valnicek SM, Zuker RM, Halpern LM, Roy WL. Perioperative complications of superior pharyngeal flap surgery in children. Plast Reconstr Surg 1994;93:954-8. https://doi.org/10.1097/00006534-199404001-00009
  32. Woo AS. Evidence-based medicine: cleft palate. Plast Reconstr Surg 2017;139:191e-203e. https://doi.org/10.1097/PRS.0000000000002854
  33. MacKenzie-Stepner K, Witzel MA, Stringer DA, Lindsay WK, Munro IR, Hughes H. Abnormal carotid arteries in the velocardiofacial syndrome: a report of three cases. Plast Reconstr Surg 1987;80:347-51. https://doi.org/10.1097/00006534-198709000-00002
  34. Lai JP, Lo LJ, Wong HF, Wang SR, Yun C. Vascular abnormalities in the head and neck area in velocardiofacial syndrome. Chang Gung Med J 2004;27:586-93.
  35. Even-Or E, Wohlgelernter J, Gross M. Medial displacement of the internal carotid arteries in velocardiofacial syndrome. Isr Med Assoc J 2005;7:749-50.
  36. James NK, Twist M, Turner MM, Milward TM. An audit of velopharyngeal incompetence treated by the orticochea pharyngoplasty. Br J Plast Surg 1996;49:197-201. https://doi.org/10.1016/S0007-1226(96)90050-8
  37. Stratoudakis AC, Bambace C. Sphincter pharyngoplasty for correction of velopharyngeal incompetence. Ann Plast Surg 1984;12:243-8. https://doi.org/10.1097/00000637-198403000-00005

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