Analysis of the effects of pharyngeal flap surgery on reducing hypernasality in patients with velopharyngeal insufficiency

Leila Sistani Karampour,Fatemeh Lalvand,Nader Saki,Soheila Nikakhlagh

doi:10.29333/ejgm/94223

Abstract

Background and Objectives:Velopharyngeal insufficiency (VPI) occurs in 25 to 43% of patients that undergo cleft palate repair. This disorder has a variety of signs including variations in nasal resonance (hypernasality), misarticulating, turmoil in nasal emissions, and grimacing. VPI can considerably affect social relations and the mental health of patients. Numerous methods have been developed for the treatment of VPI such as speech therapy, continuous positive airway pressure (CPAP), prosthetic treatment, and surgical interventions. The most common method, especially in the past three decades, has been the pharyngeal flap method. The objective of this study was to study the effects of the pharyngeal flap surgical method on the treatment of hypernasality which is a measureable sign of velopharyngeal insufficiency.Methods & Materials:In this cross-sectional study, a total of 112 patients with pharyngeal sphincter insufficiency who aged between 3 and 25 and had visited the otorhinolaryngology clinic of Imam Hospital of Ahvaz were studied from 2008 to 2015. The severity of hypernasality was measured by three speech therapists based on a universal parameter before the superior based pharyngeal flap surgery and 3 to 12 months after the surgery. The significance level for the aforementioned statistical tests was 0.05. Data was also analyzed using SPSS 16.Results:Following the superior based pharyngeal flap surgery, improved hypernasality, mild hypernasaliy, severe hypernasality, and hyponasality were observed in 42%, 6.44%, 6.11% and 8.1% of the patients, respectively. None of the 19-year old or older patients showed improvement of hyponasality and only patients aged between 3 and 6 years showed hyponasality. However, statistical analyses revealed that there was no significant difference between the responses of patients with different ages to treatment with superior based pharyngeal flap surgery (p=671).Conclusion:Results of the present study suggest that 12 months after pharyngeal flap surgery almost 87% of patients experience a complete or relative improvement of hypernasality. This finding complies with the findings of numerous previous studies.

Highlights

Cleft palate is one of the most common head and neck congenital diseases with a prevalence of one in every 700 live births
Numerous methods have been developed for the treatment of Velopharyngeal insufficiency (VPI) such as speech therapy, continuous positive airway pressure (CPAP), prosthetic treatment, and surgical interventions
109 patients had a history of cleft palate surgery and 3 patients had pharyngeal inadequacy and did not respond to speech therapy because of having a short soft palate and hypernasality

Summary

Introduction

Cleft palate is one of the most common head and neck congenital diseases with a prevalence of one in every 700 live births. Velopharyngeal insufficiency (VPI) occurs in 25 to 43% of patients that undergo cleft palate repair. This disorder has a variety of signs including variations in nasal resonance (hypernasality), misarticulating, turmoil in nasal emissions, and grimacing. Statistical analyses revealed that there was no significant difference between the responses of patients with different ages to treatment with superior based pharyngeal flap surgery (p=671). Conclusion: Results of the present study suggest that 12 months after pharyngeal flap surgery almost 87% of patients experience a complete or relative improvement of hypernasality. This finding complies with the findings of numerous previous studies

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Conclusion