Comparison between sphincter pharyngoplasty and a rolled pharyngeal myomucosal flap surgery for management of velopharyngeal incompetence

Abstract

Background Surgical techniques for velopharyngeal incompetence are directed at creating more favorable structure or function of the velopharyngeal mechanism to achieve an appropriate blend of oronasal resonance and eliminate nasal air emission. Purpose This study aimed to compare the functional outcome of sphincter pharyngoplasty and a rolled superiorly based myomucosal pharyngeal flap for surgical treatment of velopharyngeal incompetence. Patients and methods This study was conducted on a total number of 20 patients (11 male and nine9 female) with velopharyngeal insufficiency (VPI) with age ranging between 8 and 20 years. Patients were divided into two equal random groups according to the surgical technique used for correction of VPI. Group 1 comprised 10 patients with VPI were managed by sphincter pharyngoplasty and; group 2 comprised 10 patients with VPI were managed by a rolled superiorly based pharyngeal myomucosal flap. Perceptual evaluation of voice and nasopharyngoscopy were used for preoperative and postoperative assessment of velopharyngeal adequacy. Results Postoperative clinical evaluation for hypernasality revealed improvement of hypernasility in both patients group. Mean nasalance scores obtained in the postoperative evaluation revealed that both groups presented mean nasalance scores significantly lower than those obtained before surgery. Conclusion Sphincter pharyngoplasty and a rolled pharyngeal flap surgery were efficient in reducing hypernasality for treatment of VPI.