Comparison of Pharyngeal Flap and Sphincter Pharyngoplasty for Velopharyngeal Insufficiency-A Retrospective Study

Abstract

Purpose: Velopharyngeal insufficiency (VPI) is incomplete closure of the velopharyngeal space causing hypernasal resonance during phonation. Both pharyngeal flap (PF) and sphincter pharyngoplasty (SP) had been used for the correction of VPI in the Craniofacial Center, Chang Gung Memorial Hospital. The purpose of this study is to compare the effectiveness and complication between the PF and SP. Material and Method: Eighty-seven patients underwent pharyngeal flap or sphincter pharyngoplasty for VPI between June of 1995 and August of 2001. Seventy-one patients of them who had complete preoperative and follow-up evaluations were included. The follow-up period ended at October of 2006. All operations were done by one surgeon. Standard speech evaluation was performed. Results: Overall speech outcome and success rate was 68%. No significant difference on the speech outcome was found between the PF group and SP groups (chi-square test, p=0.419). Overall nasal airway obstruction rate was 14%. However, a significant difference on airway obstruction was noted between the PF group and SP group (chi-square test, p=0.015). Lower incidence of airway obstruction occurred in PF group. A concomitant finding revealed that a better speech result was achieved in patients who received the VPI surgery at an age younger than 6 years. Conclusion: This study showed that, in the authors' center, the PF is a better choice than SP for the correction of VPI.