Pattern of velopharyngeal valve closure in patients with cleft palate after primary cleft palate repair: A cross-sectional nasoendoscopic analysis

Abstract

ABSTRACT Background: The velopharyngeal valve (VPV) consists of the velum, lateral pharyngeal walls, and posterior pharyngeal walls. Velopharyngeal (VP) closure is required during attempted phonation, deglutition, and sucking, and serves to prevent nasal regurgitation of fluids or solids that are normally delivered to the oropharynx. Objectives: This study aimed to identify the patterns of VPV closure in children with cleft palate (CP) who had palatal repair done and to determine the relationship between surgical technique and pattern of closure. Patients and Methods: This study was conducted in the nasoendoscopy room of the Orofacial Cleft Clinic, Lagos University Teaching Hospital. All patients with nonsyndromic cleft lip and palate or isolated CP who had palatal repair done at age 12 months and above with either von Langenbeck, Bardach, or Furlow’s techniques were included in this review. All patients were examined using a flexible fiber-optic nasoendoscope. Results: There were 35 patients who had nasoendoscopy done and met the inclusion criteria. The most common pattern of closure of the VP mechanism in patients examined by nasoendoscopy was circular (48.6%), followed by coronal (37.1%). von Langenbeck’s technique had the highest frequency in all patterns of closure though this was not statistically significant (P = 0.47). Both von Langenbeck and Bardach techniques had both coronal and circular as their most common closure patterns, while Furlow’s had the circular as the most common pattern of closure. Conclusion: The most common pattern of closure of the VP mechanism in patients who had CP repair in this study was circular and there was no apparent relationship between the surgical technique of repair and pattern of closure.