<< Back to the abstract archive
The Non-tailored Superiorly-based Pharyngeal Flap for the Management of Velopharyngeal Incompetence
Mahmoud Hassouba, Suma Yalamanchilli, David Billmire, John van Aalst, Ann Kummer, Haithem Elhadi Babiker, Brian Pan..
Cincinnati Children's Hospital Medical Center
2016-01-31
Presenter: Mahmoud Hassouba
Affidavit:
Fully involved in the process of data gathering and analysis as well as writing the abstract.
Director Name: Brian Pan
Author Category: Fellow Plastic Surgery
Presentation Category: Clinical
Abstract Category: Craniomaxillofacial
Background and Purpose
The superiorly based pharyngeal flap is considered the gold standard for the management of velopharyngeal incompetence (VPI) following palatoplasty. Alternative techniques have been proposed to reduce the frequency of obstructive sleep apnea (OSA). The purpose of this study was to evaluate the outcomes of a single surgeon's long-term experience with a non-tailored superiorly based pharyngeal flap for the treatment of VPI in non-syndromic patients following palatoplasty.
Methods
In this retrospective cohort study, 150 non-syndromic patients who underwent palatoplasty from 1999 to 2013 underwent a non-tailored superiorly based pharyngeal flap by a single surgeon. The main outcome measures included resolution of VPI, revision rates, and the development of postoperative complications including sleep apnea.
Results
Velopharyngeal incompetence was resolved in 83% of patients following the initial surgery. Revisions were required in 11% of patients resulting in an overall success rate of 94%. Only 3% of patients required opening of the lateral pharyngeal ports due to hyponasality. 23% of patients had symptoms concerning enough to prompt further investigation with polysomnography and 20% were diagnosed with sleep apnea however only 11% of patients required positive pressure therapy and ultimately 4% required takedown of their flaps.
Conclusions
A non-tailored superiorly-based pharyngeal flap is an effective technique for treating VPI after palatoplasty with a success and complication rate comparable to other reports. Given the frequency of revisions required to narrow the ports in this series, a wide flap should be considered for all cases to adequately address VPI
