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velopharyngeal insufficiency

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https://www.readbyqxmd.com/read/28326707/-morphological-classification-and-velopharyngeal-function-analysis-of-submucous-cleft-palate-patients
#1
Yin Heng, Guo Chunli, Shi Bing, Li Yang, Li Jingtao
OBJECTIVE: To enhance the accuracy in diagnosis and management of submucous cleft palate via a thorough analysis of its anatomical and functional details. METHODS: Two hundred seventy-six submucous cleft palate cases from 2008 to 2014 were retrospectively investigated. Subgroup analysis were performed on the basis of preoperative velopharyngeal function, palatal morphology, cleft lip concurrence, and patient motives for treatment. RESULTS: Among the included cases, 96 (34...
October 1, 2016: Hua Xi Kou Qiang Yi Xue za Zhi, Huaxi Kouqiang Yixue Zazhi, West China Journal of Stomatology
https://www.readbyqxmd.com/read/28325564/the-effect-of-age-at-surgery-and-compensatory-articulation-on-speech-outcome-in-submucous-cleft-palate-patients-treated-with-double-opposing-z-plasty-a-10-year-experience
#2
Rong-Min Baek, Baek-Kyu Kim, Jae Hoon Jeong, Taeseon Ahn, Mikyong Park, Jihyeon Han
BACKGROUND: Submucous cleft palate is a congenital deformity that may present as velopharyngeal insufficiency. The degree of anatomical abnormality varies widely among patients and does not predict severity of symptom. We present our 10-year experience treating submucous cleft palate patients with double opposing z-plasty and explore the effect of age at surgery and compensatory articulation on speech. METHODS: Preoperative assessment included intraoral examination, nasoendoscopy, and perceptual speech evaluation...
March 7, 2017: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/28289675/humoral-immunodeficiency-with-hypotonia-feeding-difficulties-enteropathy-and-mild-eczema-caused-by-a-classical-foxp3-mutation
#3
Paul Tuijnenburg, Eloy Cuadrado, Annet M Bosch, Angelika Kindermann, Machiel H Jansen, Marielle Alders, Ester M M van Leeuwen, Taco W Kuijpers
We describe here the case of a boy who presented with pulmonary infections, feeding difficulties due to velopharyngeal insufficiency and gastroesophageal reflux, myopathy, and hypotonia soon after birth. Later, he was also found to have an elevated immunoglobulin (Ig) E and mild eczema and was diagnosed with inflammatory bowel disease. Further immunological screening at the age of 7 years showed low B and NK cell numbers but normal CD4(+) and CD8(+) T cells and notably, normal numbers of CD4(+) regulatory T (Treg) cells...
2017: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/28279195/post-operative-outcomes-after-cleft-palate-repair-in-syndromic-and-non-syndromic-children-a-systematic-review-protocol
#4
Zach Zhang, Michael Stein, Nigel Mercer, Claudia Malic
BACKGROUND: There is a lack of high-level evidence on the surgical management of cleft palate. An appreciation of the differences in the complication rates between different surgical techniques and timing of repair is essential in optimizing cleft palate management. METHOD: A comprehensive electronic database search will be conducted on the complication rates associated with cleft palate repair using MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials...
March 9, 2017: Systematic Reviews
https://www.readbyqxmd.com/read/28253654/automatic-identification-of-hypernasality-in-normal-and-cleft-lip-and-palate-patients-with-acoustic-analysis-of-speech
#5
Marzieh Golabbakhsh, Fatemeh Abnavi, Mina Kadkhodaei Elyaderani, Fatemeh Derakhshandeh, Fatemeh Khanlar, Panying Rong, David P Kuehn
Hypernasality is seen in cleft lip and palate patients who had undergone repair surgery as a consequence of velopharyngeal insufficiency. Hypernasality has been studied by evaluation of perturbation, noise measures, and cepstral analysis of speech. In this study, feature extraction and analysis were performed during running speech using six different sentences. Jitter, shimmer, Mel frequency cepstral coefficients, bionic wavelet transform entropy, and bionic wavelet transform energy were calculated. Support vector machines were employed for classification of data to normal or hypernasal...
February 2017: Journal of the Acoustical Society of America
https://www.readbyqxmd.com/read/28212126/comparison-of-the-speech-results-after-correction-of-submucous-cleft-palate-with-furlow-palatoplasty-and-pharyngeal-flap-combined-with-intravelar-veloplasty
#6
Mert Calis, Galip Gencay Ustun, Mehtap Ozturk, Riza Onder Gunaydin, Mavis Emel Kulak Kayikci, Figen Ozgur
Submucous cleft palate (SMCP) is a relatively rare variant of the common pathology of cleft palate with specific anatomic and clinical features. Even though there are many surgical options defined previously to correct the SMCP, correction of the velopharyngeal insufficiency and obtaining ideal speech results remains as a challenge. The aim of this article was to compare the speech benefits of Furlow double opposing Z plasty and posterior pharyngeal flap operation combined with intravelar veloplasty for the correction of SMCP using objective assessment tools...
February 16, 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28140670/speech-in-adults-treated-for-unilateral-cleft-lip-and-palate-long-term-follow-up-after-one-or-two-stage-palate-repair
#7
Staffan Morén, Maria Mani, Stålhammar Lilian, Per Åke Lindestad, Mats Holmström
OBJECTIVE:   To evaluate speech in adults treated for unilateral cleft lip and palate with one-stage or two-stage palate closure and compare the speech of the patients with that of a noncleft control group. DESIGN:   Cross-sectional study with long-term follow-up. PARTICIPANTS/SETTING:   All unilateral cleft lip and palate patients born from 1960 to 1987 and treated at Uppsala University Hospital, Sweden, were invited (n = 109). Participation rate was 67% (n = 73) at a mean of 35 years after primary surgery...
January 31, 2017: Cleft Palate-craniofacial Journal
https://www.readbyqxmd.com/read/28116979/long-term-incidence-of-velopharyngeal-insufficiency-and-other-sequelae-following-uvulopalatopharyngoplasty
#8
Jessica A Tang, Anna M Salapatas, Lauren B Bonzelaar, Michael Friedman
Objective The aim of this study is to (1) assess incidence of long-term velopharyngeal insufficiency (VPI) and (2) determine other sequelae following classic and modified uvulopalatopharyngoplasty (UPPP and mUPPP) for treatment of obstructive sleep apnea (OSA). Data Sources Medline, PubMed, Cochrane Library database. Review Methods A systematic review was performed following standard Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. Original research articles reporting on sequelae of UPPP and mUPPP for treatment of OSA, at a mean of 1 year follow-up, were included...
January 1, 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/28106695/velopharyngeal-insufficiency-after-le-fort-i-osteotomy-in-a-patient-with-undiagnosed-occult-submucous-cleft-palate
#9
Rushil R Dang, Bonnie L Padwa, Cory M Resnick
The authors present a 16-year-old patient with no known history of cleft palate who developed velopharyngeal insufficiency after a Le Fort I osteotomy performed for the correction of maxillary hypoplasia and a Class III malocclusion. Postoperative evaluation revealed the presence of velopharyngeal insufficiency and subtle findings of an occult submucous cleft palate. She had a pharyngeal flap 6 months later with successful correction of the velopharyngeal insufficiency. This case illustrates the need to screen for submucous cleft palate prior to orthognathic surgery...
January 18, 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28033190/modified-superior-based-pharyngeal-flap-is-effective-in-treatment-of-velopharyngeal-insufficiency-regardless-of-the-preoperative-closure-pattern
#10
Omer Ekin, Mert Calis, Mavis Emel Kulak Kayikci, Mehtap Icen, Riza Onder Gunaydin, Figen Ozgur
Velopharyngeal insufficiency (VPI) is certainly one of the most important problems confronted after cleft palate repairs. In this study, it was aimed to evaluate the preoperative and postoperative speaking results of patients who underwent modified superior-based pharyngeal flap. Sixty-six children who underwent modified superiorly based pharyngeal flap for treatment of VPI between 2005 and 2013 were retrospectively reviewed. The study population was evaluated in 2 distinctive groups depending on their preoperative velopharyngeal closure pattern as: coronal closure pattern or noncoronal closure patterns (ie, circular, sagittal with or without the presence of a Passavant ridge)...
March 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28027255/evidence-based-medicine-cleft-palate
#11
Albert S Woo
LEARNING OBJECTIVES: After studying this article, the participant should be able to: 1. Describe the incidence of cleft palate and risk factors associated with development of an orofacial cleft. 2. Understand differences among several techniques to repair clefts of both the hard and soft palates. 3. Discuss risk factors for development of postoperative fistulas, velopharyngeal insufficiency, and facial growth problems. 4. Establish a treatment plan for individualized care of a cleft palate patient...
January 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28006043/health-care-resource-use-in-patients-with-and-without-22q11-2-deletion-syndrome-undergoing-sphincter-pharyngoplasty-for-velopharyngeal-insufficiency
#12
Darrell T Wright, Shaun A Nguyen, Ronald J Teufel, David R White
Importance: The use of health care resources in patients with velopharyngeal insufficiency undergoing sphincter pharyngoplasty is unknown. Objectives: To examine the use of health care resources by patients with velopharyngeal insufficiency who have undergone sphincter pharyngoplasty and investigate whether patients with 22q11.2 deletion syndrome (22qDS) had a longer length of stay, increased cost of admission, and higher number of complications. Design, Setting, and Participants: Using data from the Kids' Inpatient Database for January 1 to December 31, 2012, we retrospectively analyzed all patients undergoing pharyngoplasty for velopharyngeal insufficiency...
March 1, 2017: JAMA Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/27939039/velopharyngeal-insufficiency-treated-with-levator-muscle-repositioning-and-unilateral-myomucosal-buccinator-flap
#13
Robrecht J H Logjes, Maaike T A van den Aardweg, Meike M J Blezer, Anne M B van der Heul, Corstiaan C Breugem
PURPOSE: Velopharyngeal insufficiency (VPI) is common (20-30%) after cleft palate closure. The myomucosal buccinator flap has become an important treatment option for velopharyngeal insufficiency; however, published studies all use bilateral buccinator flaps. This study assesses outcomes with a unilateral myomucosal buccinator flap that might result in less operating time and might prevent the need of a bite block and an extra procedure for division of the flap pedicle at a later stage...
January 2017: Journal of Cranio-maxillo-facial Surgery
https://www.readbyqxmd.com/read/27790589/the-soft-palate-friendly-speech-bulb-for-velopharyngeal-insufficiency
#14
Sukhdeep Singh Kahlon, Monaliza Kahlon, Shilpa Gupta, Parvinder Singh Dhingra
Velopharyngeal insufficiency is an anatomic defect of the soft palate making palatopharyngeal sphincter incomplete. It is an important concern to address in patients with bilateral cleft lip and palate. Speech aid prosthesis or speech bulbs are best choice in cases where surgically repaired soft palate is too short to contact pharyngeal walls during function but these prosthesis have been associated with inadequate marginal closure, ulcerations and patient discomfort. Here is a case report of untreated bilateral cleft lip and palate associated with palatal insufficiency treated by means of palate friendly innovative speech bulb...
September 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/27787538/injection-pharyngoplasty-with-autologous-fat-as-treatment-for-stress-velopharyngeal-insufficiency-in-brass-and-woodwind-musicians
#15
Mausumi N Syamal, Paul C Bryson
Importance: Stress velopharyngeal insufficiency (SVPI) is an uncommon but often career-threatening condition affecting professional brass and woodwind musicians. Objectives: To review the evaluation of and treatment for SVPI in professional musicians with lipoinjection to the posterior pharyngeal wall. Design, Setting, and Participants: A retrospective medical record and literature review. Two professional musicians with SVPI treated with autologous lipoinjection to the posterior pharyngeal wall were included...
February 1, 2017: JAMA Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/27763974/superiorly-based-pharyngeal-flap-for-the-surgical-treatment-of-velopharyngeal-insufficiency-and-speech-outcomes
#16
Cori Rogers, Petros Konofaos, Robert D Wallace
A retrospective chart review comparing pre and postoperative speech in 19 patients who underwent pharyngeal flap surgery for the diagnosis of velopharyngeal insufficiency. Eighteen of the patients had a history of cleft palate. Patients were assigned a speech grade between 1 and 5 based on the objective and subjective quality of their speech. Comparison of pre and postoperative speech showed significant improvement in speech quality from a mean grade of 3.37 to 2.00 (P < 0.001). This study demonstrates that a wide, superiorly based pharyngeal flap did lead to significant improvement in speech outcomes in this group of patients independent of gender or age...
October 2016: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/27750489/isolated-cleft-palate-requires-different-surgical-protocols-depending-on-cleft-type
#17
Anna Elander, Christina Persson, Jan Lilja, Hans Mark
A staged protocol for isolated cleft palate (CPO), comprising the early repair of the soft palate at 6 months and delayed repair of the eventual cleft in the hard palate until 4 years, designed to improve maxillary growth, was introduced. CPO is frequently associated with additional congenital conditions. The study evaluates this surgical protocol for clefts in the soft palate (CPS) and for clefts in the hard and soft palate (CPH), with or without additional malformation, regarding primary and secondary surgical interventions needed for cleft closure and for correction of velopharyngeal insufficiency until 10 years of age...
October 18, 2016: Journal of Plastic Surgery and Hand Surgery
https://www.readbyqxmd.com/read/27727413/improvement-of-quality-of-speech-in-patients-with-velo-pharyngeal-insufficiency-corrected-using-a-buccinator-myomucosal-flap
#18
D K Dias, P D Fernando, R D Dissanayake
INTRODUCTION: Oro-facial clefts involving the palate is the commonest structural defect causing velopharyngeal insufficiency (VPI) and poor intelli gibility of speech. Proper repair of the soft palateis a surgical challenge. Posterior-based buccinator myomucosal flap (BMF) is used to lengthen the soft palate of patients who undergo primary palatoplasty at Teaching Hospital, Karapitiya (THK). BMF is a good choice for the repair of medium sized mucosal defects in the oral cavity since it has appropriate thickness, contains mucous membrane with mucous glands and has a rich blood supply...
2016: Ceylon Medical Journal
https://www.readbyqxmd.com/read/27712812/evaluation-of-speech-and-resonance-for-children-with-craniofacial-anomalies
#19
REVIEW
Ann W Kummer
Children with craniofacial anomalies often demonstrate disorders of speech and/or resonance. Anomalies that affect speech and resonance are most commonly caused by clefts of the primary palate and secondary palate. This article discusses how speech-language pathologists evaluate the effects of dental and occlusal anomalies on speech production and the effects of velopharyngeal insufficiency on speech sound production and resonance. How to estimate the size of a velopharyngeal opening based on speech characteristics is illustrated...
November 2016: Facial Plastic Surgery Clinics of North America
https://www.readbyqxmd.com/read/27711915/palatal-motion-after-primary-and-secondary-furlow-palatoplasty
#20
Pamela A Rudnicki, Christopher Tsang, Mark A Vecchiotti, Andrew R Scott
Importance: Indications for Furlow palatoplasty include primary repair of cleft palate as well as secondary repair, or secondary palatoplasty for treatment of velopharyngeal insufficiency. Speculation exists surrounding the benefit of secondary Furlow palatoplasty in cases of a previously well-reconstructed palate or a short but otherwise anatomically normal soft palate because it has been theorized that reorientation of a previously reconstructed or normal muscular levator sling should in fact worsen palatal motion...
February 1, 2017: JAMA Otolaryngology—Head & Neck Surgery
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