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velopharyngeal insufficiency

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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
#1
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
#2
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
#3
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
#4
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
#5
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)...
December 28, 2016: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28027255/evidence-based-medicine-cleft-palate
#6
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
#7
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...
December 22, 2016: JAMA Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/27939039/velopharyngeal-insufficiency-treated-with-levator-muscle-repositioning-and-unilateral-myomucosal-buccinator-flap
#8
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
#9
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
#10
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
#11
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
#12
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
#13
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
#14
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
#15
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
https://www.readbyqxmd.com/read/27669372/tooth-borne-anterior-maxillary-distraction-for-cleft-maxillary-hypoplasia-our-experience-with-147-patients
#16
Sunil Richardson, Dhivakar Selvaraj, Rakshit V Khandeparker, Nikkie S Seelan, Shweta Richardson
PURPOSE: To evaluate the results of anterior maxillary distraction for its efficacy and long-term stability in the management of cleft maxillary hypoplasia in a large series of patients with a long-term follow-up extending to 4 years. MATERIALS AND METHODS: One hundred sixty-four patients at least 10 years old with cleft maxillary hypoplasia who presented to the authors' unit from January 2009 through October 2014 were evaluated retrospectively, irrespective of gender, type of cleft lip and palate, and amount of advancement needed...
December 2016: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/27619042/velopharyngeal-videofluoroscopy-providing-useful-clinical-information-in-the-era-of-reduced-dose-radiation-and-safety
#17
Pablo Antonio Ysunza, David Bloom, Kongkrit Chaiyasate, Matthew Rontal, Rachel VanHulle, Kenneth Shaheen, Donald Gibson
BACKGROUND: The state of the art for correcting velopharyngeal insufficiency (VPI) is a surgical procedure which is customized according to findings on imaging procedures: multiplanar videofluoroscopy (MPVF) and flexible videonasopharyngoscopy (FVNP). Recently, the use of MPVF has been challenged because of the potential risk of using ionizing radiation, especially in children. OBJECTIVE: To study whether using a protocol for performing MPVF can effectively decrease radiation dose in patients with VPI while providing useful information for planning surgical correction of VPI in combination with FVNP...
October 2016: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/27617133/a-case-of-concurrent-miller-dieker-syndrome-17p13-3-deletion-and-22q11-2-deletion-syndrome
#18
Paldeep S Atwal, C Macmurdo
Features of Miller-Dieker syndrome (MDS, 17p13.3 deletion syndrome, LIS1-associated lissencephaly) include classic lissencephaly, microcephaly, cardiac malformations, growth restriction, and characteristic facial changes. Individuals with 22q11.2 deletion syndrome (DiGeorge syndrome or velocardiofacial syndrome) are known to have congenital cardiac malformations (in particular conotruncal defects), palatal abnormalities (especially velopharyngeal insufficiency), hypocalcemia, immune deficiency, learning disabilities, and characteristic facial features...
December 2015: Journal of Pediatric Genetics
https://www.readbyqxmd.com/read/27585294/augmentation-pharyngoplasty-for-treatment-of-velopharyngeal-insufficiency-in-children-results-with-injectable-dextranomer-and-hyaluronic-acid-copolymer
#19
Shelagh A Cofer, Becky Baas, Edythe Strand, Cara C Cockerill
OBJECTIVES/HYPOTHESIS: To evaluate the effectiveness, durability, and safety of a tissue filler (dextranomer and hyaluronic acid copolymer) when injected submucosally in the nasopharynx to treat velopharyngeal insufficiency (VPI) in pediatric patients. STUDY DESIGN: Retrospective case series. METHODS: Charts were reviewed for all patients treated with injectable filler at a tertiary children's center for VPI from April 2010 through September 2013...
September 1, 2016: Laryngoscope
https://www.readbyqxmd.com/read/27553116/-secondary-treatment-of-cleft-lip-and-palate
#20
J C Talmant, J C Talmant, J P Lumineau
For 18 years our protocol has corrected the cleft lip nose and achieved an intravelar veloplasty at the time of the first operation, leaving the least scaring as possible. No doubt that the best treatment of the sequellae is their prevention: - the oro-nasal fistulas have disappeared; the nostril is almost normal; the continuity of a wide maxillary arch is restored in primary dentition - all that favor a nasal ventilation. This context has changed the nature of the secondary treatment described here. When lip and nose are not good enough we must address the residual deformities with the primary surgery principles...
October 2016: Annales de Chirurgie Plastique et Esthétique
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