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https://www.readbyqxmd.com/read/27790589/the-soft-palate-friendly-speech-bulb-for-velopharyngeal-insufficiency
#1
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
#2
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...
October 27, 2016: 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
#3
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
#4
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
#5
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
#6
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
#7
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...
October 6, 2016: 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
#8
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
#9
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
#10
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
#11
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
#12
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
https://www.readbyqxmd.com/read/27526237/perforation-with-submucosal-cleft-palate-in-a-previously-undiagnosed-adult-patient
#13
Şeyda Güray Evin, Mehtap Karamese, Osman Akdag, Muhammed Nebil Selimoglu, Zekeriya Tosun
Perforation with a submucosal cleft palate (SMCP) is a rare condition with a limited number of cases reported in the literature. However, most described cases include neonates and infants, but not cases due to trauma or infection. Here, we present a case of an adult patient with SMCP with a perforation of the palate who was undiagnosed. In light of this case, diagnosis and treatment of perforation in SMCP are presented. A new diagram that can be used in the management of these patients with velopharyngeal insufficiency is proposed...
October 2016: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/27497383/speech-outcomes-in-children-with-22q11-2-deletion-syndrome-following-surgery-for-velopharyngeal-insufficiency
#14
Pawina Jiramongkolchai, Manvinder S Kumar, Derrick Sowder, Sivakumar Chinnadurai, Christopher T Wootten, Steven L Goudy
OBJECTIVE: The purpose of this study was to identify prognostic factors associated with improved speech outcomes following surgical correction for velopharyngeal insufficiency (VPI) in pediatric patients with 22q11.2 deletion syndrome (22q11DS). METHODS: Eighteen patients were identified via retrospective chart review of patients with 22q11DS between 2005 and 2014. Patient characteristics, medical histories, associated comorbidities, surgical procedures, and pre- and postoperative perceptual hypernasality (subjectively rated 1-5 with 5 being the most severe) were gathered for each patient...
September 2016: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/27465191/a-treatment-protocol-for-velopharyngeal-insufficiency-and-the-outcome
#15
Kazuaki Yamaguchi, Daniel Lonic, Che-Hsiung Lee, Shu-Hui Wang, Claudia Yun, Lun-Jou Lo
BACKGROUND: A simple algorithm is applied to treat velopharyngeal insufficiency. The purpose of this study was to assess its success rate and complications. METHODS: The diagnosis includes speech perceptual assessment and nasopharyngoscopy, focusing on velopharyngeal closure ratio. The treatment is composed of a double-opposing Z-plasty for marginal velopharyngeal insufficiency or a pharyngeal flap for moderate to severe velopharyngeal insufficiency. A retrospective chart review was conducted for 84 consecutive nonsyndromic postpalatoplasty patients undergoing velopharyngeal insufficiency surgery from August of 2007 to December of 2014...
August 2016: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/27442001/transoral-and-transnasal-odontoidectomy-complications-a-systematic-review-and-meta-analysis
#16
Michael F Shriver, Varun R Kshettry, Raj Sindwani, Troy Woodard, Edward C Benzel, Pablo F Recinos
OBJECT: The craniovertebral junction (CVJ) is a complex region of the spine with unique anatomical and functional relationships. To alleviate symptoms associated with pathological processes involving the odontoid process, decompression is often required, including odontoidectomy. Accurate knowledge of the complication rates following the transoral and transnasal techniques is essential for both patients and surgeons. METHODS: We conducted MEDLINE, Scopus and Web of Science database searches for studies reporting complications associated with the transoral and transnasal techniques for odontoidectomy...
September 2016: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/27399450/171%C3%A2-resurgery-in-craniovertebral-junction-abnormalities
#17
Pavaman Pandit Sindgikar, Kuntal Kanti Das, Awadesh K Jaiswal, Rabi Narayan Sahu, Arun K Srivastava, Anant Mehrotra, Jayesh Chunilal Sardhara, Kamlesh Singh Bhaisora, Sanjay Behari
INTRODUCTION: Surgery for craniovertebral junction (CVJ) abnormalities like atlantoaxial dislocation (AAD) with or without basilar invagination (BI) and/or with or without associated Arnold-Chiari malformation (ACM) cause high cervical myelopathy. Occasionally, mechanical factors such as inadequate canal decompression, torticollis, and/or scoliosis may lead to lack of improvement following the primary surgery. Also, implant-related factors requiring its revision/removal or surgical site infections may cause patient to undergo resurgery...
August 2016: Neurosurgery
https://www.readbyqxmd.com/read/27391499/the-management-of-iatrogenic-obstructive-sleep-apnoea-syndrome-following-bimaxillary-surgery-in-a-patient-with-cleft-lip-and-palate
#18
Giovanni Gerbino, Fernando Carmine Gervasio, John Blythe, Francesca Antonella Bianchi
A 26-year-old man presented with a 6-year history of severe obstructive sleep apnoea syndrome followed a bimaxillary osteotomy procedure for a class III skeletal pattern. The patient was born with a unilateral cleft lip and palate and underwent primary lip and palate repair and later a pharyngeal flap for severe velopharyngeal insufficiency. Surgical management of obstructive sleep apnoea syndrome with conventional osteotomy, in cleft lip and palate patients, is a difficult problem. Distraction osteogenesis may provide a safer alternative...
July 2016: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/27345603/oculo-auriculo-vertebral-spectrum-with-myopathy-and-velopharyngeal-insufficiency-a-case-report-with-a-non-branchiomeric-muscle-biopsy
#19
Giovanni Murialdo, Attilia Piazzi, Giuseppe Badolati, Enrico Calcagno, Agostino Berio
In the present paper we report on a case of oculo-auriculo-vertebral spectrum presenting fluorescence in situ hybridization and comparative genomic hybridization tests negative, hypotonia of some branchiomeric muscles (with velo-pharyngeal insufficiency, dysphagia and nasal voice) and non-branchiomeric muscles (with strabismus and limb hypotrophy). On the basis of the left quadriceps muscle biopsy, showing anisometry and prevalence of type 1 fibers, and on literature data, we underline the relevance of TBX1 gene (regulator of neural crest cells and activator of myogenic factors in branchiomeric muscles development) and of PAX3 gene (present in neural crest, inducing migration of these cells and reported in non-branchiomeric muscles)...
2016: La Pediatria Medica e Chirurgica: Medical and Surgical Pediatrics
https://www.readbyqxmd.com/read/27260592/speech-characteristics-after-articulation-therapy-in-children-with-cleft-palate-and-velopharyngeal-dysfunction-a-single-case-experimental-design
#20
Fatemeh Derakhshandeh, Mohammadreza Nikmaram, Hedieh Hashemi Hosseinabad, Mehrdad Memarzadeh, Masoud Taheri, Mohammadreza Omrani, Shohreh Jalaie, Mahmood Bijankhan, Debbie Sell
OBJECTIVE: The aim of this study was to investigate the impact of an intensive 10-week course of articulation therapy on articulation errors in cleft lip and palate patients who have Velopharyngeal Insufficiency (VPI), non-oral and passive cleft speech characteristics. METHODS: Five children with cleft palate (+/-cleft lip) with VPI and non-oral and passive cleft speech characteristics underwent 40 intensive articulation therapies over 10 weeks in a single case experimental design...
July 2016: International Journal of Pediatric Otorhinolaryngology
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