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velopharyngeal insufficiency

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https://www.readbyqxmd.com/read/28500805/unusual-otolaryngologic-manifestations-of-paracoccidioidomycosis-a-case-report-and-review-of-literature
#1
Lucas Resende Lucinda, José Fernando Polanski
AbstractParacoccidioidomycosis is a systemic mycosis caused by Paracoccidioides brasiliensis. It occurs more frequently in its chronic form, which particularly affects male adults from rural areas. These patients present with pulmonary involvement and systemic symptoms. Skin and mucosal lesions are rather typical and might suggest the diagnosis. The involvement of the upper airway mucosa is common and the patients usually complain of dysphagia and dysphonia. Nonetheless, in endemic areas, physicians should maintain a high level of suspicion even when faced with some atypical symptoms...
May 2017: American Journal of Tropical Medicine and Hygiene
https://www.readbyqxmd.com/read/28468158/velopharyngeal-insufficiency-after-le-fort-i-osteotomy-in-a-patient-with-undiagnosed-occult-submucous-cleft-palate
#2
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...
May 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28462671/the-impact-of-tympanostomy-tubes-on-speech-and-language-development-in-children-with-cleft-palate
#3
Amber D Shaffer, Matthew D Ford, Sukgi S Choi, Noel Jabbour
Objective Describe the impact of hearing loss, tympanostomy tube placement before palatoplasty, and number of tubes received on speech outcomes in children with cleft palate. Study Design Case series with chart review. Setting Tertiary care children's hospital. Subjects and Methods Records from 737 children born between April 2005 and April 2015 who underwent palatoplasty at a tertiary children's hospital were reviewed. Exclusion criteria were cleft repair at an outside hospital, intact secondary palate, absence of postpalatoplasty speech evaluation, sensorineural or mixed hearing loss, no tubes, first tubes after palatoplasty, or first clinic after 12 months of age...
April 1, 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/28460587/speech-outcomes-at-5-and-10-years-of-age-after-one-stage-palatal-repair-with-muscle-reconstruction-in-children-born-with-isolated-cleft-palate
#4
Jill Nyberg, Erik Neovius, Anette Lohmander
BACKGROUND: The aim of this study was to investigate speech outcomes in children with clefts in the hard and/or soft palate only (CPH/CPS), in order to determine the prevalence of cleft speech characteristics, the change between 5 and 10 years of age, and the difference in occurrence between CPH and CPS. METHODS: A consecutive series of 88 children born with CPH or CPS were included in a retrospective cohort. All participants were treated with one-stage palatal repair using a minimal incision technique with muscle reconstruction (mean age 13 months)...
May 2, 2017: Journal of Plastic Surgery and Hand Surgery
https://www.readbyqxmd.com/read/28390603/velopharyngeal-insufficiency-managed-by-autologous-fat-grafting-in-patients-with-aberrant-courses-of-internal-carotid-arteries
#5
Emilie Bois, Charlotte Celerier, Kahina Belhous, Michel Maulet, Nicolas Leboulanger, Noël Garabedian, Françoise Denoyelle
INTRODUCTION: Velopharyngeal insufficiency (VPI) is usually managed, besides speech therapy, by performing a velopharyngoplasty. An alternative approach is autologous fat grafting (AFG) of the posterior pharyngeal wall. About 5% of the population has internal carotid arteries (ICA) with an aberrant course. This anatomic variation can be responsible for surgical difficulties while when performing a velopharyngoplasty, and therefore lead surgeons to only consider a speech reeducation of VPI...
May 2017: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/28381372/investigation-of-the-speech-results-of-posterior-pharyngeal-wall-augmentation-with-fat-grafting-for-treatment-of-velopharyngeal-insufficiency
#6
Çağla Dinsever Eliküçük, Maviş Emel Kulak Kayıkcı, Fatma Esen Aydınlı, Mert Çalış, Fatma Figen Özgür, Mehtap Öztürk, Rıza Önder Günaydın
PURPOSE: The purpose of this study was to evaluate the speech results of posterior pharyngeal wall augmentation (PPWA) with fat grafting both in the early and late postoperative period, and to clarify the impact of the procedure concomitant with speech therapy. MATERIALS AND METHODS: This is a prospective case-control study. The study involved 87 cleft palate ± cleft lip patients with velopharyngeal insufficiency (VPI) who has been treated with PPWA. Patients were separated into two groups according to age; the first group consisted of 49 pediatric participants between 6 and 12 years of age and the second group consisted of 38 adolescent participants between 13 and 18 years of age...
March 6, 2017: Journal of Cranio-maxillo-facial Surgery
https://www.readbyqxmd.com/read/28326707/-morphological-classification-and-velopharyngeal-function-analysis-of-submucous-cleft-palate-patients
#7
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
#8
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...
May 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
#9
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
#10
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
#11
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
#12
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
#13
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
#14
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...
April 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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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