keyword
https://read.qxmd.com/read/38113420/indications-for-furlow-s-double-opposing-z-plasty-in-patients-with-velopharyngeal-insufficiency-following-two-flap-palatoplasty
#21
JOURNAL ARTICLE
Tae Hyun Park, Hyun Su Kang, Jeong Yeop Ryu, Joon Seok Lee, Jung Dug Yang, Ho Yun Chung, Kang Young Choi
BACKGROUND: Various surgical methods have been developed for treating velopharyngeal insufficiency (VPI); however, the choice of surgical treatment is controversial. Pharyngeal flap, which is commonly used, has a high success rate but frequently leads to airway complications. Furlow's double-opposing Z-plasty (DOZ) does not deform the velopharyngeal port; therefore, it is expected to show good speech outcomes while reducing airway complications if an appropriate indication is noted. This study aimed to identify indications for DOZ in cases of VPI following palatoplasty...
December 19, 2023: Plastic and Reconstructive Surgery
https://read.qxmd.com/read/38086325/pharyngeal-flap-outcomes-for-velopharyngeal-insufficiency-evaluation-of-speech-obstructive-sleep-apnea-and-velopharyngeal-anatomy
#22
JOURNAL ARTICLE
Etkin Boynuyoğun, Alaz Çırak, Fırat Atak, Tuğçe Karahan Tığrak, Mert Çalış, Rıza Önder Günaydın, Ayça Karaosmanoğlu, Ahmet Emre Süslü, Maviş Emel Kulak Kayıkçı, Figen Özgür
The purpose of this study was to evaluate the speech outcomes, reveal postoperative rates of obstructive sleep apnea, and characterize changes in the pharyngeal flap and velopharyngeal anatomy following pharyngeal flap surgery for velopharyngeal insufficiency. A retrospective chart was reviewed for patients with clefts who underwent pharyngeal flap surgery between November 2020 and November 2021. The data collected included age, gender, cleft palate type, age at pharyngeal flap surgery, postoperative complications, age and type of primary palatoplasty, preoperative and postoperative speech assessments, magnetic resonance imaging findings, and obstructive sleep apnea outcomes...
November 28, 2023: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://read.qxmd.com/read/38057178/velopharyngeal-insufficiency-speech-and-language-impairment-in-craniofacial-microsomia-a-scoping-review
#23
REVIEW
Pauline A E Tio, Wietse Rooijers, Henriëtte H W de Gier, Henriëtte G Poldermans, Maarten J Koudstaal, Cornelia J J M Caron
This review provides a comprehensive overview of the literature on velopharyngeal insufficiency, associated anomalies, and speech/language impairment in patients with craniofacial microsomia (CFM). A systematic search of the literature was conducted to identify records on VPI and speech impairment in CFM from their inception until September 2022 within the databases Embase, PubMed, MEDLINE, Ovid, CINAHL EBSCO, Web of Science, Cochrane, and Google Scholar. Seventeen articles were included, analysing 1,253 patients...
January 2024: British Journal of Oral & Maxillofacial Surgery
https://read.qxmd.com/read/37994847/lefort-i-osteotomy-with-and-without-osteogenic-distraction-in-cleft-lip-and-palate-patients-experience-at-hospital-universitario-infantil-de-san-jos%C3%A3
#24
JOURNAL ARTICLE
Jose Rolando Prada Madrid, Diana Carolina Gómez Prada, Erika Paola Gutierrez Rodríguez, Alisson Zarate Ardila, Juan Carlos Pérez Quintero
INTRODUCTION: Cleft lip and cleft palate (CLP) are congenital diseases that lead to several secondary craniofacial anomalies, such as hypoplasia of the middle third of the face, which can be treated with different surgical techniques to help improve functional and esthetic alterations associated with the maxilla. This article reports the results of patients managed with LeFort I osteotomy in the same craniofacial surgery center for 10 years. OBJECTIVE: To determine the postoperative results regarding recurrence rates, malocclusion, and speech status after surgical treatment, in patients with retrusion of the midface with CLP, who underwent LeFort I osteotomy with or without osteogenic distraction (OD)...
November 23, 2023: Journal of Craniofacial Surgery
https://read.qxmd.com/read/37993983/speech-outcomes-of-buccal-myomucosal-flap-palatal-lengthening-for-treatment-of-velopharyngeal-insufficiency-systematic-literature-review-and-meta-analysis
#25
JOURNAL ARTICLE
Marina A Lentskevich, Alice Yau, Ariel E Figueroa, Kareem M Termanini, Arun K Gosain
OBJECTIVE: Buccal myomucosal flaps (BMF) anatomically lengthen the palate in the treatment of velopharyngeal insufficiency (VPI). We systematically reviewed the existing literature on speech outcome of BMF palatal lengthening. DESIGN: Three databases were used to identify studies of interest published in English. Studies that did not use standardized speech assessments were excluded. PRISMA checklist was followed, and the risk of bias in the included studies was assessed...
November 22, 2023: Cleft Palate-craniofacial Journal
https://read.qxmd.com/read/37982999/velopharyngeal-insufficiency-following-furlow-versus-straight-line-repair-with-intravelar-veloplasty-a-single-institution-experience
#26
JOURNAL ARTICLE
Matthew J Davis, Michelle G Roy, Heather R Burns, Nicholas Yim, Kristina D Wilson, Ellen E Moore, Edward P Buchanan, Laura A Monson
BACKGROUND: Measurements of postoperative velopharyngeal dysfunction (VPD) can be used to determine the efficacy of a palatoplasty operation. Hypernasality and audible nasal air emission are typical manifestations of VPD during speech. We aimed to longitudinally compare VPD outcomes in postpalatoplasty patients who underwent Furlow repair versus straight line repair with intravelar veloplasty (IVVP). Additionally, we examined the relationship between VPD outcomes and select pre-existing patient characteristics...
November 20, 2023: Journal of Craniofacial Surgery
https://read.qxmd.com/read/37981418/surgical-management-of-velopharyngeal-dysfunction
#27
REVIEW
Jill Arganbright
Velopharyngeal dysfunction (VPD) is caused by inadequate closure of the velopharyngeal port. VPD can hinder a child's ability to communicate and can impact his/her quality of life. Evaluation of children with VPD is often completed in a multidisciplinary setting and often involves studies that allow for the visualization of the velopharyngeal closure during voluntary speech (ie, nasopharyngoscopy). Multiple surgical options exist for the treatment of VPD including pharyngeal flap, sphincter pharyngoplasty, buccal myomucosal flaps, Furlow palatoplasty, palate re-repair, intravelar veloplasty, and injection pharyngoplasty...
February 2024: Facial Plastic Surgery Clinics of North America
https://read.qxmd.com/read/37981417/revision-palate-surgery
#28
REVIEW
Neal Deot, Sherard Austin Tatum
Oronasal fistulae and velopharyngeal insufficiency are common and interdependent complications after cleft palate surgery. Bone grafting can complement cleft habilitation. Early identification and intervention are vital for optimal outcomes. Collaboration with experienced healthcare professionals is crucial to develop a comprehensive treatment plan which considers speech therapy, prosthetic devices, and surgery. This article aims to review the current literature on the management of VPI and oronasal fistulae following cleft palate surgery and additionally highlight the role of alveolar bone grafting to improve outcomes for these patients...
February 2024: Facial Plastic Surgery Clinics of North America
https://read.qxmd.com/read/37981416/primary-cleft-palate-repair
#29
REVIEW
Barry Daniel Long, Rajanya Shah Petersson
There are several factors to consider when planning cleft palate repair. It is important to review the patient's associated comorbidities, as they impact decisions on perioperative management and family counseling. Many comorbidities change the risk of postoperative airway obstruction, velopharyngeal insufficiency, or fistula formation. It is also critical to determine the type of cleft palate to be addressed, as this influences the decision on which technique is most appropriate for optimal patient outcome...
February 2024: Facial Plastic Surgery Clinics of North America
https://read.qxmd.com/read/37973037/cleft-maxillary-hypoplasia-comparison-of-techniques-and-proposal-of-a-novel-treatment-protocol-for-management
#30
JOURNAL ARTICLE
Sunil Richardson, Rakshit Vijay Sinai Khandeparker, Shreya Krishna, Meghali Diwaker
This study was designed to compare different techniques of managing cleft maxillary hypoplasia and to propose a treatment protocol taking patient's age of presentation, amount of maxillary hypoplasia, and presence/absence of velopharyngeal insufficiency (VPI) into consideration. Five treatment modalities, viz. facemask therapy (Group I), anterior maxillary distraction (Group II), total maxillary distraction osteogenesis using rigid external distraction devices (Group III) and internal distraction devices (Group IV), and conventional orthognathic surgery (Group V), were assessed retrospectively using lateral cephalograms (taken at 3 intervals) and speech records (studied pre- and post-operatively)...
November 16, 2023: Journal of Craniofacial Surgery
https://read.qxmd.com/read/37973027/the-life-cycle-of-orofacial-cleft-operations
#31
JOURNAL ARTICLE
Daniel J Koh, Jung Ho Gong, Nikhil Sobti, Luke Soliman, Victor King, Albert S Woo
Patients with cleft lip and palate must undergo various surgical interventions at appropriate times to achieve optimal outcomes. While guidelines for the timing of these operations are well known, it has not yet been described if national surgical practice reflects these recommendations. This study evaluates whether orofacial operations are performed in time frames that align with advised timing. Time-to-event analyses were performed using the 2012-2020 Pediatric National Surgical Quality Improvement Program database on the ages at time of orofacial operations...
November 16, 2023: Journal of Craniofacial Surgery
https://read.qxmd.com/read/37955448/diagnosing-and-managing-velopharyngeal-insufficiency-in-patients-with-cleft-palate-after-primary-palatoplasty
#32
JOURNAL ARTICLE
Veera V Pitkanen, Ahmed Geneid, Anne M Saarikko, Sanna Hakli, Suvi A Alaluusua
Velopharyngeal insufficiency (VPI) after palatoplasty is caused by improper anatomy preventing velopharyngeal closure and manifests as a hypernasal resonance, audible nasal emissions, weak pressure consonants, compensatory articulation, reduced speech loudness, and nostril or facial grimacing. A multidisciplinary team using multimodal instruments (speech analysis, nasoendoscopy, videofluoroscopy, nasometry, and magnetic resonance imaging) to evaluate velopharyngeal function should manage these patients. Careful monitoring of velopharyngeal function by a speech pathologist remains paramount for early identification of VPI and the perceptual assessment should follow a standardized protocol...
November 13, 2023: Journal of Craniofacial Surgery
https://read.qxmd.com/read/37951499/strip-pharyngoplasty-as-a-secondary-functional-surgery-for-persistent-velopharyngeal-insufficiency-in-cleft-palate
#33
JOURNAL ARTICLE
Florent Barry, Matthias Schlund, Joël Ferri
Despite a satisfactory primary repair, velopharyngeal insufficiency (VPI) may be a sequel of soft palate clefts, resulting in hypernasality and phonation disorders. In order to increase the function of the pharyngeal flap during a secondary pharyngoplasty, we have developed a strip pharyngoplasty technique involving the middle constrictor muscle of the pharynx. This article describes the successive steps of the intervention and discuss its indications, advantages and limitations. Strip pharyngoplasty as a secondary functional surgery for persistent VPI after primary cleft palate repair is an attractive surgical procedure, particularly adapted to cases with defective muscle contraction by providing a muscle contingent in addition to the mucosal flap...
November 9, 2023: Journal of Stomatology, Oral and Maxillofacial Surgery
https://read.qxmd.com/read/37950988/long-term-outcomes-of-sphincter-pharyngoplasty-in-patients-with-cleft-palate
#34
JOURNAL ARTICLE
Madeline G Chin, Yvonne Roca, Kelly X Huang, Shahrzad Moghadam, Jonnby S LaGuardia, Meiwand Bedar, Libby F Wilson, Justine C Lee
OBJECTIVE: The purpose of this study was to evaluate long-term outcomes of sphincter pharyngoplasties, including speech outcomes, revision surgeries, and postoperative incidence of obstructive sleep apnea (OSA). DESIGN: Retrospective matched-cohort study SETTING: Two craniofacial centers in Los Angeles, CA PATIENTS: Patients (n = 166) with cleft lip and palate (CLP) or isolated cleft palate (iCP) who underwent sphincter pharyngoplasty from 1992 to 2022 were identified...
October 23, 2023: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://read.qxmd.com/read/37948711/optimization-of-power-assisted-adenoidectomy-in-children-using-shaver-tips-of-various-modification
#35
JOURNAL ARTICLE
Anatolii L Kosakovskyi, Kateryna V Liakh, Yaroslav V Shkorbotun
OBJECTIVE: The aim: To study the efficacy of surgical treatment of patients with adenoid vegetations by implementing a differential method for choosing a tip for endo-scopic power-assisted adenoidectomy in children depending on dentition. PATIENTS AND METHODS: Materials and methods: We investigated the presence of nasal air emissions in 127 children (2-12 years old) before and after the operation. We excluded 12 patients due to the presence of nasal air emission before the operation...
2023: Wiadomości Lekarskie: Organ Polskiego Towarzystwa Lekarskiego
https://read.qxmd.com/read/37943678/modified-furlow-palatoplasty-using-small-double-opposing-z-plasty-long-term-outcome-and-comparison-with-two-flap-palatoplasty
#36
JOURNAL ARTICLE
Yoshitsugu Hattori, Betty Chien-Jung Pai, Takafumi Saito, Junior Chun-Yu Tu, Pang-Yun Chou, Lun-Jou Lo
BACKGROUND: The post-palatoplasty velopharyngeal function needs to be evaluated through long-term follow-up, but such reports are limited in the literature and there has been no consensus as to which surgical technique yields optimal velopharyngeal function with minimum complication rate. This study aimed to evaluate the long-term outcome of the modified Furlow palatoplasty using small double-opposing Z-plasty (small-DOZ). METHODS: A retrospective review of consecutive patients who received palatoplasty performed by the senior author between January 2000 and March 2014 was conducted...
November 7, 2023: Plastic and Reconstructive Surgery
https://read.qxmd.com/read/37931079/characterizing-speech-phenotype-in-individuals-with-craniofacial-microsomia-a-scoping-review
#37
JOURNAL ARTICLE
Sara Kinter, Katelyn Kotlarek, Anna Meehan, Carrie Heike
INTRODUCTION: Craniofacial microsomia (CFM) is a complex congenital condition primarily affecting the ear, mandible, facial nerve and muscles, and tongue. Individuals with CFM are at increased risk of hearing loss, obstructive sleep apnea, and feeding/swallowing difficulties. The purpose of this scoping review was to summarize evidence pertaining to speech production in CFM. METHOD: All articles reporting any characteristic of speech production in CFM were included and screened by two independent reviewers by title, abstract, and full text...
November 6, 2023: American Journal of Speech-language Pathology
https://read.qxmd.com/read/37928635/comparative-effectiveness-of-secondary-furlow-and-buccal-myomucosal-flap-lengthening-to-treat-velopharyngeal-insufficiency
#38
JOURNAL ARTICLE
Thomas J Sitzman, Jamie L Perry, Taylor D Snodgrass, M'hamed Temkit, Davinder J Singh, Jessica L Williams
BACKGROUND: Secondary Furlow (Furlow) and buccal myomucosal flaps (BMMF) treat velopharyngeal insufficiency by lengthening the palate and retropositioning the levator veli palatini muscles. The criteria for choosing one operation over the other remain unclear. METHODS: A single-center retrospective cohort study was conducted. Thirty-two patients with nonsyndromic, repaired cleft palate were included. All patients underwent a Furlow or BMMF. Outcome measures included (1) resolution of hypernasality 12 months postoperatively, (2) degree of improvement of hypernasality severity; and (3) change in velar length, as measured on magnetic resonance imaging scans obtained preoperatively and 12 months postoperatively...
November 2023: Plastic and Reconstructive Surgery. Global Open
https://read.qxmd.com/read/37916854/exploring-reliable-and-identifiable-quantitative-anatomical-timing-and-displacement-measures-in-the-vfs-of-speech
#39
JOURNAL ARTICLE
Melanie Street, Maeve Morrison, Anna Miles
AIM: Videofluroscopy studies of speech are a recognized assessment of velopharyngeal insufficiency (VPI). Yet, this method is subjective and has low inter-rater reliability. Quantitative measures of timing, distance, and area in videofluoroscopic studies of swallowing have been shown to be valid and reliable, but quantitative measures are not routinely used in videofluroscopy studies for VPI. This study explored the use of quantitative measures in patients with VPI in terms of feasibility and reliability...
November 2, 2023: Journal of Craniofacial Surgery
https://read.qxmd.com/read/37888088/velopharyngeal-incompetence-in-musicians-a-state-of-the-art-review
#40
REVIEW
Lucía Mata-Pose, Miguel Mayo-Yáñez, Carlos M Chiesa-Estomba, Jérôme R Lechien, Luigi A Vaira, Antonino Maniaci, Alberto M Saibene, Christian Calvo-Henríquez, Irma Cabo-Varela
The velopalatine sphincter is a muscular valve that creates a hermetic seal between the nasopharynx and the oropharynx. It guarantees phonation, swallowing, and breathing (forces expirations). In wind musicians, sphincter closure must be precise during sound generation. Its failure will cause velopharyngeal incompetence (VPI) and the end of professional success. The objective of this article was to conduct a state-of-art review of VPI in wind musicians with a systematic approach based on the PRISMA Statement...
October 9, 2023: Journal of Personalized Medicine
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