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Surgical Treatment of Patients with Velopharyngeal Insufficiency using Superiorly Based Pharyngeal Flap: Report of 2 Cases

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ÀåÀçÈ£ ( Jang Jae-Ho ) - Seoul National University Dental Hospital Department of Oral and Maxillofacial Surgery
±è½Ã¿µ ( Kim Si-Young ) - Seoul National University Dental Hospital Department of Oral and Maxillofacial Surgery
ÇϼºÈ£ ( Ha Sung-Ho ) - Seoul National University Dental Hospital Department of Oral and Maxillofacial Surgery
ÃÖÁø¿µ ( Choi Jin-Young ) - Seoul National University Dental Hospital Department of Oral and Maxillofacial Surgery

Abstract


Velopharyngeal insufficiency (VPI) is a disorder that presents difficulty in closure of soft plate against the posterior pharyngeal wall and causes failure of closing of the nasal cavity during oral speech. There are many available treatment modalities to treat severe VPI, and among surgical treatment methods, there is no consensus for gold standard. According to the anatomy and physiologic variations, we can choose the right modality for the surgical treatment. Some recent studies suggest an algorithmic approach for each patient classified by their velopharyngeal port closure pattern and the gap size. In this case report, we present a case report of a patient with congenital cleft palate and tongue tie, who has received superiorly based pharyngeal flap surgery and lingual frenectomy to treat velopharyngeal insufficiency and speech abnormalities. In the second case, the patient was diagnosed with submucosal cleft causing velopharyngeal insufficiency, therefore received pharyngeal flap surgery. In both cases the patient¡¯s post operative speech ability was much improved, with satisfactory results.

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Pharyngeal flap; Velopharyngeal insufficiency; Cleft palate; Submucosal cleft palate

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