Velopharyngeal closure function following modified unified velopharyngeal plasty performed by a single surgeon was evaluated pre- and postoperatively in 14 children with cleft palate after cleft palate closure and no ...Velopharyngeal closure function following modified unified velopharyngeal plasty performed by a single surgeon was evaluated pre- and postoperatively in 14 children with cleft palate after cleft palate closure and no improvement by speech training. Subjects were evaluated for velopharyngeal closure function before and after surgery at 1 (short-term evaluation) and 3 (mid-term evaluation) years. Degree of hypernasality and degree of air leakage through the nose in the soft blowing test were each classified into three grades and each grade was given scores. Velopharyngeal closure function was classified according to the total score into four grades: “good”, 'fair”, 'slightly poor” and “poor”. At the short-term evaluation, 11 patients (78.6%) achieved an improvement to “good” or “fair” on the overall evaluation. More satisfactory results were obtained at the mid-term evaluation, with 14 patients (100%) graded as “good” or “fair”. Our results indicate that this modified unified velopharyngeal plasty effectively improves velopharyngeal insufficiency when performed as a secondary surgery for cleft palate in children.展开更多
Background:Management of severe velopharyngeal dysfunction is best performed by a multispecialty team.This team could include a speech-language pathologist,otolaryngologist,prosthodontist,and a plastic surgeon.The mos...Background:Management of severe velopharyngeal dysfunction is best performed by a multispecialty team.This team could include a speech-language pathologist,otolaryngologist,prosthodontist,and a plastic surgeon.The most commonly performed surgical procedures in complicated cases with scarred soft palate are sphincter pharyngoplasty and pharyngeal flaps.In this study,a multidisciplinary approach was applied for proper assessment and surgical intervention using sphincter pharyngoplasty for velopharyngeal insufficiency after cleft palate repair.Methods:Twenty patients underwent sphincter pharyngoplasty.Preoperative diagnosis was performed using auditory perceptual assessment,nasoendoscopy assessment,nasometry,and videofluoroscopy.Results:There were statistically significant differences between the preoperative and postoperative assessments.Bleeding occurred in two patients.Obstructive sleep apnea occurred in three patients and was resolved spontaneously within three months,and one patient experienced slight wound dehiscence.Conclusion:Velopharyngeal dysfunction after cleft palate repair is best treated by a multidisciplinary team through speech therapy together with sphincter pharyngoplasty.展开更多
OBJECTIVE: To evaluate the effect of a system of velopharyngeal incompetence (VPI) management after the application of obturator. METHODS: Using nasopharyngofiberoscope (NPF) and a computer analysis system, we quantit...OBJECTIVE: To evaluate the effect of a system of velopharyngeal incompetence (VPI) management after the application of obturator. METHODS: Using nasopharyngofiberoscope (NPF) and a computer analysis system, we quantitatively analyzed the improved state of velopharyngeal incompetence in 100 patients with unilateral and/or bilateral cleft palate. RESULTS: The velopharyngeal closure (VPC) can be greatly improved by using a temporary oral prosthesis (obturator) and speech training. An objective quantitative standard was established to evaluate the change of velopharyngeal closure of cleft palate patients after surgery and conservative treatment. CONCLUSIONS: The method used is more succinct, accurate and practical than previous methods. In order to reflect the state of velopharyngeal incompetence, the concept of improvement rate of velopharyngeal incompetence (IRVPI) is put forward.展开更多
文摘Velopharyngeal closure function following modified unified velopharyngeal plasty performed by a single surgeon was evaluated pre- and postoperatively in 14 children with cleft palate after cleft palate closure and no improvement by speech training. Subjects were evaluated for velopharyngeal closure function before and after surgery at 1 (short-term evaluation) and 3 (mid-term evaluation) years. Degree of hypernasality and degree of air leakage through the nose in the soft blowing test were each classified into three grades and each grade was given scores. Velopharyngeal closure function was classified according to the total score into four grades: “good”, 'fair”, 'slightly poor” and “poor”. At the short-term evaluation, 11 patients (78.6%) achieved an improvement to “good” or “fair” on the overall evaluation. More satisfactory results were obtained at the mid-term evaluation, with 14 patients (100%) graded as “good” or “fair”. Our results indicate that this modified unified velopharyngeal plasty effectively improves velopharyngeal insufficiency when performed as a secondary surgery for cleft palate in children.
文摘Background:Management of severe velopharyngeal dysfunction is best performed by a multispecialty team.This team could include a speech-language pathologist,otolaryngologist,prosthodontist,and a plastic surgeon.The most commonly performed surgical procedures in complicated cases with scarred soft palate are sphincter pharyngoplasty and pharyngeal flaps.In this study,a multidisciplinary approach was applied for proper assessment and surgical intervention using sphincter pharyngoplasty for velopharyngeal insufficiency after cleft palate repair.Methods:Twenty patients underwent sphincter pharyngoplasty.Preoperative diagnosis was performed using auditory perceptual assessment,nasoendoscopy assessment,nasometry,and videofluoroscopy.Results:There were statistically significant differences between the preoperative and postoperative assessments.Bleeding occurred in two patients.Obstructive sleep apnea occurred in three patients and was resolved spontaneously within three months,and one patient experienced slight wound dehiscence.Conclusion:Velopharyngeal dysfunction after cleft palate repair is best treated by a multidisciplinary team through speech therapy together with sphincter pharyngoplasty.
文摘OBJECTIVE: To evaluate the effect of a system of velopharyngeal incompetence (VPI) management after the application of obturator. METHODS: Using nasopharyngofiberoscope (NPF) and a computer analysis system, we quantitatively analyzed the improved state of velopharyngeal incompetence in 100 patients with unilateral and/or bilateral cleft palate. RESULTS: The velopharyngeal closure (VPC) can be greatly improved by using a temporary oral prosthesis (obturator) and speech training. An objective quantitative standard was established to evaluate the change of velopharyngeal closure of cleft palate patients after surgery and conservative treatment. CONCLUSIONS: The method used is more succinct, accurate and practical than previous methods. In order to reflect the state of velopharyngeal incompetence, the concept of improvement rate of velopharyngeal incompetence (IRVPI) is put forward.
