Nasometric and aerodynamic outcome analysis of pharyngeal flap surgery for the management of velopharyngeal insufficiency.

OBJECTIVE

This study aimed to evaluate the effectiveness of pharyngeal flap surgery (PFS) for the management of velopharyngeal insufficiency in cleft lip/palate patients and to assess the impact of age at surgery, surgeon's skills, and postoperative speech therapy on the outcomes.

METHODS

Prospective preoperative and postoperative assessments were performed on 240 patients aged 6 to 57 years using nasometry and pressure-flow studies.This study was carried out in a quaternary hospital.This study was superiorly based on PFS.Speech nasalance scores were assessed by nasometry and velopharyngeal orifice area assessed by pressure-flow technique, 2 days before and 1 year after PFS, on average. Differences were considered significant when P < 0.05.

RESULTS

Significant reduction in nasalance scores was observed in 68% of the cases, and improvement of velopharyngeal area was observed in 66%. Rates of 55% and 48%, respectively, were observed when complete resolution was considered. Higher success rates were observed in children (81%) compared with other age groups analyzed and in patients who had concluded postoperative speech therapy (86%). Results did not differ among surgeons.

CONCLUSIONS

Pharyngeal flap surgery was shown to be effective in reducing nasalance scores and velopharyngeal area during speech for a significant number of patients. Complete resolution was observed in smaller number of cases. Age at surgery and postoperative speech therapy were relevant factors for treatment success.