Retraction of the Soft Palate During a Modified Hynes Pharyngoplasty: A Technical Note.

Surgical management of velopharyngeal insufficiency by construction of sphincter pharyngoplasty is well described in the medical literature. Hynes advocated splitting an intact soft palate when it would be helpful for better exposure of the posterior pharyngeal wall for flap inset. We describe a modification to the Hynes pharyngoplasty whereby the soft palate is retracted upward, giving the operator unrestricted surgical access to the salpingopharyngeus muscles and their overlying mucosa. This allows the surgeon to raise and inset the flaps, as described by Hynes, without the need to divide the soft palate. The retraction catheters avoid the need for splitting a soft palate, which has been optimized by either a Furlow or soft palate re-repair in the past, avoiding unnecessary compromise of the integrity and architecture of the soft palate.