Readaptation of the velopharyngeal valve following the uvulopalatopharyngoplasty operation.

We have studied the mechanism of velopharyngeal valving in 27 patients undergoing uvulopalatopharyngoplasty for obstructive sleep apnea before and after surgery. The patients were assessed by peroral examination and nasendoscopy. Our observations and findings of the readaptation process of the velopharyngeal valve following the operation show us that its different closure patterns are due to a variable anatomy. A certain compensatory mechanism is possible mainly in the circular pattern and the circular pattern with Passavant's ridge and sagittal patterns. Passavant's ridge is an anatomic variant rather than a compensatory mechanism. The muscularis uvulae is important mainly in nonphonetic activities of the velopharyngeal valve. This information is important for clinical purposes in order to better correct problems associated with velopharyngeal incompetence.