Short-term Outcomes of Fat Injection for Posterior Pharyngeal Wall Augmentation in the Management of Velopharyngeal Insufficiency with Different Etiologies.

INTRODUCTION

Fat injection for posterior pharyngeal wall augmentation has become an emerging method of enhancing velopharyngeal structures. This study aimed to evaluate the short-term outcomes of fat injection in the enhancement of the posterior pharyngeal wall with different volumes in improving velopharyngeal valve (VPV) function in velopharyngeal insufficiency (VPI) patients with grade III to IV VPV closure.

METHODS

Observational prospective case series of 24 patients, aged 4 to 24 years, presenting with persistent velopharyngeal insufficiency (VPI) secondary to cleft palate, submucous cleft palate, or post-adenoidectomy. Autologous fat was injected trans orally into the submucosal layer of the posterior pharyngeal wall, varying from a minimum of 5 cc to a maximum of 15 cc.

RESULTS

The present study demonstrated that fat augmentation significantly improved velopharyngeal closure, auditory perceptual assessment "APA" parameters regarding all obligatory speech errors and the degree of speech unintelligibility, and velar mobility. Significant reduction was demonstrated in the gap measurements between the soft palate and posterior pharyngeal wall at both rest and during phonation post-operatively. Most patients reported mild discomfort in the area of fat harvesting and the neck, with no major complications.

CONCLUSION

Fat augmentation of the posterior pharyngeal wall was a safe and well-tolerated procedure for enhancing velopharyngeal function in VPI patients with grade III-IV VPV closure, with minimal complications due to autologous tissue application.