Results with sphincter pharyngoplasty and pharyngeal flap

Lianne M. De Serres, Frederic W B Deleyiannis, Linda E. Eblen, Joseph S. Gruss, Mark A. Richardson, Kathleen C Y Sie

Research output: Contribution to journalArticle

72 Citations (Scopus)

Abstract

Objective: To evaluate speech outcomes and complications of sphincter pharyngoplasty and pharyngeal flap performed for management of velopharyngeal insufficiency (VPI). Design: Case series. Setting: Tertiary care children's hospital. Patients: All patients who underwent pharyngeal flap or sphincter pharyngoplasty from 1990 to 1995. Methods: Perceptual speech analysis was used to assess severity of VPI, presence of nasal air emissions and quality of nasal resonance (hyper, hypo, or normal). Pre-operative measures of velopharyngeal function were based upon nasendoscopy and videofluoroscopic speech assessment. Recommendations for management were made by the attending surgeon. Complications of hyponasality and obstructive sleep symptoms (OSS) were noted. Patient characteristics were compared using univariate analysis. Results: Sixteen patients underwent sphincter pharyngoplasty and 18 patients underwent superiorly based pharyngeal flap. Patients were similar in terms of lateral pharyngeal wall medial motion and palatal elevation. The groups were also similar with regard to VPI severity, though there was a trend for more severe VPI in patients undergoing sphincter pharyngoplasty than pharyngeal flap (50 vs. 33.3% respectively). Patients with pharyngoplasty had a higher rate of resolution of VPI than those who had pharyngeal flap (50 vs. 22.2%, respectively), although this was not statistically significant. Post- operative hyponasality and obstructive sleep symptoms were present in both groups. However, only patients who underwent PF and had postoperative OSS had obstructive sleep apnea (OSA). Conclusions: There were no detectable anatomic differences between treatment groups implying that treatment selection during the study period was not guided by strict anatomic criteria. Sphincter pharyngoplasty may have a higher success rate with a lower risk of OSS.

Original languageEnglish (US)
Pages (from-to)17-25
Number of pages9
JournalInternational Journal of Pediatric Otorhinolaryngology
Volume48
Issue number1
DOIs
StatePublished - Apr 25 1999
Externally publishedYes

Fingerprint

Velopharyngeal Insufficiency
Sleep
Nose
Obstructive Sleep Apnea
Tertiary Healthcare
Air
Therapeutics

Keywords

  • Cleft palate
  • Pharyngeal flap
  • Speech
  • Sphincter pharyngoplasty
  • Velopharyngeal insufficiency

ASJC Scopus subject areas

  • Otorhinolaryngology
  • Pediatrics, Perinatology, and Child Health
  • Pulmonary and Respiratory Medicine
  • Surgery

Cite this

De Serres, L. M., Deleyiannis, F. W. B., Eblen, L. E., Gruss, J. S., Richardson, M. A., & Sie, K. C. Y. (1999). Results with sphincter pharyngoplasty and pharyngeal flap. International Journal of Pediatric Otorhinolaryngology, 48(1), 17-25. https://doi.org/10.1016/S0165-5876(99)00006-3

Results with sphincter pharyngoplasty and pharyngeal flap. / De Serres, Lianne M.; Deleyiannis, Frederic W B; Eblen, Linda E.; Gruss, Joseph S.; Richardson, Mark A.; Sie, Kathleen C Y.

In: International Journal of Pediatric Otorhinolaryngology, Vol. 48, No. 1, 25.04.1999, p. 17-25.

Research output: Contribution to journalArticle

De Serres, LM, Deleyiannis, FWB, Eblen, LE, Gruss, JS, Richardson, MA & Sie, KCY 1999, 'Results with sphincter pharyngoplasty and pharyngeal flap', International Journal of Pediatric Otorhinolaryngology, vol. 48, no. 1, pp. 17-25. https://doi.org/10.1016/S0165-5876(99)00006-3
De Serres LM, Deleyiannis FWB, Eblen LE, Gruss JS, Richardson MA, Sie KCY. Results with sphincter pharyngoplasty and pharyngeal flap. International Journal of Pediatric Otorhinolaryngology. 1999 Apr 25;48(1):17-25. https://doi.org/10.1016/S0165-5876(99)00006-3
De Serres, Lianne M. ; Deleyiannis, Frederic W B ; Eblen, Linda E. ; Gruss, Joseph S. ; Richardson, Mark A. ; Sie, Kathleen C Y. / Results with sphincter pharyngoplasty and pharyngeal flap. In: International Journal of Pediatric Otorhinolaryngology. 1999 ; Vol. 48, No. 1. pp. 17-25.
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abstract = "Objective: To evaluate speech outcomes and complications of sphincter pharyngoplasty and pharyngeal flap performed for management of velopharyngeal insufficiency (VPI). Design: Case series. Setting: Tertiary care children's hospital. Patients: All patients who underwent pharyngeal flap or sphincter pharyngoplasty from 1990 to 1995. Methods: Perceptual speech analysis was used to assess severity of VPI, presence of nasal air emissions and quality of nasal resonance (hyper, hypo, or normal). Pre-operative measures of velopharyngeal function were based upon nasendoscopy and videofluoroscopic speech assessment. Recommendations for management were made by the attending surgeon. Complications of hyponasality and obstructive sleep symptoms (OSS) were noted. Patient characteristics were compared using univariate analysis. Results: Sixteen patients underwent sphincter pharyngoplasty and 18 patients underwent superiorly based pharyngeal flap. Patients were similar in terms of lateral pharyngeal wall medial motion and palatal elevation. The groups were also similar with regard to VPI severity, though there was a trend for more severe VPI in patients undergoing sphincter pharyngoplasty than pharyngeal flap (50 vs. 33.3{\%} respectively). Patients with pharyngoplasty had a higher rate of resolution of VPI than those who had pharyngeal flap (50 vs. 22.2{\%}, respectively), although this was not statistically significant. Post- operative hyponasality and obstructive sleep symptoms were present in both groups. However, only patients who underwent PF and had postoperative OSS had obstructive sleep apnea (OSA). Conclusions: There were no detectable anatomic differences between treatment groups implying that treatment selection during the study period was not guided by strict anatomic criteria. Sphincter pharyngoplasty may have a higher success rate with a lower risk of OSS.",
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