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Related Experiment Videos

Palate re-repair revisited.

Brian C Sommerlad1, Felicity V Mehendale, Malcolm J Birch

  • 1St. Andrew's Centre for Plastic Surgery, Broomfield Hospital, Essex , England, UK. brian@sommerlad.co.uk

The Cleft Palate-Craniofacial Journal : Official Publication of the American Cleft Palate-Craniofacial Association
|May 23, 2002
PubMed
Summary

Palate re-repair surgery effectively treats velopharyngeal incompetence (VPI) after cleft palate repair, improving speech and velar function. This procedure offers a less invasive and more physiological alternative to pharyngoplasty or pharyngeal flap surgery.

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Area of Science:

  • Plastic Surgery
  • Speech Pathology
  • Otolaryngology

Background:

  • Velopharyngeal incompetence (VPI) is a common complication following cleft palate repair, significantly impacting speech quality.
  • Re-repair of the palate aims to correct persistent VPI by addressing anatomical and functional deficits.

Purpose of the Study:

  • To evaluate the outcomes of palate re-repair surgery using an operating microscope.
  • To identify factors predicting successful outcomes in patients with VPI after cleft palate repair.

Main Methods:

  • Prospective study of 85 patients undergoing palate re-repair with radical dissection and retropositioning of velar muscles.
  • Objective assessments included speech analysis (Cleft Audit Protocol for Speech - CAPS), videofluoroscopy, and nasendoscopy.

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  • Intraoperative grading of anatomical and surgical findings was performed.

    • Main Results:

    • Significant improvements were observed in hypernasality, nasal emission, and nasal turbulence.
    • Objective measures of velar function, including closure ratio and velar movement, showed marked improvement.
    • The surgical technique demonstrated efficacy in patients with and without prior intravelar veloplasty.

    Conclusions:

    • Palate re-repair is an effective treatment for VPI in patients with cleft palate.
    • The procedure yields better functional outcomes with lower morbidity compared to pharyngoplasty or pharyngeal flap.
    • Microscope-assisted palate re-repair offers a physiological and successful approach to VPI correction.