A comparison of speech results after the pharyngeal flap and the dynamic sphincteroplasty procedures

Eighty-five patients underwent surgery to reduce velopharyngeal incompetence with either a pharyngeal flap (n = 75) or a dynamic sphincteroplasty (n = 10) performed between April 1958 and August 1989, and were evaluated preoperatively and postoperatively by a plastic surgeon, speech pathologist, and otolaryngologist. Improvement in speech was noted in 75% (n = 56) of the patients with pharyngeal flaps and 70% (n = 7) of the patients with dynamic sphincteroplasties postoperatively. Thirty percent of the patients in both groups showed no improvement postoperatively in speech. Three patients (4%) who underwent pharyngeal flap procedures developed sleep apnea postoperatively. Persistent velopharyngeal incompetence may be treated effectively with either a pharyngeal flap or a dynamic sphincteroplasty. Either procedure appears to result in improved speech in most patients.