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Is there an optimal resting velopharyngeal gap in operated cleft palate patients?
Rajesh Yellinedi1, Mukunda Reddy Damalacheruvu
1Department of Plastic and Reconstructive Surgery, Nizams Institute of Medical Sciences, Hyderabad, Andhra Pradesh, India.
Context:
Videofluoroscopy in operated cleft palate patients.
Aims:
To determine the existence of an optimal resting velopharyngeal (VP) gap in operated cleft palate patients.
Settings And Design:
A retrospective analysis of lateral view videofluoroscopy of operated cleft palate patients.
Materials And Methods:
A total of 117 cases of operated cleft palate underwent videofluoroscopy between 2006 and 2011. The lateral view of videofluoroscopy was utilised in the study. A retrospective analysis of the lateral view of videofluoroscopy of these 117 patients was performed to analyse the resting VP gap and its relationship to VP closure.
Statistical Analysis Used:
None.
Results:
Of the 117 cases, 35 had a resting gap of less than 6 mm, 34 had a resting gap between 6 and 10 mm and 48 patients had a resting gap of more than 10 mm.
Conclusions:
The conclusive finding was that almost all the patients with a resting gap of <6 mm (group C) achieved radiological closure of the velopharynx with speech; thus, they had the least chance of VP insufficiency (VPI). Those patients with a resting gap of >10 mm (group A) did not achieve VP closure on phonation, thus having full-blown VPI. Therefore, it can be concluded that the ideal resting VP gap is approximately 6 mm so as to get the maximal chance of VP closure and thus prevent VPI.
