Surgical interventions in velopharyngeal dysfunction: comparative perceptual speech and nasometric outcomes for three...

Area of Science:

• Plastic Surgery
• Speech-Language Pathology
• Otolaryngology

Background:

• Velopharyngeal dysfunction (VPD) affects speech clarity and resonance.
• Surgical intervention is a common treatment for VPD.
• Understanding the impact of different surgical techniques on speech outcomes is crucial for patient care.

Purpose of the Study:

• To evaluate speech outcomes after surgical correction of VPD.
• To analyze the influence of patient factors (congenital abnormalities, cleft lip/palate, age) on surgical success.
• To inform the development of treatment algorithms for VPD.

Main Methods:

• Retrospective analysis of 202 VPD patients (2005-2018).
• Surgical procedures included superiorly based pharyngeal flap, Furlow palatoplasty, and sphincteroplasty.
• Speech outcomes assessed using ACPA perceptual assessment and SNAP-R for nasalance.

Main Results:

• Significant improvement in mean perceptual speech scores postoperatively (p < .0001).
• Pharyngeal flap yielded superior outcomes in hypernasality, nasal emissions, and velopharyngeal function compared to other methods.
• Success rates: pharyngeal flap (94.2%), Furlow palatoplasty (75.0%), sphincteroplasty (66.7%).

Conclusions:

• Surgical management of VPD is highly effective in improving speech.
• Pharyngeal flap surgery shows robust improvements in speech outcomes for selected patients.
• All three procedures are viable for VPD treatment with appropriate patient selection.