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Updated: Jul 26, 2025

Minimally Invasive Murine Laryngoscopy for Close-Up Imaging of Laryngeal Motion During Breathing and Swallowing
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Minimally Invasive Murine Laryngoscopy for Close-Up Imaging of Laryngeal Motion During Breathing and Swallowing

Published on: December 1, 2023

578

Pharyngeal flap in velopharyngeal insufficiency: Proposal of an algorithm in a series of 31 patients

N Ben Slama1, C Maquet2, O Trost3

  • 1Department of Oral and Maxillofacial Surgery, Rouen University Hospital, Rouen 76000, France.

Journal of Stomatology, Oral and Maxillofacial Surgery
|June 12, 2023
PubMed

Insights

Pharyngeal flap surgery significantly improved velopharyngeal function in children with cleft palate, with a 93.5% success rate. Worse initial function correlated with greater improvement, validating the surgical protocol.

Area of Science:

  • Pediatric Surgery
  • Craniofacial Surgery
  • Speech-Language Pathology

Background:

  • Velopharyngeal insufficiency (VPI) is a common complication in children with cleft palate.
  • Pharyngeal flap surgery is a recognized treatment for VPI.
  • A reproducible protocol is essential for optimizing surgical outcomes.

Purpose of the Study:

  • To evaluate the efficacy of a pharyngeal flap protocol in children with cleft palate and VPI.
  • To determine factors influencing the success of pharyngeal flap surgery.
  • To assess the reliability of a combined clinical and classification algorithm for surgical indication.

Main Methods:

  • Retrospective review of 31 patients undergoing pharyngeal flap surgery (2010-2019).
  • Exclusion of patients with primary VPI or residual fistulas.
  • Primary outcome: Improvement in Borel Maisonny Classification (BMC) by at least one rank.

Main Results:

  • Successful improvement in velopharyngeal function achieved in 29 out of 31 patients (93.5%).
  • No significant correlation between age or cleft type and functional gain.
  • Significant correlation between worse baseline VPI (BMC) and greater functional improvement (p=0.035).

Conclusions:

  • The pharyngeal flap protocol is highly effective for treating VPI in pediatric cleft palate patients.
  • Pre-operative VPI severity is a key predictor of surgical success.
  • The developed algorithm reliably guides surgical indication, emphasizing multidisciplinary follow-up.

Keywords:
Borel MaisonnyPharyngeal flapPharyngoplastyVelopharyngeal insufficiency

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