Bilateral Z-flap pharyngoplasty in the treatment of rhinolalia

The use of a bilateral Z-plasty with superiorly based myomucosal flaps of the posterior pharyngeal wall in the treatment of nasopharyngeal incontinence in 16 patients with rhinolalia is reported. The transposition of these flaps leads to the formation of a dynamic and physiologic velopharyngeal sphincter that produces a marked improvement in speech. The same procedure yielded satisfactory results in 3 cases of pharyngitis sicca. We have maintained a postoperative follow-up of these patients from 6 months to 16 years and have been very pleased with the sustained good results.