A modified palatopharyngeous flap operation and its application in the correction of velopharyngeal incompetence

The conventional sphincteric pharyngoplasty does not achieve velopharyngeal competence in certain cases because of the intrinsic deficiency of the technique. A modified palatopharyngeous flap operation was introduced and used as a secondary procedure for the correction of velopharyngeal incompetence in 15 cleft palate patients. The results showed that the lateral-to-lateral connection and the high attachment of the palatopharyngeal flaps can form a new velopharyngeal port that is easily closed by velar movement. The surgical result is satisfactory, as revealed by the speech intelligibility test, videofluoroscopy, and nasopharyngoscopy. The surgical technique is described and the importance of presurgical identification of velopharyngeal movements is stressed in this paper.