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Upper airway obstruction after pharyngeal flap surgery
M A Lesavoy1, L J Borud, T Thorson
1Division of Plastic Surgery, Harbor/UCLA Medical Center, USA.
Annals of Plastic Surgery
|January 1, 1996
Summary
Superiorly based pharyngeal flap surgery effectively treats velopharyngeal insufficiency. While early upper airway obstruction is common, it usually resolves, and flap revision is rarely needed.
Area of Science:
- Plastic Surgery
- Otolaryngology
- Speech Pathology
Background:
- Velopharyngeal insufficiency (VPI) significantly impacts speech and quality of life.
- Superiorly based pharyngeal flap (SBPF) is a surgical technique to address VPI.
- Potential complications, including upper airway obstruction (UAO), require careful evaluation.
Purpose of the Study:
- To assess the incidence and management of upper airway obstruction following SBPF.
- To evaluate the efficacy of SBPF in treating velopharyngeal insufficiency.
- To explore potential correlations between patient factors and outcomes.
Main Methods:
- Retrospective review of 32 SBPF procedures in 29 patients (1979-1993).
- Analysis of early postoperative UAO symptoms and their resolution.
- Assessment of VPI improvement and need for flap revision.
Main Results:
- 38% of patients experienced early postoperative UAO, resolving in most within 5 months.
- No flap revisions were required for UAO; 87% of patients showed VPI improvement.
- Transient UAO correlated with a lower likelihood of residual VPI.
Conclusions:
- SBPF is effective for VPI, with manageable early UAO.
- Transient UAO may be an acceptable trade-off for successful VPI correction.
- Patient factors did not predict UAO or VPI treatment success.