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Flap surgery: experience with 1,030 operations and cephalometric investigation
1Madarász Children's Hospital, Cleft Palate Center, Budpest, Hungary.
Summary
Velopharyngoplasty significantly improves speech in 90% of patients with cleft lip and palate. While pharyngeal flap surgery may impact facial growth, its functional benefits outweigh potential adverse effects.
Area of Science:
- Plastic Surgery
- Speech Pathology
- Craniofacial Surgery
Background:
- Velopharyngoplasty is a surgical procedure to correct velopharyngeal insufficiency.
- Hyperrhinophony, or nasal speech, is a common consequence of cleft palate.
- Long-term outcomes of velopharyngoplasty require ongoing investigation.
Purpose of the Study:
- To evaluate the long-term anatomical and functional outcomes of velopharyngoplasty.
- To assess the impact of pharyngeal flap surgery on craniofacial growth in patients with unilateral cleft lip and palate (UCLP).
Main Methods:
- Retrospective analysis of 1,030 velopharyngoplasties performed over 40 years.
- Comparison of cephalograms from 53 UCLP patients with pharyngeal flaps versus 38 UCLP patients without flaps.
Main Results:
- Excellent anatomical results (98%) and significant reduction in hyperrhinophony (90%) post-surgery.
- Pharyngeal flap surgery demonstrated adverse effects on sagittal and vertical facial growth.
- Observed craniofacial changes were not severe enough to negate the functional improvements.
Conclusions:
- Velopharyngoplasty is highly effective for improving speech in UCLP patients.
- Pharyngeal flap surgery's impact on facial growth is a consideration but does not outweigh its functional benefits.