Flap surgery: experience with 1,030 operations and cephalometric investigation

The authors report 1,030 (velo)pharyngoplasties performed in 40 years. The anatomical result was good in 98%, hyperrhinophony ceased or became minimal in 90% after surgery. The surgical indication and technique, the operative complications and the factors influencing the functional effect are discussed. In the present investigation cephalograms of 53 unilateral cleft lip and palate (UCLP) patients with inferiorly based pharyngeal flap were compared with the cephalograms of 38 UCLP patients without pharyngeal flap operation. Pharyngeal flap surgery has an adverse effect on the growing face both in the sagittal and vertical dimensions, but the changes do not reach a degree that would justify the abandonment of the good functional effect of velopharyngoplasty.