Abstract
The purpose of this study was to compare speech and breathing after sphincter pharyngoplasty
and the Hogan pharyngeal flap in the management of cleft-related velopharyngeal insufficiency
(VPI). We reviewed 78 patients with VPI who had either the Hogan flap (n = 30) or sphincter pharyngoplasty (n = 48) between 2009 and 2011. Velopharyngeal function, nasal patency, and speech were
compared. In the Hogan flap group, 25 patients had achieved velopharyngeal competence
and nine had normal speech. In the sphincter pharyngoplasty group, 29 patients achieved
velopharyngeal competence and 20 normal speech. The Hogan flap group had a higher
rate of velopharyngeal competence (n = 25) than the sphincter pharyngoplasty group (p = 0.033), but there was no significant difference in intelligibility of speech. Eighteen
patients in the Hogan flap group and 33 in the sphincter pharyngoplasty group reported
symptoms of snoring, with no significant difference in nasal ventilation. Our results
suggest that a posterior pharyngeal flap is a more effective technique for managing
VPI after repair of cleft palate than sphincter pharyngoplasty, and causes no more
postoperative complications in nasal breathing.
Keywords
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Article info
Publication history
Published online: December 18, 2019
Accepted:
November 25,
2019
Identification
Copyright
© 2019 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.
