Abstract
We aimed to evaluate velopharyngeal function and speech outcomes of Sommerlad palatoplasty
combined with sphincter pharyngoplasty in surgical repair of cleft palate in patients
over five years old. Fifty-eight patients were reviewed between the years 2013 and
2017, 31 of whom were treated with Sommerlad palatoplasty combined with sphincter
pharyngoplasty, (mean age 15 (range 9 - 22) years), and 27 were treated with Sommerlad
palatoplasty alone (mean age 18 (range 10-25) years). Velopharyngeal function was
evaluated by radiographic lateral cephalometry and nasoendoscopy. Hypernasality, nasal
emissions, and intelligibility were used to assess speech. The rate of velopharyngeal
competence was 20/31 in the palatoplasty plus pharyngoplasty group and 7/27 in the
palatoplasty alone group after surgical treatment (p = 0.003). The improvements in hypernasality (p = 0.024), air emission (p = 0.004), and speech intelligibility (p = 0.004) in the palatoplasty plus pharyngoplasty group was better than that in the palatoplasty
alone group. It has been suggested that the surgical approach with the palatoplasty
together with the sphincter pharyngoplasty has a higher rate of success in surgical
repair of older patients with cleft palate.
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to British Journal of Oral and Maxillofacial SurgeryAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Influential factors affecting the postoperative velopharyngeal function among aged cleft palate patients.West China Journal of Stomatology. 2014; 32 (in Chinese): 54-57
- Application of team approach and key techniques of cleft lip and palate.West China Journal of Stomatology. 2017; 35 (in Chinese): 8-16
- Pharyngeal flap versus sphincter pharyngoplasty for the treatment of velopharyngeal insufficiency: a meta-analysis.J Plast Reconstr Aesthet Surg. 2012; 65: 864-868
- Study of relationship between clinical factors and velopharyngeal closure in cleft palate patients.J Res Med Sci. 2011; 16: 945-950
- Universal parameters for reporting speech outcomes in individuals with cleft palate.Cleft Palate Craniofac J. 2008; 45: 1-17
- Management of velopharyngeal insufficiency: development of a protocol and modifications of sphincter pharyngoplasty.Facial Plast Surg. 2007; 23: 128-139
- A technique for cleft palate repair.Plast Reconstr Surg. 2003; 112: 1542-1548
- Speech outcomes at 5 and 10 years of age after one-stage palatal repair with muscle reconstruction in children born with isolated cleft palate.J Plast Surg Hand Surg. 2018; 52: 20-29
- Incidence of palatal fistula after palatoplasty with levator veli palatini retropositioning according to Sommerlad.Br J Oral Maxillofac Surg. 2010; 48: 637-640
- Incidence of postoperative velopharyngeal insufficiency in late palate repair.J Craniofac Surg. 2012; 23: 1602-1606
- Velopharyngeal insufficiency treated with levator muscle repositioning and unilateral myomucosal buccinator flap.J Craniomaxillofac Surg. 2017; 45: 1-7
- Prospective analysis of presurgical risk factors for outcomes in primary palatoplasty.Plast Reconstr Surg. 2013; 132: 165-171
- What’s new in cleft palate and velopharyngeal dysfunction management.Plast Reconstr Surg. 2017; 139 (1343e-55e)
- Velopharyngeal dysfunction.Semin Plast Surg. 2012; 26: 170-177
- Surgicla anatomy of the levator veli palatini: a previously undescribed tendinous insertion of the anterolateral fibers.Plast Reconstr Surg. 2004; 114: 307-315
- Analysis of velopharyngeal morphology in adults with velopharyngeal incompetence after surgery of a cleft palate.Ann Plast Surg. 2006; 57: 50-54
- Clinical study on modified Langenbeck’s technique combined with sphincter pharyngoplasty repair of cleft palate patients over seven years old.Chinese Journal of Aesthetic Medicine. 2012; 21 (in Chinese): 1515-1518
- Investigation of the optimized surgical procedure for the cleft palate patients over six years old.West China Journal of Stomatology. 2010; 28 (in Chinese): 294-297
- Effect of palate re-repairs and hynes pharyngoplasties on pediatric airways:an analysis of preoperative and postoperative cardiorespiratory sleep studies.Cleft Palate Craniofac J. 2013; 50: 257-267
- Cleft palate repair and velopharyngeal dysfunction.Plast Reconstr Surg. 2014; 133 (852e-64e)
- Prevalence of obstructive sleep apnea after orticochea pharyngoplasty for velopharyngeal insufficiency management.Cleft Palate Craniofac J. 2015; 52: 682-687
- Morphological evaluation of changes in velopharyngeal function following maxillary distraction in patients with repaired cleft Palate during mixed dentition.Cleft Palate Craniofac J. 2004; 41: 355-363
Article info
Publication history
Published online: May 23, 2020
Accepted:
April 21,
2020
Identification
Copyright
© 2020 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.
