Perceptual analysis of speech and the activity in the lateral pharyngeal walls before and after velopharyngeal flap surgery

The purpose of this study was to investigate the effects of velopharyngeal flap surgery on speech and its relation with the activity in the lateral pharyngeal wall. Videofluoroscopic recordings made before and after operation were used in this retrospective study, which comprised 28 patients who had pharyngeal flap surgery between 5:5 and 14:3 (mean 8:6) years:months of age at the Sahlgrenska University Hospital, Göteborg, Sweden. Twenty-four patients had different types of clefts and four had velopharyngeal impairment (VPI) without a cleft palate. Eleven had additional malformations. Speech and activity in the lateral pharyngeal walls were rated perceptually preoperatively and postoperatively. The study confirmed that patients with VPI can be helped by a velopharyngeal flap operation. There seemed to be a relation with the activity in the lateral pharyngeal wall and speech. The later the postoperative assessment, the better the speech, but the age at operation did not affect the result. The impact of additional anomalies and syndromes should be investigated further.

[1]  M. Meek,et al.  Short-Term and Long-Term Results of Speech Improvement After Surgery for Velopharyngeal Insufficiency With Pharyngeal Flaps in Patients Younger and Older Than 6 Years Old: 10-Year Experience , 2003, Annals of plastic surgery.

[2]  G. Sloan Posterior pharyngeal flap and sphincter pharyngoplasty: the state of the art. , 2000, The Cleft palate-craniofacial journal : official publication of the American Cleft Palate-Craniofacial Association.

[3]  M. Moerman Cleft palate speech. , 2000, Acta oto-rhino-laryngologica Belgica.

[4]  G. Henningsson,et al.  Comparison between two types of pharyngeal flap with regard to configuration at rest and function and speech outcome. , 1999, The Cleft palate-craniofacial journal : official publication of the American Cleft Palate-Craniofacial Association.

[5]  G. Henningsson,et al.  Adaptation of pharyngeal wall adduction after pharyngeal flap surgery. , 1999, The Cleft palate-craniofacial journal : official publication of the American Cleft Palate-Craniofacial Association.

[6]  B. Bauer Cleft Palate Speech Management: A Multidisciplinary Approach. , 1997 .

[7]  J. Bardach,et al.  Cleft Palate Speech Management: A Multidisciplinary Approach , 1995 .

[8]  N. Gellrich,et al.  Speech results and velopharyngeal morphology following 151 cranially based velopharyngoplasties. , 1995, Folia phoniatrica et logopaedica : official organ of the International Association of Logopedics and Phoniatrics.

[9]  R. Haro,et al.  Obstructive sleep apnea secondary to surgery for velopharyngeal insufficiency. , 1993, The Cleft palate-craniofacial journal : official publication of the American Cleft Palate-Craniofacial Association.

[10]  R. Schmelzeisen,et al.  Long-term results following velopharyngoplasty with a cranially based pharyngeal flap. , 1992, Plastic and reconstructive surgery.

[11]  G. Henningsson,et al.  Comparison between multiview videofluoroscopy and nasendoscopy of velopharyngeal movements. , 1991, The Cleft palate-craniofacial journal : official publication of the American Cleft Palate-Craniofacial Association.

[12]  M P Karnell,et al.  Standardization for the reporting of nasopharyngoscopy and multiview videofluoroscopy: a report from an International Working Group. , 1990, The Cleft palate journal.

[13]  A. Seyfer,et al.  The Effectiveness of the Superiorly Based Pharyngeal Flap in Relation to the Type of Palatal Defect and Timing of the Operation , 1988, Plastic and reconstructive surgery.

[14]  G. Henningsson,et al.  Velopharyngeal movement patterns in patients alternating between oral and glottal articulation: a clinical and cineradiographical study. , 1986, The Cleft palate journal.

[15]  D. V. Van Demark,et al.  Longitudinal evaluation of articulation and velopharyngeal competence of patients with pharyngeal flaps. , 1985, The Cleft palate journal.

[16]  S. Prytz,et al.  Surgical and speech results following palatopharyngoplasty operations in Denmark 1959-1977. , 1984, The Cleft palate journal.

[17]  R. Shprintzen,et al.  The effect of pharyngeal flap surgery on the movements of the lateral pharyngeal walls. , 1980, Plastic and reconstructive surgery.

[18]  R. Shprintzen,et al.  The role of lateral pharyngeal wall movement in pharyngeal flap surgery. , 1980, Plastic and reconstructive surgery.

[19]  D. Larson,et al.  Nasal obstruction as a complication of pharyngeal flap surgery. , 1980, The Cleft palate journal.

[20]  H. Pashayan,et al.  The effects of pharyngeal flap surgery on laternal pharyngeal wall motion: a videoradiographic evaluation. , 1980, The Cleft palate journal.

[21]  R. Shprintzen,et al.  A comprehensive study of pharyngeal flap surgery: tailor made flaps. , 1979, The Cleft palate journal.

[22]  S. Ewanowski,et al.  Lateral pharyngeal-wall motion as a predictor of surgical success in velopharyngeal insufficiency. , 1972, The New England journal of medicine.

[23]  B. Fritzell,et al.  A study of speech improvement following palatopharyngeal flap surgery. , 1970, The Cleft palate journal.

[24]  D. C. Spriestersbach,et al.  The Pharyngeal Flap as a Speech Mechanism , 1967, Plastic and reconstructive surgery.