medigraphic.com
ISSN 2007-3178 (Print)
Asociación Mexicana de Cirugía Bucal y Maxilofacial, Colegio Mexicano de Cirugía Bucal y Maxilofacial, A.C.

2021, Number 2

Next >>

Rev Mex Cir Bucal Maxilofac 2021; 17 (2)

Analysis of velopharyngeal closure patterns in patients with cleft palate when performing the linear sphincteroplasty and Furlow double z-plasty surgical techniques. Pilot study

Hernández ÁMJ, Castilla CH, Góngora CG, Salgado CF

Language: Spanish
References: 23
Page: 55-61
PDF size: 265.85 Kb.


ABSTRACT

Objective: Correlate type of velopharyngeal closure pattern in patients with cleft palate using two different types of surgical closure with the Bardach linear sphincteroplasty and Furlow double z-plasty techniques. Material and methods: A retrospective, cross-sectional pilot study was realized at Peralvillo Pediatric Hospital, in the period from January 2017 to February 2020. Results: 118 patients with cleft palate who were treated surgically were registered, only 16 fulfilled the inclusion criteria, 11 were male (68.75%), five female (31.25%). The main surgical technique used was Bardach 62.5 and the double Z Furlow was used on six occasions (37.5%). The circular closure pattern was the most prevalent [mean 10.1 years] performed in eight males and three females, followed by the coronal [mean 5.2 years] performed in four children, two females and two males, and Passavant's ridge [mean 14 years] performed in a masculine. Conclusions: Few studies describe velopharyngeal closure patterns in patients with cleft palate, but they agree that physiologically the circular pattern is the most common worldwide. This study can be used to continue carrying out other investigations in which there is a larger sample for analysis of velopharyngeal closure patterns and comparing surgical techniques to find out which of them is the most appropriate velopharyngeal closure pattern obtained for phonation in Spanish speaking patients.


REFERENCES

  1. Beer AJ, Hellerhoff P, Zimmermann A, Maddy K, Sader R, Rummeny EJ et al. Dynamic Near -Real- Time magnetic resonance imagin for analysing the velopharingeal closure in comparison with videofluoroscopy. Journal of Magnetic Resonance Imaging. 2004; 20: 791-797.

  2. Sadove AM, van Aalst JA, Culp JA. Cleft palate repair: art and issues. Clin Plast Surg. 2004; 31: 231-241.

  3. Perry JL. Anatomy and physiology of the velopharyngeal mechanism. Semi Speech Lang. 2011; 32: 83-92.

  4. Naiman N, Disant F. Cirugía de la Insuficiencia velofaríngea. EMC Consulte. 2001; E-46-310.

  5. Skolnick M, McCall G, Carnes M. The sphincteric macanism of velopharyngeal closure. New York, NY: McGraw-Hill; 2009, 653.

  6. Prada MJR, García VT, Echeverri B, MP, Tavera HMC. Patterns of velopharyngeal closure: comparative study between healthy population and patients with cleft palate. Cir Plást Iberotatinoam. 2010; 36: 305-312.

  7. Fisher D, Sommerlad B. Cleft lip, cleft palate, and velopharyngeal insufficiency. CME. Plast Reconstr Surg. 2011; 128 (4): 342e-360e.

  8. Golding-Kushner KJ, Argamaso RV, Cotton RT. Standardization for the reporting of nasopharyngoscopy and multiview videofloroscopy. A report from an international working group. Cleft Palate J. 1990; 27: 337-347.

  9. Engelke W, Poppelreuter S, Burns T, Quantitative Analysis of the velopharingeal Sphincter function during speech. Cleft Palate Craniofac J. 2000; 37 (2): 157-165.

  10. Hopper RA, Tse R, Smartt J, Swanson J, Kinter S. Cleft palate repair and velopharyngeal dysfunction. Plastic Reconstr Surg. 2014; 133 (6): 852-864.

  11. Paliobei V, Psifidis A, Anagnostopoulos D. Hearing and speech assessment of cleft palate patients after palatal closure. Long term results. Int J Pediatr Otorhinolaryngol. 2005; 69: 1373-1381.

  12. Smith M, Losse J. Cleft palate repair. Clin Plastic Surg. 2014; 41: 189-2010.

  13. Arboleda C, Dueñas B. Frases en español para distintos fonemas. CCC-SLP. Leadersproject. 2009.

  14. Wong LS, Lim E, Lu TC, Chen PKT. Management of velopharyngeal insufficiency by modified Furlow palatoplasty with pharyngeal flap: a retrospective outcome review. Int J Oral Maxillofac Surg. 2019; 48: 703-707.

  15. MacKenzie-Stepner K, Witzel MA, Stringer DA, Laskin R. Velopharyngeal insuficiency due to hypertrophic tonsils. A reporte of two cases. Int J Pediatr Otorhinolaryngol. 1987; 14: 57-63.

  16. Pearson G, Kirschner R. Surgery for clerf palate and velopharyngeal dysfunction. Seminars in Speech and Language. 2011; 32 (2): 179-190.

  17. Riski JE, Ruff GL, Georgiade GS, Barwick WJ, Edward PD. Evaluation of the sphincter pharyngoplasty. Cleft Palate Craniofac J. 1992; 29: 254-261.

  18. Witt PD, Marsh JL, Arlis H, Grames LM, Ellis RA, Pilgrim TK. Quantification of Dynamic velopharyngeal port excursion following sphincter pharyngoplasty. Plast Reconstr Surg. 1998; 101: 1205-1211.

  19. Campbell A, Costello BJ, Ruiz RL. Cleft lip and palate surgery: an update of clinical outcomes for primary repair. Oral Maxillofacial Surg Clin N Am. 2010; 22: 43-58.

  20. Michael S, Arun K. Surgical management of velopharyngeal insufficiency. Clin Plastic Surg. 2014; 41: 253-270.

  21. Monserat E, Sillet M. Paladar hendido tratamiento quirúrgico. Acta Odontológica Venezolana. 2002; 40 (3): 289-293.

  22. Ragab A. Cerclage sphincter pharyngoplasty: a new technique for velopharyngeal insufficiency. Int J Pediatr Otorhinolaryngol. 2007; 71: 793-800.

  23. Rudnick EF, Sie KC. Velopharyngeal insufficiency: current concepts in fiagnosis an management. Curr Opin Otolaryngol Head Neck Surg. 2008; 16: 530-535.




2020     |     www.medigraphic.com