Management of the black hole in velopharyngeal incompetence: combined use of a Furlow palatoplasty and sphincter pharyngoplasty
Abstract
BACKGROUND: Patients with velopharyngeal incompetence may have a combination of a large velopharyngeal gap and poor lateral wall motion on phonation, simulating a "black hole" on nasendoscopy. Pharyngeal flaps for treatment of velopharyngeal incompetence in these patients are of questionable efficacy, because poor lateral wall motion necessitates such a wide flap that nasal airway obstruction is likely.
METHODS: Thirteen patients with velopharyngeal incompetence were managed between 1994 and 2003 with a combined Furlow palatoplasty and sphincter pharyngoplasty by a single surgeon. A diagnosis of velopharyngeal incompetence was established by means of perceptual speech evaluation performed by a trained speech pathologist using a standardized speech/voice rating scale (0 to 13); scores of 4 or higher indicated an incompetent velopharyngeal valving mechanism. Surgical inclusion criteria were a large velopharyngeal gap (> or =7 mm) and poor lateral wall motion (1 or 2 of 5, with 3 being rated as average) measured by multiview videofluoroscopy and nasendoscopy.
RESULTS: The mean preoperative score on the speech and voice rating scale was 10.5 (range, 4 to 13), with a mean postoperative score of 1.9 (range, 0 to 8) following Furlow palatoplasty and sphincter pharyngoplasty in 13 patients. Two patients required an additional surgical procedure to achieve complete correction of velopharyngeal incompetence without nasal airway obstruction, to achieve a final mean score of 0.8 (range,…
How strong is the evidence?
Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 13 participants or records.
Read the paper
Related studies
- A Survey on Knowledge Graphs: Representation, Acquisition, and Applications
- Toxicity of nanomaterials
- The Human Gene Mutation Database: towards a comprehensive repository of inherited mutation data for medical research, genetic diagnosis and next-generation sequencing studies
- Halogen bonding (X‐bonding): A biological perspective
- Biofilm formation at the air–liquid interface by the Pseudomonas fluorescens SBW25 wrinkly spreader requires an acetylated form of cellulose
- Opioid Activation of Toll-Like Receptor 4 Contributes to Drug Reinforcement
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.