Buccinator myomucosal flap for the treatment of velopharyngeal insufficiency in patients with cleft palate and/or lip

Abstract

The buccinator myomucosal flap is effective in reducing/eliminating hypernasality in patients with cleft palate (± lip) and velopharyngeal insufficiency.

Measuring Patient-Reported Health-Related Quality of Life in Velopharyngeal Insufficiency: Reliability and Validity of the Brazilian Portuguese Version of the VELO Instrument

“…In this study, we were thorough in including the degree of intra- and interevaluators agreement for hypernasality severity assessments. This methodology has been replicated both in VPI clinical practice and in subsequent outcome studies (Denadai et al, 2017; Denadai et al, 2018a; Denadai et al, 2018b; Denadai et al, 2018c; Mangilli and Sabbag, 2018; Denadai et al, 2019).…”

“…For criterion validity testing, we adopted hypernasality severity on perceptual speech analysis because among the obligatory distortions, hypernasality is considered the most representative symptom of VPI (Kummer, 2014). Although the hypernasality severity is not truly a gold standard, it is the most widely used measure (Lam et al, 2006; Kummer, 2014; Denadai et al, 2017; de Blacam et al, 2018; Denadai et al, 2018c; Kummer et al, 2019). The Brazilian-Portuguese version attained correlations of −.50 for total VELO and subscales, demonstrating that participants with more severe hypernasality were less likely to have a high VELO score.…”

“…Although no such gold standard criterion exists for VPI, perceptual speech analysis is the most widely used current standard in diagnostic and therapeutic outcome studies in the VPI literature (Lam et al, 2006;Kummer, 2014;Denadai et al, 2017;de Blacam et al, 2018;Denadai et al, 2018c;Kummer et al, 2019). For criterion validity testing, we adopted hypernasality severity on perceptual speech analysis because among the obligatory distortions, hypernasality is considered the most representative symptom of VPI (Kummer, 2014).…”

"Treatment of Velopharyngeal Insufficiency via Bilateral Myomucosal Buccinator Flaps "

“…16,17 The anatomic and physiologic characteristics of buccinator flaps have been supported in obstructive sleep apnea assessments as a treatment modality for VPI. 2,18…”

Single-stage Palatal Lengthening Using Modified Buccinator Myomucosal and Buccal Fat Flaps

“…[1][2][3][4] Advantages of the buccinator myomucosal flap include anatomic lengthening of the soft palate with minimal donor site morbidity and airway compromise. 1,2,[5][6][7][8] The majority of recent literature describes this flap in two stages, with a secondary procedure for pedicle division to avoid mastication issues near the pedicle. 2,5,6,[9][10] We describe multiple modifications of this technique to allow a one-stage procedure via fullthickness mucosal cuts at the pedicle of the buccinator flaps and coverage of the pedicle with adjacent buccal fat flaps.…”