Incidence and Severity of Obstructive Sleep Apnea Following Pharyngeal Flap Surgery in Patients With Cleft Palate

Liao, Yu‐Fang; Chuang, Ming-Lung; Chen, Philip K.T.; Chen, Ning‐Hung; Yun, Claudia; Huang, Chiung-Shing

doi:10.1597/1545-1569(2002)039<0312:iasoos>2.0.co;2

Cited by 61 publications

(55 citation statements)

References 18 publications

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“…One of the few studies comparing the outcomes of these two surgeries on speech (10) demonstrated that pharyngeal flap was more efficient than intravelar veloplasty for reduction of hypernasality and adequacy of velopharyngeal closure in individuals with residual VPI. Conversely, pharyngeal flap changes the anatomy of the velopharyngeal region and thus alters the permeability of the nasopharynx, possibly leading to undesirable respiratory symptoms as oral respiration, snoring, obstructive sleep respiratory disorders, and even hyponasality (9,15,23,26,27) . In all these studies, surgeries were performed as the single procedure for correction of VPI.…”

Section: Discussionmentioning

confidence: 99%

“…There is consensus in the literature about the high success rate of pharyngeal flap surgery to reduce or eliminate the speech symptoms caused by VPI (12,13,14) . However, there is concern among clinicians and investigators in this field about surgeries that change the anatomy of the velopharyngeal region and alter the nasopharyngeal permeability, such as the pharyngeal flap (9,13,15) . For this reason, the literature has advocated surgical techniques that allow adequate velopharyngeal closure in a condition more similar to the normal anatomical conditions, i.e.…”

Section: Introductionmentioning

confidence: 99%

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Comparação entre duas abordagens diferentes de tratamento cirúrgico da insuficiência velofaríngea

Yamashita

Rissato

Scarmagnani

et al. 2017

Audiol., Commun. Res.

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Introduction: Secondary palatoplasty with intravelar veloplasty (IV) may be performed before pharyngeal flap (PF) for surgical treatment of velopharyngeal insufficiency in individuals with cleft palate. This surgical approach aims to improve the velopharyngeal conditions, thus avoiding indication of a large pharyngeal flap and its undesirable effects on respiration. Purpose: To investigate the effects of pharyngeal flap performed after intravelar veloplasty for the treatment of velopharyngeal insufficiency on nasality and respiration. Methods: Analysis of postoperative outcomes of speech nasality and respiration in 50 individuals with repaired cleft palate and velopharyngeal insufficiency, being 23 submitted to pharyngeal flap after intravelar veloplasty (Group IV+PF) and 27 submitted only to pharyngeal flap (Group PF). Nasality was determined by nasometry, and the effect of surgery on respiration was assessed by measuring the minimum nasopharyngeal transverse section area, obtained by the pressure-flow technique and investigation of respiratory complaints, using a specific questionnaire. Statistical comparison between groups was performed by the Mann-Whitney test and Student t test, at a significance level of p<0.05. Results: There was no difference between groups for the outcomes of nasality, measurement of nasopharyngeal area and investigation of respiratory complaints. Conclusion: Both approaches for surgical treatment of velopharyngeal insufficiency demonstrated similar outcomes concerning the elimination of hypernasality, as well as for respiration, suggesting that accomplishment of pharyngeal flap after intravelar veloplasty did not provide better speech resonance outcomes nor favored respiration.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Comparação entre duas abordagens diferentes de tratamento cirúrgico da insuficiência velofaríngea

Yamashita

Rissato

Scarmagnani

et al. 2017

Audiol., Commun. Res.

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“…According to the literature, the occurrence of respiratory changes after pharyngoplasty is extremely diverse, ranging from 4% to 92% (12)(13)(14) . Such diversity may be related to the methodology used, the age of the population studied and the criteria used to define the presence of respiratory changes, taking into account each patient's individual tolerance of symptoms after surgery.…”

Section: Discussionmentioning

confidence: 99%

“…Several studies have demonstrated the great success of pharyngeal flap surgery in reducing or eliminating VPI symptoms in speech, with success rates varying between 25% and 98% (8)(9)(10) . However, the pharyngeal flap is also associated with upper airway impairment, which may cause hyponasality, chronic nasal obstruction, snoring and obstructive sleep apnea, symptoms that interfere with respiratory function and, consequently, quality of life (11)(12)(13)(14) . It is also important to consider that a cleft lip/palate determines nasal deformities that often reduce the dimensions of the nasal cavity (15) and increase nasal resistance to respiratory airflow.…”

Section: Introductionmentioning

confidence: 99%

Dimensões nasofaríngeas e sintomas respiratórios após a cirurgia de retalho faríngeo em crianças e adultos

Fukushiro

Zwicker

Genaro

et al. 2013

Audiol., Commun. Res.

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Purpose: To investigate the influence of age on nasopharyngeal dimensions and respiratory symptoms in patients undergoing surgery to correct velopharyngeal insufficiency using the pharyngeal flap technique. Methods: A sample comprising 103 individuals divided into three groups: children (6-12 years old), young adults (18-30 years old) and middle-aged adults (≥ 40 years old). This was a retrospective study that analyzed the values for the nasopharyngeal area (pressure-flow technique, reference value: 0.570 cm 2 ) and the symptoms of oral respiration, snoring and respiratory difficulties during sleep. The values were obtained, on average, 12 months after surgery. The nasopharyngeal area was compared between the groups using analysis of variance, and respiratory symptoms were compared using the chi-squared test (p<0.05). Results

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“…Muitos estudos relataram a efetividade do retalho farín-geo na redução dos sintomas da fala (4,6,(10)(11)(12)(13)(14)(15)(16)(17)(18) . Por outro lado, o retalho faríngeo está associado a um potencial e significante de comprometimento das vias aéreas superiores, incluindo-se entre esses comprometimentos desde a hiponasalidade, obstrução nasal crônica, até ronco e apnéia obstrutiva do sono, que podem trazer consequências graves aos pacientes (4,10,(19)(20)(21) . O efeito do retalho faríngeo sobre a fala e a respiração dos pacientes tem sido estudado há anos, no Laboratório de Fisiologia do Hospital de Reabilitação de Anomalias Craniofaciais (HRAC-USP).…”

Section: Introductionunclassified

Correlação entre fechamento velofaríngeo e dimensões nasofaríngeas após cirurgia de retalho faríngeo avaliados por meio da técnica fluxo-pressão

Lanziani

Yamashita

Fukushiro

et al. 2010

Rev. soc. bras. fonoaudiol.

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RESUMOObjetivo: Verificar se a área dos orifícios velofaríngeos obtida após o retalho faríngeo (RF) durante a respiração de repouso (AVFr) é um indicador do grau de fechamento velofaríngeo durante a fala (AVFf). Métodos: Os sujeitos foram 62 pacientes com fissura de palato, associada ou não à fissura de lábio, de ambos os gêneros, com idades entre seis e 32 anos, submetidos ao RF há, pelo menos, . Para propiciar condições anatômicas e favorecer o fechamento velofaríngeo, é realizada a cirurgia primária de palato; porém esta pode não eliminar os sintomas da insuficiência velofaríngea, fazendo-se necessário uma cirurgia secundária do palato que tem como objetivo estreitar o orifício velofaríngeo a fim de permitir um completo fechamento velofaríngeo (4)(5)(6)(7) . Existem várias técnicas cirúrgicas empregadas para a correção da IVF, sendo o retalho faríngeo de pedículo superior a mais utilizada. A técnica consiste na construção de uma ponte de tecido miomucoso entre a parede posterior da faringe e o palato mole, delimitando dois orifícios laterais. A base do retalho faríngeo deve ficar no nível do corpo da primeira vértebra cervical, que corresponde à área de transição entre a mucosa faríngea e o início do tecido adenoideano. Está demonstrado através de estudos com nasoendoscopia e videofluoroscopia

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Incidence and Severity of Obstructive Sleep Apnea Following Pharyngeal Flap Surgery in Patients With Cleft Palate

Cited by 61 publications

References 18 publications

Comparação entre duas abordagens diferentes de tratamento cirúrgico da insuficiência velofaríngea

Comparação entre duas abordagens diferentes de tratamento cirúrgico da insuficiência velofaríngea

Dimensões nasofaríngeas e sintomas respiratórios após a cirurgia de retalho faríngeo em crianças e adultos

Correlação entre fechamento velofaríngeo e dimensões nasofaríngeas após cirurgia de retalho faríngeo avaliados por meio da técnica fluxo-pressão

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