The effect of sphincter pharyngoplasty on the range of velar movement

Efficacy of speech aid prostheses for acquired defects of the soft palate and velopharyngeal inadequacy—clinical assessments and cephalometric analysis: A Memorial Sloan-Kettering Study

“…The diagnosis, staging, and surgical resection areas were included and recorded in such detail as an attempt to compare our speech outcomes with patients in other studies who received microvascular flaps for similar surgeries. Most other studies report that most patients reconstructed with free flaps had tumors ranging from T1 to T3 9–15. Most of this study population had tumors ranging from T3 to T4.…”

“…Several investigations and reports (Table 5), including this study, attempt to relay this information diagrammatically. Many of these reports are difficult to interpret, with limited diagrams to quantify the surgical defects and reconstructive efforts by labeling with fractions or percentages, our study included 9–15. Other reports attempt to quantify the surgical defects and reconstructive efforts by labeling with fractions or percents 10, 11…”

Palatopharyngeal sling: A new technique in treatment of velopharyngeal insufficiency

“…It is formed of two myomucosal flaps similar to the flaps of sphincter pharyngoplasty but they passed through palatal splits created bilaterally to meet each other on a raw area on the oral surface of the soft palate producing together a U-shaped sling. In the sphincter pharyngoplasty operation as mentioned by many authors, both flaps attached together and sutured in a raw area in the posterior pharyngeal wall in order to close the velopharynx against the palate [9,10]. Elevation of the soft palate by this new technique would facilitate velopharyngeal closure by decreasing the distance between it and the posterior pharyngeal wall.…”

“…In this technique, we included the palatopharyngeus muscle in the flap for two reasons: firstly, its antagonistic action to the levator palati as suggested by Georgantopoulou et al dividing and transposing the palatopharyngeus muscles would then allow the levators to act unopposed, thus resulting in increased velar elevation [9]. Secondly, not to leave a lateral gutter between the sling and the lateral pharyngeal wall, if the flap was formed of superior constrictor muscle only, this gutter may be a site for mucus accumulation.…”

Contractility of sphincter pharyngoplasty: Relevance to speech outcomes

“…Georgantopoulou et al (4) used tracings of a velopharyngeal port made from pre-and postoperative videofluoroscopies to measure velar elevation associated with port closure in patients who had undergone BACkGRound: Sphincter pharyngoplasty has demonstrated timetested results as a surgical treatment for velopharyngeal incompetence (VPI). However, controversy surrounding the contractility of the transposed muscles persists.…”