Velopharyngeal Function in Cleft Palate

Ml, Skolnick

doi:10.1016/s0094-1298(20)30073-0

Cited by 38 publications

(4 citation statements)

References 7 publications

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“…Postadenoidectomy velopharyngeal insufficiency has been estimated to occur in 1 in 1500 to 1 in 10 000 cases. [2][3][4] Nasopharyngeal stenosis and eustachian tube stenosis likely occur even less frequently. All of these complications are difficult to handle if they occur; treatments ranging in invasiveness from speech and swallowing therapy to multiple operations are required.…”

Section: Commentmentioning

confidence: 99%

Powered Partial Adenoidectomy

Murray¹,

Fitzpatrick²,

Guarisco³

2002

Arch Otolaryngol Head Neck Surg

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Section: Commentmentioning

confidence: 99%

Powered Partial Adenoidectomy

Murray¹,

Fitzpatrick²,

Guarisco³

2002

Arch Otolaryngol Head Neck Surg

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“…It is a condition characterized by hypernasal speech, nasal emission and turbulence, and in some cases nasal regurgitation of fluids. Its true incidence is difficult to establish but has been estimated between one in 1500 and one in 10 000 adenoidectomies 1,2 . It is often because of the unmasking of a pre‐existing palatal problem by removal of the tissue against which a poorly functioning palate was achieving nasopharyngeal closure.…”

mentioning

confidence: 99%

Velopharyngeal insufficiency following adenoidectomy1

Saunders

Hartley²,

Sell

et al. 2004

Clin Otolaryngol

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Velopharyngeal insufficiency (VPI) is a well recognized but rare complication of adenoidectomy. Twenty children with this condition were seen and assessed at Great Ormond Street Hospital between 1993 and 2000. The commonest aetiology was occult submucous cleft palate (n = 5) but there was a wide range of other causes. Two children with severe behavioural disorders and normal palates developed mild symptoms, an aetiology not previously reported. Only two children had a classical submucous cleft palate. Nine children required surgical intervention and three revision procedures. Of the 15 treated children for whom follow-up data was available, 13 regained normal or near-normal speech. Many cases of postadenoidectomy VPI was not foreseeable. Following referral to a specialist cleft unit, normal or near-normal speech can be achieved in the majority with a combination of surgery and speech therapy.

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“…Based on our findings and physiological studies of the velopharyngeal closure (Skolnick and McCall, 1972;Skolnick et al, 1973Skolnick et al, , 1975Skolnick, 1975;Shprintzen et al, 1977;Glaser et al, 1979;Croft et al, 1981;Witzel and Posnick, 1989;Isberg and Henningsson, 1990;Dua et al, 1995;Perry, 2011aPerry, , 2011bPerry et al, 2013Perry et al, , 2014Perry et al, , 2017Perry et al, , 2018aPerry et al, , 2018bNakayama et al, 2013;Sakamoto et al, 2015;Kotlarek et al, 2017), a series of successive movements for velopharyngeal closure may be proposed as follows.…”

Section: Discussionmentioning

confidence: 75%

Anatomical Significance of the Spatial Distribution of the Palatopharyngeus With Regard to Velopharyngeal Closure

Fukino

Tsutsumi

Sañudo

et al. 2018

The Cleft Palate-Craniofacial Journal

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Objective: Coordination of the various soft palate and pharyngeal muscles should be considered while evaluating velopharyngeal closure. However, it remains unclear whether different muscle bundles have specific functions during velopharyngeal closure. We macroscopically and microscopically examined these muscles in detail and particularly clarified the morphology of the palatopharyngeus (PP) in velopharyngeal closure. Design: Forty halves of 21 heads from Japanese cadavers (average: 83.9 years) were used for analysis; 37 halves of 19 heads were macroscopically examined and 3 halves of 2 heads were histologically examined. Results: The PP consisted of muscle bundles originating from the superior and inferior surfaces of the palatine aponeurosis. The most superior part of the superior constrictor (SC) and most lateral part of PP on the palatine aponeurosis initially ran in parallel and subsequently, in superoposterior and inferoposterior directions, respectively. The PP appeared as a single continuous sheet that was radially spread as a whole. Its medial margins, located superior and inferior to the aponeurosis, formed a fold that established the palatopharyngeal arch. The stylopharyngeus (StP) adjoined the base of this arch. Conclusions: Since PP consisted of muscle bundles running in various directions, various functions of these bundles should be considered during velopharyngeal closure. The PP can function as a sphincter with SC and as an elevator with StP. In addition, PP forms the medial protrusion in collaboration with StP and SC. Thus, PP plays an important role in velopharyngeal closure with the coordination of various muscles.

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Velopharyngeal Function in Cleft Palate

Cited by 38 publications

References 7 publications

Powered Partial Adenoidectomy

Powered Partial Adenoidectomy

Velopharyngeal insufficiency following adenoidectomy1

Anatomical Significance of the Spatial Distribution of the Palatopharyngeus With Regard to Velopharyngeal Closure

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