Does velopharyngeal closure pattern affect the success of pharyngeal flap pharyngoplasty?

Abstract:

:Historically at The Hospital for Sick Children in Toronto, pharyngeal flap pharyngoplasty has been the treatment of choice for treatment of velopharyngeal insufficiency, regardless of velopharyngeal closure pattern. The authors hypothesize that pharyngeal flap pharyngoplasty is more effective in treating velopharyngeal insufficiency in patients with circular or sagittal velopharyngeal closure and less effective in treating the coronal closure pattern. Ninety-three patients who underwent superiorly based pharyngeal flap surgery for velopharyngeal insufficiency were evaluated in a retrospective chart review. Closure pattern was determined preoperatively by nasopharyngoscopy or multiview videofluoroscopy. Nasalance was assessed preoperatively and at 6 weeks and 1 year postoperatively. Nasalance during nonnasal speech was decreased on average, for all closure patterns, postoperatively. However, a significantly higher percentage of patients were corrected to normal nasalance scores in thenoncoronal group than in the coronal group (57 percent versus 35 percent, respectively) at 1 year postoperatively (p < 0.05). Surgical overcorrection, as determined by postoperative hyponasality, occurred at a rate of 13 percent in the coronal group versus 7 percent in the noncoronal group (not statistically significant). The results demonstrate that hypernasality in patients with a coronal velopharyngeal closure pattern can be improved by pharyngeal flap pharyngoplasty. This procedure, however, is more frequently effective in correcting noncoronal closure pattern velopharyngeal insufficiency than coronal pattern velopharyngeal insufficiency. The authors are now more selective in their approach to the management of velopharyngeal insufficiency and are more inclined to treat coronal pattern velopharyngeal insufficiency with sphincter pharyngoplasty.

journal_name

Plast Reconstr Surg

authors

Armour A,Fischbach S,Klaiman P,Fisher DM

subject

Has Abstract

pub_date

2005-01-01 00:00:00

pages

45-52; discussion 53

issue

1

eissn

0032-1052

issn

1529-4242

pii

00006534-200501000-00006

journal_volume

115

pub_type

杂志文章,评审
  • Benchmarking outcomes in plastic surgery: national complication rates for abdominoplasty and breast augmentation.

    abstract:BACKGROUND:The authors evaluated the use of national databases to track surgical complications among abdominoplasty and breast augmentation patients. METHODS:Their study population included all patients with abdominoplasty or breast augmentation in the Tracking Operations and Outcomes for Plastic Surgeons (TOPS) and C...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/PRS.0b013e3181bf8378

    authors: Alderman AK,Collins ED,Streu R,Grotting JC,Sulkin AL,Neligan P,Haeck PC,Gutowski KA

    更新日期:2009-12-01 00:00:00

  • Dorsalis pedis flap donor site: acceptable or not?

    abstract::The dorsalis pedis flap has been used successfully for 20 years, both as a pedicled transfer for local foot reconstruction and as a free microvascular transfer. Proponents cite the reliable vascularity, versatility, ease of harvest, and thinness. Although significant donor-site morbidity has been recognized previously...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/00006534-199810000-00031

    authors: Samson MC,Morris SF,Tweed AE

    更新日期:1998-10-01 00:00:00

  • Inframammary fold: a histologic reappraisal.

    abstract::The inframammary fold is a defining element in the shape and structure of the female breast. It should be preserved whenever possible in ablative procedures and recreated accurately when the breast is reconstructed after mastectomy. To date, no accurate anatomic description of this essential structure exists. Previous...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/00006534-200002000-00011

    authors: Muntan CD,Sundine MJ,Rink RD,Acland RD

    更新日期:2000-02-01 00:00:00

  • Diastematomyelia: a congenital anomaly not to be confused with a giant hairy nevus.

    abstract::The role of the plastic surgeon in the diagnosis and management of congenital anomalies is often a complicated one that involves the integration of input from numerous specialists into the evaluation process. Diastematomyelia is a serious neurosurgical problem that often presents with cutaneous findings in a neurologi...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:

    authors: Weinzweig J,Holman PD,Rekate HL

    更新日期:1995-07-01 00:00:00

  • SMAD6 Genotype Predicts Neurodevelopment in Nonsyndromic Craniosynostosis.

    abstract:BACKGROUND:De novo or rare transmitted mutations in the SMAD6 gene affect 7 percent of midline nonsyndromic synostosis patients. This study aimed to determine the neurocognitive sequelae of SMAD6 synostosis. METHODS:Nonsyndromic synostosis patients 6 years or older with SMAD6 mutations and non-SMAD6 nonsyndromic synos...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/PRS.0000000000006319

    authors: Wu RT,Timberlake AT,Abraham PF,Gabrick KS,Lu X,Peck CJ,Sawh-Martinez RF,Steinbacher DM,Alperovich MA,Persing JA

    更新日期:2020-01-01 00:00:00

  • Patterns of Dupuytren disease in fingers: studying correlations with a multivariate ordinal logit model.

    abstract:BACKGROUND:Dupuytren disease affects fingers in a variable fashion. Knowledge about specific disease patterns (phenotype) based on location and severity of the disease is lacking. METHODS:In this cross-sectional study, 344 primary affected hands with Dupuytren disease were physically examined. The Pearson correlation ...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/PRS.0000000000000429

    authors: Lanting R,Nooraee N,Werker PMN,van den Heuvel ER

    更新日期:2014-09-01 00:00:00

  • Pakistan Comprehensive Fistula Classification: A Novel Scheme and Algorithm for Management of Palatal Fistula/Dehiscence.

    abstract:BACKGROUND:It is not easy to find a management-based classification of palatal fistula in the literature. A few attempts have been made to classify the wide variety of fistulae that do not describe the fistula details comprehensively and guide toward its management. The authors have come across a wide variety of fistul...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/PRS.0000000000005169

    authors: Fayyaz GQ,Gill NA,Ishaq I,Aslam M,Chaudry A,Ganatra MA,Obaid O,Tarar MN,Chen PK,Laub DR

    更新日期:2019-01-01 00:00:00

  • A reliable method for monitoring the microvascular patency of free jejunal transfers in reconstructing the pharynx and cervical esophagus.

    abstract::Reconstruction of the pharynx and esophagus with revascularized segments of jejunum remains a time-proven entity. Most thromboses and subsequent flap failures have occurred within the first 24 hours after revascularization of the flap. What would therefore be desirable is a safe, proven monitoring system to assess the...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/00006534-198905000-00024

    authors: Bafitis H,Stallings JO,Ban J

    更新日期:1989-05-01 00:00:00

  • Intralesional corticosteroid therapy for infantile hemangiomas.

    abstract::Intralesional corticosteroid injections were performed in 31 hemangiomas in 30 infants aged 1 to 10 months at first injection. One to five injections were given, spaced 6 weeks apart. Lesions were located throughout the head and neck region, except one that was on the buttock. A mixture of betamethasone acetate and tr...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/00006534-198903000-00009

    authors: Sloan GM,Reinisch JF,Nichter LS,Saber WL,Lew K,Morwood DT

    更新日期:1989-03-01 00:00:00

  • "Sensible" flap coverage of pressure sores in patients with meningomyelocele.

    abstract::Restoration of sensibility in the paraplegic patient is the optimal therapy for the management and prevention of debilitating pressure sores. In patients with an absence of sensibility below the L3 spinal level, a locally transposed arterialized neuromyocutaneous gracilis flap may be uniquely utilized for ischial rest...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:

    authors: Lesavoy MA,Dubrow TJ,Korn HN,Cedars MG,Castro DJ

    更新日期:1990-03-01 00:00:00

  • The effect of unilateral partial facial paralysis on nasofrontal sutural growth: an experimental study in the rabbit.

    abstract::In a previous study in the rabbit, it was demonstrated that paralysis of the midfacial musculature results in decreased anteroposterior growth of the snout. At the end of growth, these animals showed macroscopically striking similarities to animals with unilateral fusion of the nasofrontal suture. In this study, wheth...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/00006534-199906000-00013

    authors: Sinsel NK,Guelinckx PJ,Opdebeeck H

    更新日期:1999-06-01 00:00:00

  • Reconstruction of Posterior Mandibulectomy Defects in the Modern Era of Virtual Planning and Three-Dimensional Modeling.

    abstract:BACKGROUND:Posterior mandibulectomy defects can be reconstructed using either soft tissue or vascularized bone. The authors hypothesize that advances in computer-aided design and manufacturing (CAD-CAM) have resulted in osteocutaneous free flaps now proving superior to soft-tissue flaps. METHODS:The authors conducted ...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/PRS.0000000000005954

    authors: Chang EI,Boukovalas S,Liu J,Largo RD,Hanasono MM,Garvey PB

    更新日期:2019-09-01 00:00:00

  • The Pushback Pharyngeal Flap: An 18-Year Experience.

    abstract:BACKGROUND:The pharyngeal flap is one of the oldest and most popular techniques for correction of velopharyngeal insufficiency. The authors describe a large series using a technique that combines a pharyngeal flap with a palate pushback to avoid common causes of operative failure while restoring the velopharyngeal mech...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/PRS.0000000000005645

    authors: Rochlin DH,Mittermiller PA,Sheckter CC,Menard RM

    更新日期:2019-06-01 00:00:00

  • Medical decision-making among adolescents with neonatal brachial plexus palsy and their families: a qualitative study.

    abstract:BACKGROUND:Elective surgical management of neonatal brachial plexus palsy is complex, variable, and often individualized. Little is known about the medical decision-making process among adolescents with neonatal brachial plexus palsy and their families when faced with making complex treatment decisions. The experiences...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/PRS.0b013e31828bd52b

    authors: Squitieri L,Larson BP,Chang KW,Yang LJ,Chung KC

    更新日期:2013-06-01 00:00:00

  • The "knot twist": a new method of securing wire loops--an assessment of mechanical properties.

    abstract::A model simulating intraosseous wire fixation was used to assess different methods of securing wire loops. Square knotting, twisting, and a new method, the "knot twist," were assessed. The importance of anchoring the butt ends of twisted wire is emphasized. A new, convenient technique of wire fixation is described. ...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:

    authors: Green RA,Zins JE

    更新日期:1988-06-01 00:00:00

  • Traumatic hemipelvectomy.

    abstract::This is a report of a patient who sustained a traumatic avulsion of the hemipelvis and survived this catastrophic challenge. Survival of the patient is dependent on multiple factors of associated injuries, early management, and general health of the patient. Early involvement of the plastic surgical team offers a coor...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/00006534-198512000-00030

    authors: Danisi FJ,Stromberg BV

    更新日期:1985-12-01 00:00:00

  • Three- and four-dimensional arterial and venous anatomies of the thoracodorsal artery perforator flap.

    abstract:BACKGROUND:The vascular anatomy of the thoracodorsal artery perforator flap, which has not previously been elucidated, was examined using three- and four-dimensional computed tomographic angiography and venography. METHODS:Twenty-five thoracodorsal artery perforator flaps were harvested from fresh cadavers from the We...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/PRS.0b013e31816b1479

    authors: Schaverien M,Saint-Cyr M,Arbique G,Brown SA,Rohrich RJ

    更新日期:2008-05-01 00:00:00

  • Pharmacologic manipulation of postoperative labial wound contraction and midfacial growth in rabbits.

    abstract::Recent experimental work has suggested that increased lip pressure and scar contraction following lip repair with wide soft-tissue undermining may, in part, contribute to midfacial growth inhibition. The present study was designed to test this hypothesis through the application of pharmacologic agents reported to mini...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/00006534-199107000-00021

    authors: Mooney MP,Siegel MI,Hurwitz DJ,Edington H

    更新日期:1991-07-01 00:00:00

  • Late reconstruction of two total metacarpal bone defects using lengthening devices and a double-barrel osteocutaneous free parascapular flap.

    abstract::A case was presented in which the late reconstruction of left ring and little metacarpal bone defects was carried out using a lengthening device and a double-barrel osteocutaneous free parascapular flap. With this flap, up to 14 cm of nearly straight bone of a suitable width and length for the reconstruction of two me...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/00006534-200007000-00019

    authors: Masaki F,Takehiro D,Ryuuichi M,Kumi M

    更新日期:2000-07-01 00:00:00

  • Quality of life and disease-specific functional status following microvascular reconstruction for advanced (T3 and T4) oropharyngeal cancers.

    abstract::In an effort to evaluate quality-of-life benefits of ablative head and neck cancer surgery and microvascular reconstruction, a longitudinal study was undertaken in which patients with T3 or T4 oropharyngeal cancers without systemic metastases at presentation were administered both general and disease-specific quality-...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/00006534-200004050-00005

    authors: Netscher DT,Meade RA,Goodman CM,Alford EL,Stewart MG

    更新日期:2000-04-01 00:00:00

  • Cleft palate closure at 3 to 7 months of age: a preliminary report.

    abstract::The evolution and present criteria for early soft palate closure are reviewed. A definitive group of patients (operated on at 3 to 7 months of age) is reviewed at least 2 years following their surgery. They are compared with our general clinic population (operated on at 12 to 18 months of age) and had significantly fe...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/00006534-198305000-00007

    authors: Randall P,LaRossa DD,Fakhraee SM,Cohen MA

    更新日期:1983-05-01 00:00:00

  • Pharyngeal flap outcomes in nonsyndromic children with repaired cleft palate and velopharyngeal insufficiency.

    abstract:BACKGROUND:Velopharyngeal insufficiency occurs in 5 to 20 percent of children following repair of a cleft palate. The pharyngeal flap is the traditional secondary procedure for correcting velopharyngeal insufficiency; however, because of perceived complications, alternative techniques have become popular. The authors' ...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/PRS.0b013e3181c2a6c1

    authors: Sullivan SR,Marrinan EM,Mulliken JB

    更新日期:2010-01-01 00:00:00

  • Treatment of facial fat atrophy related to treatment with protease inhibitors by autologous fat injection in patients with human immunodeficiency virus infection.

    abstract::A parallel effect of the use of protease inhibitors in human immunodeficiency virus-positive patients is the appearance of facial fat atrophy. To correct this, the authors propose lipoinjection of autologous fat into the areas of facial atrophy by a technique based on the atraumatic procurement of fat and posterior tr...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/01.prs.0000128427.54445.63

    authors: Serra-Renom JM,Fontdevila J

    更新日期:2004-08-01 00:00:00

  • Interventions to Decrease Postoperative Edema and Ecchymosis after Rhinoplasty: A Systematic Review of the Literature.

    abstract:BACKGROUND:Today, minimally invasive procedures are becoming more popular because of the fast recovery. Rhinoplasty is a common facial plastic surgery procedure that can be associated with significant postoperative morbidities, especially periorbital edema and ecchymosis. The aim of this review is to summarize the resu...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章,评审

    doi:10.1097/PRS.0000000000002101

    authors: Ong AA,Farhood Z,Kyle AR,Patel KG

    更新日期:2016-05-01 00:00:00

  • The effect of total maxillary advancement on facial growth.

    abstract::The effect of total maxillary advancement on the growing skull was examined in 25 pigs, subjected to facial operations of varied severity at the age of 5 weeks (elevation of periosteum, simple osteotomy, and osteotomy immobilized by wire fixation, with or without bone grafts) and in controls. When the animals were kil...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/00006534-197811000-00015

    authors: Munro IR

    更新日期:1978-11-01 00:00:00

  • Toxic shock syndrome after chemical face peel.

    abstract::Two cases of toxic shock syndrome following chemical face peel are reported. Toxic shock syndrome is a severe toxin-mediated multisystem disease. The major signs are fever, rash, desquamation, and hypotension. It can occur in males as well as females and is not necessarily related to menstruation. The surgical wound d...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/00006534-198707000-00020

    authors: LoVerme WE,Drapkin MS,Courtiss EH,Wilson RM

    更新日期:1987-07-01 00:00:00

  • Surgical treatment of erythroplasia of Queyrat.

    abstract::An operative technique is described for the treatment of large lesions of erythroplasia of the penis. The defect on the glans and on the coronary sulcus is covered by a flap prepared from the external part of the prepuce. This therapy has been effective and has given a good functional result. ...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/00006534-197705000-00003

    authors: Happle R

    更新日期:1977-05-01 00:00:00

  • Photographic standards in plastic surgery.

    abstract::Standard photographic technique in plastic surgery is an important topic that has been stressed in the discipline over the past several years. Clinical photographs should always be taken with the same camera lens, lens setting, lighting, film, and patient position to ensure reproducibility and to enable valid pre- and...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/00006534-199808000-00045

    authors: DiBernardo BE,Adams RL,Krause J,Fiorillo MA,Gheradini G

    更新日期:1998-08-01 00:00:00

  • Umbilicus Reconstruction with Bilateral Square "Pumpkin-Teeth" Advancement Flaps.

    abstract::The creation of a neoumbilicus is a common challenge for plastic surgeons. The authors present their technique of umbilical reconstruction with bilateral square "pumpkin-teeth" advancement flaps. The technique described is applicable in both the setting of a vertical midline incision and when no midline incision is pr...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章,评审

    doi:10.1097/PRS.0000000000003929

    authors: Purnell CA,Turin SY,Dumanian GA

    更新日期:2018-01-01 00:00:00

  • The Internet as a source of information on breast augmentation.

    abstract::The Internet was evaluated as a source of information for the layperson on the topic of breast augmentation. Three commonly used search engines (Excite, AOL, and Yahoo) were employed using the term "breast augmentation." These sites were then evaluated by each of three experienced plastic surgeons for their quality an...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/00006534-200101000-00028

    authors: Gordon JB,Barot LR,Fahey AL,Matthews MS

    更新日期:2001-01-01 00:00:00