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Revista Española de Cirugía Oral y Maxilofacial

On-line version ISSN 2173-9161Print version ISSN 1130-0558


CORTES ARAYA, J.; NINO DUARTE, A.Y.; SUNG HSIEH, H.H.  and  GOMEZ SANCHEZ, B.. Secondary functional veloplasty: a non-obstructive approach to valopharyngeal insufficiency. Rev Esp Cirug Oral y Maxilofac [online]. 2004, vol.26, n.2, pp.110-119. ISSN 2173-9161.

Introduction: Velopharyngeal insufficiency could be produced by a partial or inappropriate veloplasty performed to correct palate clefts. Phonoaudiologic therapy is often limited, and generally only obtains partial results. In these cases, pharyngoplasty seems to be the procedure of choice, there being several techniques published. Whatever they are, they have the common factor of the use of pharyngeal flaps that determine a reduction of the upper airway diameter with the consequent risk of generating obstructive sleep disorder.  Objective: In order to obviate this situation and simultaneously lengthen and provide velopalatine competence, a surgical technique, inspired by the DELAIRE principles, that aims to make the velar mophofunctional reconstruction or secondary functional veloplasty has been designed.  Surgical procedure: We present our experience based on a series of 15 cases treated in this new way: the soft palate, affecting the middle line and exposing both hemivelar portions until the retrouvular region. At this moment, the remaining muscular structures are identifyed, the palatal bone and nasal and buccal mucosa border are separated and are joined in a more posterior position of the contralaterals of the midline.  Results: In our experience, we have achieved velar lengthening and hypernasal correction or improvement. After the surgery, patients were evaluated with a phonetic test and aerophonoscopy. The outcome of this evaluation has shown the effectiveness of this surgical technique.

Keywords : Velopharyngeal Insufficiency; Velopharyngeal Incompetence; Palatoplasty.

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