Primary Pharyngeal Flap

Abstract

In 1954, we performed our first pharyngeal flap as a primary operation in the one-year-old patient with cleft palate, adding the pharyngeal flap to the palate which had been closed by a vein Langenbeck palatoplasty. This had become our routine procedurelat the St. Luke's Cleft Palate Clinic in a careful study to ascertain whether extant palatoplasty procedures for cleft palate patients alone provide optimum speech Without the use of an associated pharynhg'oplasty. The historic patterns and the theoretical reasons upon which this choice of therapy was based, plus the operative technique, have all been covered in the past (1, 2, 3) and will not be reiterated. We are concerned herein with an assay of results. Results To date, von Langenbeck palatoplasty with primary pharyngeal 'flap for cleft palate before-the onset'of speech has been performed upon 81 patients. Forty—two have passed the. age of"five years, when speech can be meaningfully evaluated. Our study deals with thirty-two of these patients; ten have been: excluded from the study because of mental retardation (five patients), flap disruption (three), tracheostomy (one)1, and death (one)? SPEECH. The same speech pathologist;,-(P.D.B.) has recorded and evaluated the speech on all of the patients, Language and voice—articula-tion characteristics were rated on a fiv'eipoint scale: one, considerably above average; two, slightly above average; three, average; four, slightly below average; and five, considerably below average.