Pre and Post-Operative Analysis of Velar and Pharyngeal Flap Mobility

Abstract

Although investigators agree that pharyngeal flap surgery is effective in correcting palatopharyngeal incompetence, opinions differ as to the mechanics of valving after surgery. Opinions also differ relative to: the effect of pharyngeal flap surgery upon the mobility of the velum (3, 4, 8, 10) and the importance of flap mobility as it pertains to post— operative speech status (1, 4). The study reviewed here was undertaken to investigate relationships between: a) pre—Operative velar movement and pharyngeal flap move— ment; b) activity in the lateral pharyngeal walls before and after surgery, and; c) pharyngeal flap movement and the success of the operative technique as defined by nasality ratings. Sample. The sample included 60 subjects ranging from 6 to 4.3 years of age, with the majority (34) falling within the 6 to 12 year category. \Vith the exception of four patients, superiorly based flaps were con— structed to correct velopharyngeal incompetence. Of the 60 subjects studied, there were 14 with submucous cleft palate, 20 with posterior cleft palate; 18 with unilateral cleft lip and palate, and; 8 with bilateral cleft lip and palate. All subjects, with the exception of the submucous group and 8 subjects with posterior cleft palate, had had at least one surgical procedure for palate closure. Procedures Ratings of nasality and nasal emission were used to differentiate successful and unsuccessful speech results (12). To evaluate activity in the lateral pharyngeal walls, oropharyngeal examinations were made