AUTOLOGUS FAT INJECTION INTO POSTERIOR PHARYNGEAL WALL FOR VELOPHARYNGEAL INSUFFICIENCY MANAGEMENT AFTER REPAIR OF CLEFT PALATE AND POST-ADENOIDECTOMY

Document Type : Preliminary preprint short reports of original research

Authors

1 Department of Otorhinolaryngology, Faculty of Medicine, Alexandria University

2 phoniatrics, faculty of medicine, Alexandria university, Alexandria, Egypt

3 Department of Otorhinolaryngology, Head and Neck Surgery, Faculty of Medicine, Alexandria University

Abstract

Introduction:
Velopharyngeal insufficiency (VPI) disrupts the valve separating nasal and oral cavities, impairing speech and swallowing. Understanding normal and abnormal closure mechanisms is vital for surgical interventions. The velopharyngeal (VP) valve involves the soft palate, lateral, and posterior pharyngeal wall, adjusting during speech and swallowing to prevent nasal regurgitation.
VPI stems from various factors like cleft palate or neurological conditions. Diagnosis combines history, physical exam, and speech assessments. Surgical options include Furlow Z-Palatoplasty, pharyngeal flap, and sphincter pharyngoplasty. Augmentation surgeries use materials like autologous fat. Careful technique and patient selection are crucial due to associated complications.
Aim:
The aim of this article was to describe the assessment of speech outcomes after fat augmentation of the posterior pharyngeal wall in cases of both persistent velopharyngeal insufficiency (VPI) following adenoidectomy and VPI after repair of cleft palate. A prospective study was conducted to evaluate the efficacy of this procedure.
Methods and patients:
This prospective observational study spanned six months, involving 30 patients with persistent velopharyngeal insufficiency (VPI) post-adenoidectomy and cleft palate repair. Candidates were selected and followed up using Flexible Nasoendoscopy FNE, nasometer, perceptual speech analysis.

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