Patients Requiring Multiple Surgeries for Velopharyngeal Insufficiency: Findings From a 10-Year Retrospective Review.

Autor:	Sink MC; The University of Mississippi Medical Center, School of Medicine., Hopper SJ; The University of Mississippi Medical Center, School of Medicine., Phillips JB; The University of Mississippi Medical Center, School of Medicine., Goza SD; The University of Mississippi Medical Center, School of Medicine., Brown MI; The University of Mississippi Medical Center, School of Medicine., Brown KW; The University of Mississippi Medical Center, Jackson, MS., Fernstrum CJ; The University of Mississippi Medical Center, Jackson, MS., Humphries LS; The University of Mississippi Medical Center, Jackson, MS., Hoppe IC; The University of Mississippi Medical Center, Jackson, MS.
Jazyk:	angličtina
Zdroj:	The Journal of craniofacial surgery [J Craniofac Surg] 2024 May 14. Date of Electronic Publication: 2024 May 14.
DOI:	10.1097/SCS.0000000000010213
Abstrakt:	This study analyzed patients undergoing multiple surgeries for velopharyngeal insufficiency (VPI) and reviewed their preoperative evaluations and techniques selected for subsequent surgeries. A retrospective chart review was performed including patients having undergone multiple surgeries for VPI at the authors' institution between 2012 and 2022. All patients were evaluated and managed at the author's institution under the direction of 4 senior surgeons. The objective of this study was to provide insight into preoperative evaluation, surgical technique selection, and other factors that may contribute to patients who require multiple VPI surgeries. Of 71 patients having undergone surgery for VPI, 8 required at least 1 additional operation for persistent VPI following the initial intervention. Six patients who initially underwent a superiorly based posterior pharyngeal flap (PPF) required additional surgery, and for those patients' subsequent operations, 5 different techniques were used throughout their treatment. Of the remaining 2 patients who had multiple VPI surgeries, 1 initially received autologous fat transfer and 1 initially underwent a furlow palatoplasty. Finally, 0 patients that initially underwent buccal flaps or collagen injection required further unplanned surgical intervention. This study demonstrates the importance of selecting an appropriate surgical approach when operating on patients following a failed VPI surgery. The algorithm developed from these findings emphasizes the importance of properly identifying the anatomical deficiency resulting from the failed intervention. A review of the advantages of nasopharyngoscopy as a preoperative evaluative technique of velopharyngeal form and function when compared to lateral barium video fluoroscopy was also included. Competing Interests: The authors report no conflicts of interest. (Copyright © 2024 by Mutaz B. Habal, MD.)
Databáze:	MEDLINE
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