Cephalic de-mucosalized superiorly-based pharyngeal flap: A modified mucosa-preserving technique for velopharyngeal insufficiency
| Autor: | Mohammad Waheed El-Anwar, Ashraf Elmalt, Mohammed S. Abd EL-Azeem, Ahmed Ibrahim Elsayed, Ahmed M. Anany, Sherif M. Askar, Amal S. Quriba, Ahmed Shaker ElAassar |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
Male
medicine.medical_specialty Basic premise Velopharyngeal Insufficiency media_common.quotation_subject Nasal emission Dehiscence Surgical Flaps 03 medical and health sciences 0302 clinical medicine Velopharyngeal insufficiency Throat medicine Humans Speech 030223 otorhinolaryngology Child Pharyngeal flap media_common Wound Healing Soft palate business.industry Convalescence Endoscopy 030206 dentistry General Medicine Plastic Surgery Procedures medicine.disease Surgery medicine.anatomical_structure Treatment Outcome Otorhinolaryngology Child Preschool Pediatrics Perinatology and Child Health Pharynx Female business Follow-Up Studies |
| Zdroj: | International journal of pediatric otorhinolaryngology. 115 |
| ISSN: | 1872-8464 |
| Popis: | Introduction Superiorly-based pharyngeal flap (PF) is the most frequently employed surgical technique to correct velopharyngeal insufficiency (VPI). Bared posterior pharyngeal wall might prolong the period of convalescence with throat pain and discomfort. Delayed donor site healing problems and subsequent fibrosis with downward migration of the transposed flap might be one a cause of failure and might necessitate revision. Aim of the work To present a modified technique of PF aiming at dealing with the problems of donor site defects via immediate self-mucosal covering of the cephalic portion of the bed. Methods This case series study was conducted on patients with persistent VPI. All patients underwent the new modified technique of cephalic de-mucosalized pharyngeal flap (CDPF). The basic premise was to harvest a laterally-based mucosal flap from the upper part of the posterior pharyngeal wall. A superiorly-based pharyngeal flap (with a bared cephalic segment and a mucosalized caudal segment) was elevated off the posterior pharyngeal wall and inserted in the soft palate. Then the laterally-based mucosal flap was spread over the superior part of donor site of the posterior pharyngeal wall. Results 13 VPI patients were included in this study. Their age ranged from 5 to 12 years with a mean of 5.6 ± 1.2. The follow-up period ranged from 8 to 14 months. All flaps and beds were completely healed within 2–3 weeks and no patients showed flap dehiscence, infection or palatal fistula. Postoperative speech assessment showed significant improvement of velopharyngeal function, resonance balance, and reduction in nasal emission. Conclusions The modified technique provides an immediate self-mucosa cover to the superior part of the posterior pharyngeal wall, thus it could promote primary healing at the donor site with a short period of convalescence. CDPF separates the two opposing raw surfaces of the flap and the posterior pharyngeal wall. The mucosal flap might guard against downward migration of the flap. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full Text from ScienceDirect