Hassan, M., Zein, A., Shooukr, T., Tomoum, M., Sadaka, M. (2020). Age-Related Analysis of Improvement Regression after Repair by Superiorly Pharyngeal Flap in Velopharyngeal Insufficiency Patients. The Egyptian Journal of Plastic and Reconstructive Surgery, 44(2), 252-262. doi: 10.21608/ejprs.2020.112461
Medhat Hassan; Ahmed M. Zein; Tarek Shooukr; Mohamed Tomoum; Mohamed Sadaka. "Age-Related Analysis of Improvement Regression after Repair by Superiorly Pharyngeal Flap in Velopharyngeal Insufficiency Patients". The Egyptian Journal of Plastic and Reconstructive Surgery, 44, 2, 2020, 252-262. doi: 10.21608/ejprs.2020.112461
Hassan, M., Zein, A., Shooukr, T., Tomoum, M., Sadaka, M. (2020). 'Age-Related Analysis of Improvement Regression after Repair by Superiorly Pharyngeal Flap in Velopharyngeal Insufficiency Patients', The Egyptian Journal of Plastic and Reconstructive Surgery, 44(2), pp. 252-262. doi: 10.21608/ejprs.2020.112461
Hassan, M., Zein, A., Shooukr, T., Tomoum, M., Sadaka, M. Age-Related Analysis of Improvement Regression after Repair by Superiorly Pharyngeal Flap in Velopharyngeal Insufficiency Patients. The Egyptian Journal of Plastic and Reconstructive Surgery, 2020; 44(2): 252-262. doi: 10.21608/ejprs.2020.112461
Age-Related Analysis of Improvement Regression after Repair by Superiorly Pharyngeal Flap in Velopharyngeal Insufficiency Patients
1The Department of Plastic, Reconstructive & Burn Surgery, Faculty of Medicine, Menoufia University
2The Department of Otorhinolaryngology & Phonetics, Faculty of Medicine, Menoufia University
3The Departmentof Plastic & Reconstructive Surgery, Faculty of Medicine,
4The Department of Otolaryngology/Head & Neck Surgery, Faculty of Medicine, Tanta University
5The Department of Plastic & Reconstructive Surgery, Faculty of Medicine, Tanta University
Abstract
Velopharyngeal insufficiency (VPI) has many signs that usually affects social relations and mental health of patients including hypernasality, misarticulating, and grimacing. The most commonly used method has been the pharyngeal flap < br />method especially the superiorly based pharyngeal flap, due its ability to solve former problems with high grades of improvement. However, with long term follow-up, these high grades of improvement showed regression. It has been reported that these flaps tend to contract, resulting in narrowing and tethering of the palate, and that the age factor has a rule in this regression. The aim of this study is to evaluate the relation between age of repair and the changes that happen in superior pharyngeal flap after surgery leading to regression of the improvement we have gained. In this cross-sectional study, 36 patients with velopharyngeal insufficiency who aged between 3 and 15 were included in this study, the study was performed at Department of plastic, reconstructive and burn surgery, Menoufia University Hospital, Egypt. The hypernasality degrees and misarticulating was measured by Menoufia hospital speech therapists on the basis of special professional parameters preoperatively, 3 months and 18 months after superiorly based pharyngeal flap surgery was performed. This was also associated with video recorded endoscopic investigations to determine the shape and size of the flaps performed and the postoperative lateral ports dimensions during each follow-up. Following repair by superiorly based pharyngeal flap, improvement in the variant degrees of hyper-nasality was recorded among different age categories and statistical analyses expressed loss of significant differences between the responses of patients undergoing superiorly based pharyngeal flap repair among different ages. But after 18 months, Ages below 6 years showed regression in this improvement more than ages above 6 years. Video recordings revealed that degree of flap tubing was obvious in ages below 6 than those above 6 years. Results of this study suggest that most of patients undergoing superiorly based pharyngeal flaps experience a significant improvement of hyper-nasality and misarticulating. But after 18 months, regression in this improvement is noticed especially in ages below 6 years due to flap tubing unless certain precautions are followed to decrease this regression.
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