Velopharyngeal Insufficiency after Palatoplasty with or without Pharyngeal Flap : Fiberscopic Assessment.

Abstract

A variety of pharyngeal flaps or pharyngoplasties have been postulated, the techniques of which are not difficult in general. However, dynamic velopharyngeal function, open for breathing and closed for speech, is not easy to restore by surgery. The first step toward this goal should be an accurate assessment of the mobility of the lateral pharyngeal wall which plays the major role in dynamic V-P function after pharyngeal flap. Our experiences with the use of fluorovideoscope and fiberscope have led us to think that these are the essential instruments to obtain detailed information on the V-P function such as mobility of the lateral wall, asymmetry of its mobility if any, the level of maximal stricture, and the degree of incompetence. With such information, a pharyngeal flap can be individually tailored to match each V-P insufficiency.