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On the role of the frontal projection in videoradiography of velopharynx in decision-making for a velopharyngeal flap plasty in patients with cleft palate

Appelros, Frida ; Becker, Magnus LU orcid ; Salé, Hanna and Svensson, Henry LU (2020) In Journal of Plastic Surgery and Hand Surgery 54(4). p.255-259
Abstract

Despite uneventful primary surgery, patients with cleft palate may experience velopharyngeal insufficiency (VPI) and hypernasal speech. Videoradiography of velopharynx is a commonly used method to visualize velopharyngeal function and a velopharyngeal flap is often used to counteract VPI. The aim of this study was to investigate whether the frontal projection on videoradiography plays a role in the decision-making about velopharyngeal flap surgery, or possibly the width and orientation of the flap. A secondary aim was to evaluate the effect of the flap in improving velopharyngeal function. Between 2007 and 2016, 75 patients had received a flap at our department. During the same period of time, 41 patients who had undergone... (More)

Despite uneventful primary surgery, patients with cleft palate may experience velopharyngeal insufficiency (VPI) and hypernasal speech. Videoradiography of velopharynx is a commonly used method to visualize velopharyngeal function and a velopharyngeal flap is often used to counteract VPI. The aim of this study was to investigate whether the frontal projection on videoradiography plays a role in the decision-making about velopharyngeal flap surgery, or possibly the width and orientation of the flap. A secondary aim was to evaluate the effect of the flap in improving velopharyngeal function. Between 2007 and 2016, 75 patients had received a flap at our department. During the same period of time, 41 patients who had undergone videoradiography did not receive a flap. Medical records, particularly regarding speech assessments, videoradiography statements and operating records, were scrutinised to seek information about the factors leading up to the decision about whether or not to perform a flap. In only one instance, reduced lateral pharyngeal wall movement found on the frontal projection was clearly taken into account when deciding to refrain from performing a velopharyngeal flap. Only a slight agreement was found between pre-operative speech assessment and findings in videoradiography. Hypernasality was reduced by flap surgery in 97% of the patients. We conclude the frontal projection of the videoradiographic examination seems to have no crucial role in the decision-making on performing a velopharyngeal flap or not in patients with cleft palate. Even with reduced lateral pharyngeal wall movement, a velopharyngeal flap effectively reduces hypernasality and VPI.

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author
; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Cleft lip and palate, pharyngoplasty, videoradiography
in
Journal of Plastic Surgery and Hand Surgery
volume
54
issue
4
pages
5 pages
publisher
Taylor & Francis
external identifiers
  • pmid:32401563
  • scopus:85085500216
ISSN
2000-656X
DOI
10.1080/2000656X.2020.1763372
language
English
LU publication?
yes
id
f166d4c0-2db0-476f-9ecc-a8d2342a8974
date added to LUP
2020-06-25 09:31:52
date last changed
2024-04-03 09:50:18
@article{f166d4c0-2db0-476f-9ecc-a8d2342a8974,
  abstract     = {{<p>Despite uneventful primary surgery, patients with cleft palate may experience velopharyngeal insufficiency (VPI) and hypernasal speech. Videoradiography of velopharynx is a commonly used method to visualize velopharyngeal function and a velopharyngeal flap is often used to counteract VPI. The aim of this study was to investigate whether the frontal projection on videoradiography plays a role in the decision-making about velopharyngeal flap surgery, or possibly the width and orientation of the flap. A secondary aim was to evaluate the effect of the flap in improving velopharyngeal function. Between 2007 and 2016, 75 patients had received a flap at our department. During the same period of time, 41 patients who had undergone videoradiography did not receive a flap. Medical records, particularly regarding speech assessments, videoradiography statements and operating records, were scrutinised to seek information about the factors leading up to the decision about whether or not to perform a flap. In only one instance, reduced lateral pharyngeal wall movement found on the frontal projection was clearly taken into account when deciding to refrain from performing a velopharyngeal flap. Only a slight agreement was found between pre-operative speech assessment and findings in videoradiography. Hypernasality was reduced by flap surgery in 97% of the patients. We conclude the frontal projection of the videoradiographic examination seems to have no crucial role in the decision-making on performing a velopharyngeal flap or not in patients with cleft palate. Even with reduced lateral pharyngeal wall movement, a velopharyngeal flap effectively reduces hypernasality and VPI.</p>}},
  author       = {{Appelros, Frida and Becker, Magnus and Salé, Hanna and Svensson, Henry}},
  issn         = {{2000-656X}},
  keywords     = {{Cleft lip and palate; pharyngoplasty; videoradiography}},
  language     = {{eng}},
  month        = {{05}},
  number       = {{4}},
  pages        = {{255--259}},
  publisher    = {{Taylor & Francis}},
  series       = {{Journal of Plastic Surgery and Hand Surgery}},
  title        = {{On the role of the frontal projection in videoradiography of velopharynx in decision-making for a velopharyngeal flap plasty in patients with cleft palate}},
  url          = {{http://dx.doi.org/10.1080/2000656X.2020.1763372}},
  doi          = {{10.1080/2000656X.2020.1763372}},
  volume       = {{54}},
  year         = {{2020}},
}