Sphincter Pharyngoplasty for Velopharyngeal Dysfunction

Donald S. Mowlds, R. Vyas
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Abstract

The surgical correction of velopharyngeal insufficiency (VPI) seeks to augment the deficient aspect of the velopharyngeal apparatus. The objective of the sphincter pharyngoplasty is to narrow the velopharyngeal gap transversely by addressing lateral pharyngeal wall motion. Superiorly based lateral palatopharyngeus myomucosal flaps are transposed 90 degrees and inset into the posterior pharyngeal wall mucosa. Following sphincter pharyngoplasty, the patient is monitored overnight for impending airway compromise. If symptomatic VPI persists, repeat diagnostic evaluation is performed. Success is determined by acceptable perceptual oral resonance, adequate velopharyngeal closure on endoscopy, and the absence of upper airway obstruction or sleep apnea.
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括约肌咽成形术治疗腭咽功能障碍
手术矫正腭咽功能不全(VPI)旨在增加腭咽器官的缺陷方面。括约肌咽成形术的目的是通过解决咽壁外侧运动来横向缩小咽口间隙。上基腭咽外侧肌粘膜瓣转置90度并插入咽后壁粘膜。在括约肌咽部成形术后,对患者进行夜间监测,以防气道受损。如果症状性VPI持续存在,则进行重复诊断评估。成功与否取决于可接受的感知口腔共振,内窥镜检查时充分的腭咽闭合,以及没有上呼吸道阻塞或睡眠呼吸暂停。
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