A multidisciplinary approach to sphincter pharyngoplasty for correction of velopharyngeal dysfunction following repair of cleft palate

Background

Management of severe velopharyngeal dysfunction is best performed by a multispecialty team. This team could include a speech-language pathologist, otolaryngologist, prosthodontist, and a plastic surgeon. The most commonly performed surgical procedures in complicated cases with scarred soft palate are sphincter pharyngoplasty and pharyngeal flaps. In this study, a multidisciplinary approach was applied for proper assessment and surgical intervention using sphincter pharyngoplasty for velopharyngeal insufficiency after cleft palate repair.

Methods

Twenty patients underwent sphincter pharyngoplasty. Preoperative diagnosis was performed using auditory perceptual assessment, nasoendoscopy assessment, nasometry, and videofluoroscopy.

Results

There were statistically significant differences between the preoperative and postoperative assessments. Bleeding occurred in two patients. Obstructive sleep apnea occurred in three patients and was resolved spontaneously within three months, and one patient experienced slight wound dehiscence.

Conclusion

Velopharyngeal dysfunction after cleft palate repair is best treated by a multidisciplinary team through speech therapy together with sphincter pharyngoplasty.