The Relationship between Age and Speech Improvement in the Patients Performed Pharyngeal Flap for Correction of Velopharyngeal Dysfunction

구개인두기능부전의 교정을 위한 인두피판술의 나이에 따른 발음 개선 효과

Purpose: The pharyngeal flap is one of the popular surgical method to treat the problem of velopharyngeal dysfunction. This study evaluated speech outcomes of patients who underwent superiorly based pharyngeal flap surgery based on timing of surgery. Methods: A restrospective review of 50 patients who underwent pharyngeal flap surgery for velopharyngeal insufficiency between September 1996 and January 2008 was undertaken. Thirty patients with an available preoprative and postoperative speech assessments with at least 6 months of follow-up were included in this study. We checked out the significance of speech improvement after surgery analysing preoperative and postoperative scoring of speech assessment. We also investigated the direct relationship between the age at surgery and the degree of speech improvement, and the improvement score in different age groups. Results: The mean score of preoperative speech was $52.6{\pm}7.4points$ and postoperative speech was $58.6{\pm}6.5points$, which presented significant postoperative speech improvement with an average of 5.9 points(p<0.01). There was a significant inverse relationship between the age at operation and speech improvement degree(p<0.01, r = -0.54). Comparing the age groups, the age group of 4 to 5 years presented statistically significant speech improvement(p<0.01). Conclusion: we propose that all patients indicated should take pharyngeal flap irrespective of age. In this study, the younger the age at surgery, the higher degree of speech improvement, for which we suggest that surgical approach should be undertaken as early as possible, especially younger than age 5 years.