Maxillofacial Plastic and Reconstructive Surgery

  • Volume 40
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  • Pages.23.1-23.6
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  • 2018
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  • 2288-8101(pISSN)
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  • 2288-8586(eISSN)
Korean Association of Maxillofacial Plastic and Reconstructive Surgeons (대한악안면성형재건외과학회)
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Investigation of postoperative hypernasality after superiorly based posterior pharyngeal flap

  • Shin, Yu-Jeong (Research Institute of Speech Sciences, Chonbuk National University) ;
  • Kim, Yongsoo (Department of Oral and Maxillofacial Surgery, Institute of Oral Bioscience, School of Dentistry, Clinical Research Institute of Chonbuk National University Hospital, Chonbuk National University)
  • Received : 2018.06.11
  • Accepted : 2018.08.14
  • Published : 2018.12.31
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Abstract

Background: Velopharyngeal insufficiency that accompanies speech resonance and articulation disorders can be managed through several intervention methods such as speech-language therapy, prosthetic aids, and surgery. However, for patients with severe hypernasality, surgical interventions are highly recommended. Among available surgical techniques, the posterior pharyngeal flap is most common. Case presentation: Two adult males with high nasalance scores underwent superiorly based posterior pharyngeal flap surgery, followed by speech testing by an expert speech-language therapist. Nasalance scores and articulation accuracy were assessed up until 1 year after the surgery. Nasalance scores were measured five times using a nasometer, after which the average value was calculated. Conclusions: Consistent declines in hypernasality over time are not easy to explain since the pedicled pharyngeal flap narrowed over time, secondary to cicatrization. However, scar tethering of the soft palate in a posterior direction could reduce the velopharyngeal port size over time. Therefore, long-term follow-up with intensive speech therapy is suggested for patients with severe hypernasality.

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References

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