• Journal of Rhinology
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• 제25권2호
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• pp.99-102
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• 2018

Lateral pharyngoplasty is a surgical option for treatment of obstructive sleep apnea (OSA). Here, we present a case involving a 40-year-old healthy man who underwent surgery, including lateral pharyngoplasty and robotic tongue base resection, for OSA. There were no intraoperative or immediate postoperative complications. However, on postoperative day 3, the patient presented with swelling in the temporal and buccal areas and was diagnosed with subcutaneous emphysema, later confirmed by computed tomography. The patient was carefully monitored under conservative care and discharged without complications. Although subcutaneous emphysema following tonsillectomy is a rare complication and usually resolves with conservative management, in certain cases, it might require surgical intervention. Lateral pharyngoplasty involves tonsillectomy and additional incision along the tonsillar fossa, which makes it susceptible to pharyngeal wall defects and, consequently, subcutaneous emphysema. Additionally, lateral pharyngoplasty and robotic tongue base resection cause pain and might thus contribute to the increase in intrapharyngeal pressure, which might aggravate subcutaneous emphysema. Lateral pharyngoplasty should be performed with meticulous dissection of the superior pharyngeal constrictor muscle. Healthcare providers should be aware of these complications and, upon suspicion of the same, place the patient under close observation to prevent life-threatening situations.

• 대한후두음성언어의학회지
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• 제33권3호
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• pp.188-192
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• 2022

Velopharyngeal insufficiency (VPI) is a phenomenon that can occur due to anatomical or neurological causes of the soft palate. VPI can make the patient difficult to articulate through hypernasality and nasal emission. There has been needed the customized treatment, as VPI can occur for many causes. We present the case of 21-year-old male who took palate plastic surgery 20 years ago for congenital submucosal cleft palate. As he had poor contraction of both lateral side of velopharynx, he was diagnosed with coronal type VPI. Through sphincter pharyngoplasty, he can obtain improvement of articulation accuracy. We would like to share this challenged case.

• Archives of Plastic Surgery
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• 제32권5호
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• pp.660-662
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• 2005

It is well documented that adenoidectomy is attributed to hypernasality in certain cases, but not clear that the enlarged tonsils affect the quality of speech. Hypertrophied tonsils may cause and complicate the problem of velopharyngeal incompetency. The huge tonsils prevent lateral pharyngeal walls from a medial movement and interfere velar elevation, being hypernasality. Hyponasality developes as the tonsils encroach in nasopharyngeal space. Voluminous tonsils also interfere airflow in the oropharyneal passage and produce the phenomenon of cul-de-sac resonance or muffled sound. The authors and et al. present a case of velopharyngeal insufficiency accompanied with hypertrophic tonsils. Improving the lateral constricting pharyngeal wall and velar elevation after tonsillectomy minimized the velopharyngeal gap. Accordingly, the procedures of sphincter pharyngoplasty and palatal lengthening resolved the problem of hypernasality instead of pharyngeal flap. Tonsillectomy prior to pharyngeal flap surgery tends to reduce the postoperative airway problems. Sometimes, however, only tonsillectomy does without pharyngeal flap. Surgical approach by stages and intermittent evaluation are recommended at intervals of at least six weeks.