The role of intravelar veloplasty in primary cleft palate repair
Keywords:Cleft palate, Palatoplasty, Intravelar veloplasty, Velopharyngeal insufficiency
Background and objective: The presence of a cleft palate introduces feeding difficulties, problems in speech development, and the possibility of impaired facial growth. Intravelar veloplasty aids to gain functional repair of the palate. This study aimed to evaluate the effect of intravelar veloplasty on the function of velum in primarily repaired palates.
Methods: A review study was done in Rizgary Teaching Hospital, Erbil. Clinical and nasopharyngeal endoscopic examination was done for patients who underwent primary palatal repair with intravelar veloplasty between 2009 to 2014. The study assessed the velopharyngeal port for adequacy of closure, hypernasality of speech, and oronasal fistula rate.
Results: This study included 47 patients. The mean age of patients ± SD was 3.4±4 years (range 1- 20 years) at time of repair. Major improvement in intelligibility and production of pharyngeal sounds and velopharyngeal closure was noticed when using intravelar veloplasty in palatal repair. There was a significant association between defect type and degree of velopharyngeal port closure (P = 0.009), i.e., inadequate velopharyngeal closure was more common in the complete cleft palate.
Conclusion: This study showed that intravelar veloplasty helps to improve the velopharyngeal closure and oropharyngeal sounds production. The poor velopharyngeal closure is more likely related to wide, complete cleft palate.
Hopper RA. Cleft Lip and Palate: Embryology, Principles, and Treatment. In: Thorn CH (editor). Grabb and Smith plastic Surgery: 7th ed. Philadelphia: Lippincott Williams & Wilkins; 2013. P. 173-99.
Leow AK, Lo LJ. Palatoplasty: Evolution and Controversies. Chang Gung Med J 2008; 31(4):335-45.
Georgiade GS. Plastic, Maxillofacial, and reconstructive surgery. 3rd ed. Baltimore: Williams and Wilkins; 1997.
Barbosa DA, Scarmagnani RH, Fukushiro AP, Trindade IE, Yamashita RP. Surgical Outcome of Pharyngeal flap surgery and Intravelar veloplasty on the velopharyngeal Function. CoDAS 2013; 25(5):451-5.
Marsh JL, Grames LM, Holtman B. Intravelar Veloplasty: A Prospective Study. Cleft Palate J 1989; 1(26):46-9.
Marsh JL. Velo-Pharyngeal Dysfunction: Evaluation and Management. Indian J PlastSurg 2009; 42(suppl):S129-36.
Jarvis BL, Trier WC. The effect of Intravelar Veloplasty on Velopharyngeal Competence following Pharyngeal Flap Surgery. Cleft Palate J 1988; 25(4):389-93.
Agrawal K. Cleft Palate Repair and Variations. Indian J Plast Surg 2009; 42(suppl): S102-9.
Nahai FR, Williams JK, Burstein FD, Martin J, Thomas J. The Management of Cleft Lip and Palate: Pathways for Treatment and Longitudinal Assessment. Seminars in Plastic Surgery 2005; 19(4):275-85.
Andrades P, Monteros AE, Shell DH, Thurston TE, Fowler jS, Xavier ST, et al. The Importance of Radical Intravelar Veloplasty during Two- Flaps Palatoplasty. Plast Reconstr Surg 2008; 122(4):1121-30.
Kummer AW. Cleft palate and Crainiofacial anomalies: Effect on speech and resonance: 2nd ed. New York: Delmar Healthcare; 2008.
Fattah JH, Ali HS. Evaluation of cleft lip and palate management in Erbil. Zanco J Med Sci 2015;19(1):866-73.
Henkel KO, Dieckmann A, Dieckmann O, Lenz JH, Gundlach KKH. Veloplasty Using TheWave-Line Technique Versus Classic Intravelar Veloplasty. Cleft Palate Craniofac J 2004;41(1).
Ha S, Koh KS, Moon H, Jung S, Oh TS. Clinical Outcomes of Primary Palatal Surgery in Children with Non-Syndromic Cleft Palate with or without Lip. BioMed Research International 2015; 2015:185459.
Talmant JC. Evolution of the Functional Repair Concept for Cleft Lip and Palate Patients. Indian J PlasSurg 2006; 39(2):196-209.
Murthy J. Management of Cleft Lip and Palate in Adults. Indian J PlastSurg 2009; 42(suppl):S116-22.
How to Cite
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
The copyright on any article published in Zanco J Med Sci is retained by the author(s) in agreement with the Creative Commons Attribution Non-Commercial ShareAlike License (CC BY-NC-SA 4.0).