Document Detail


Aerodynamic and cephalometric analyses of velopharyngeal structure and function following re-pushback surgery for secondary correction in cleft palate.
MedLine Citation:
PMID:  12498605     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: The goal of this study was to clarify the efficacy of and indication for re-pushback surgery as secondary treatment for cleft palate. PARTICIPANTS: Fifteen patients treated by re-pushback surgery involving intravelar veloplasty (IVV) with buccal mucosal grafting on the nasal surface and followed up more than 6 months were enrolled in this study. MAIN OUTCOME MEASURES: Pre- and postoperative velopharyngeal functions were analyzed by perceptual voice analysis, blowing ratio, and nasalance scores during phonation of /i/ and /tsu/. Cephalometric analysis was used to evaluate the relationship between velopharyngeal structure and the outcome of re-pushback surgery. Control data were obtained from the longitudinal files of normal 10-year-old children in Kyushu University Dental Hospital. RESULTS: Eight of 15 patients obtained complete velopharyngeal closure (complete group), five patients improved remarkably (improved group), and no effective result was seen in two patients (ineffective group). Nasality disappeared or remarkably improved after the operation in 13 patients. Effective surgical results were found in 86.7% of the patients. Partial flap necrosis was seen in two patients in whom re-pushback surgery was performed using mucosal palatal flaps instead of mucoperiosteal flaps. Preoperative velar length and the length/depth ratio of the re-pushback group were significantly smaller than the controls, but there was no difference after the operation. Furthermore, the preoperative length/depth ratio of the complete group (ranged more than 100%) was significantly greater than those of the other two groups (ranged less than 100%). CONCLUSION: Re-pushback surgery by IVV with free mucous grafting on the nasal surface was effective in managing velopharyngeal incompetence secondarily, improving velopharyngeal structure and function.
Authors:
Norifumi Nakamura; Yuko Ogata; Masaaki Sasaguri; Akira Suzuki; Rumiko Kikuta; Masamichi Ohishi
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  The Cleft palate-craniofacial journal : official publication of the American Cleft Palate-Craniofacial Association     Volume:  40     ISSN:  1055-6656     ISO Abbreviation:  Cleft Palate Craniofac. J.     Publication Date:  2003 Jan 
Date Detail:
Created Date:  2002-12-24     Completed Date:  2003-04-22     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  9102566     Medline TA:  Cleft Palate Craniofac J     Country:  United States    
Other Details:
Languages:  eng     Pagination:  46-53     Citation Subset:  D; IM    
Affiliation:
First Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Kyushu University, Fukuoka, Japan. nakamura@dent.kyushu-u.ac.jp
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Air
Cephalometry
Child
Cleft Palate / complications,  surgery*
Female
Follow-Up Studies
Humans
Male
Mouth Mucosa / transplantation
Necrosis
Palate, Soft / pathology,  physiopathology*
Pharynx / pathology,  physiopathology*
Phonation / physiology
Postoperative Complications
Reoperation
Speech / physiology
Speech Perception / physiology
Statistics as Topic
Surgical Flaps / pathology
Treatment Outcome
Velopharyngeal Insufficiency / etiology,  surgery*
Voice / physiology

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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