| Aerodynamic and cephalometric analyses of velopharyngeal structure and function following re-pushback surgery for secondary correction in cleft palate. | |
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MedLine Citation:
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PMID: 12498605 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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Norifumi Nakamura; Yuko Ogata; Masaaki Sasaguri; Akira Suzuki; Rumiko Kikuta; Masamichi Ohishi |
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Publication Detail:
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Type: Comparative Study; Journal Article |
Journal Detail:
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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:
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Created Date: 2002-12-24 Completed Date: 2003-04-22 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 9102566 Medline TA: Cleft Palate Craniofac J Country: United States |
Other Details:
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Languages: eng Pagination: 46-53 Citation Subset: D; IM |
Affiliation:
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First Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Kyushu University, Fukuoka, Japan. nakamura@dent.kyushu-u.ac.jp |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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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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