| Autologous fat transfer in velopharyngeal insufficiency: indications and results of a 25 procedures series. | |
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MedLine Citation:
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PMID: 21872348 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: To assess the efficiency of autologous fat transfer (AFT/Coleman procedure) in the management of velopharyngeal insufficiency (VPI). SETTINGS: Tertiary academic center, retrospective case series over a 4 year period. Pre- and post-speech assessment by a speech pathologist using the Borel-Maisonny scale. PATIENTS AND METHOD: Twenty-five (25) procedures were performed on 22 patients during the considered period. Mean age at surgery was 12.4 ± 4.1 years-old. Main associated conditions were 22q11 deletion (n=6 including 2 with cleft palate), isolated cleft palate (n=3), and Robin sequence (n=2). Indications were VPI grade 2a (n=5), 2b (n=11) and 3 (n=6), despite prolonged speech therapy (pre-op mean duration: 4.2 years) and previous surgery (velopharyngoplasty, n=13). Four patients had a contraindication of velopharyngoplasty (aberrant internal carotid arteries). RESULTS AND CONCLUSION: Fat harvesting sites were umbilicus (n=23) and buttock (n=2). Mean injected fat volume was 7.8 ml, in the posterior wall of the pharynx (n=25) the soft palate (n=15), the peritonsillar arches (n=3), and the pre-existing flap (n=3). Mean follow-up was 17 months. Two patients relapsed once and one patient twice, requiring additional injections. Final post-operative examination 1 year after the last procedure showed an improvement of speech in 90% of cases (grade 1, n=2; 1/2a, n=5; 2a n=10; 2b, n=5). AFT is a safe technique indicated in the primary and secondary management of VPI, with stable results on speech. However, if a complete return to normal is difficult to achieve, its simplicity allows multiple procedures in the same patient. |
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Authors:
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Nicolas Leboulanger; Leboulanger Nicolas; Marion Blanchard; Blanchard Marion; Françoise Denoyelle; Denoyelle Françoise; Fergal Glynn; Glynn Fergal; Jean-Baptiste Charrier; Charrier Jean-Baptiste; Gilles Roger; Roger Gilles; Jean-Paul Monteil; Monteil Jean-Paul; Eréa-Noël Garabedian; Garabedian Eréa-Noël |
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Publication Detail:
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Type: Comparative Study; Journal Article Date: 2011-08-26 |
Journal Detail:
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Title: International journal of pediatric otorhinolaryngology Volume: 75 ISSN: 1872-8464 ISO Abbreviation: Int. J. Pediatr. Otorhinolaryngol. Publication Date: 2011 Nov |
Date Detail:
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Created Date: 2011-10-17 Completed Date: 2012-02-27 Revised Date: 2012-06-14 |
Medline Journal Info:
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Nlm Unique ID: 8003603 Medline TA: Int J Pediatr Otorhinolaryngol Country: Ireland |
Other Details:
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Languages: eng Pagination: 1404-7 Citation Subset: IM |
Copyright Information:
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Copyright © 2011 Elsevier Ireland Ltd. All rights reserved. |
Affiliation:
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Otolaryngology, Head and Neck Surgery Department, Armand-Trousseau Children Hospital, Paris, France. nicolas.leboulanger@trs.aphp.fr |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adipose Tissue
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transplantation* Adolescent Child Cohort Studies Female Follow-Up Studies Humans Male Recovery of Function Retrospective Studies Risk Assessment Severity of Illness Index Time Factors Transplantation, Autologous Treatment Outcome Velopharyngeal Insufficiency / diagnosis*, surgery* |
| Comments/Corrections | |
Erratum In:
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Int J Pediatr Otorhinolaryngol. 2012 Jun;76(6):918 Note: Nicolas, Leboulanger [corrected to Leboulanger, Nicolas]; Marion, Blanchard [corrected to Blanchard, Marion]; Françoise, Denoyelle [corrected to Denoyelle, Françoise]; Fergal, Glynn [corrected to Glynn, Fergal]; Jean-Baptiste, Charrier [corrected to Charrier, Jean-Baptiste]; Gilles, Roger [corrected to Roger, Gilles]; Jean-Paul, Monteil [corrected to Monteil, Jean-Paul]; Eréa-Noël, Garabedian [corrected to Garabedian, Eréa-Noël] |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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