Document Detail

Posterior Pharyngeal Fat Grafting for Velopharyngeal Insufficiency.
MedLine Citation:
PMID:  22329568     Owner:  NLM     Status:  Publisher    
Abstract Objective: To determine if autologous fat grafting to the posterior pharynx can reduce hypernasality in patients with cleft palate and mild velopharyngeal insufficiency (VPI). Design: Retrospective case series. Setting: Tertiary care center. Patients: Eleven (11) patients with cleft palate, status-post palatoplasty (+/- secondary speech surgery) with nasendoscopic evidence of VPI. Interventions: Autologous fat was harvested and injected into the posterior pharynx under general anesthesia. Main Outcome Measures: Pre- and postoperative subjective, nasometry, and nasendoscopy data. Apnea-hypopnea indices (AHI), were also assessed. Comparisons were made using Fisher's exact test, student t-tests, and relative risk assessments. Results: An average of 13.1cc of fat was injected (range: 5-22cc). Mean follow-up was 17.5 months (range: 12-25 months). Statistically significant improvements in speech resonance were identified in nasometry (Zoo passage; p = 0.027), and subjective hypernasality assessment (p = 0.035). Seventy-three percent of patients demonstrated normal speech resonance after PPFG on either subjective or objective assessment (p = 0.001). All patients (100%) with previous secondary speech surgeries demonstrated normal speech resonance on similar assessment (RR = 1.8; p = 0.13). Complete velopharyngeal closure was observed in 7 patients on postoperative nasendoscopy. No changes in AHIs were observed (p = 0.581). Conclusion: PPFG may be best used as an adjunct to secondary speech surgery. In this series, PPFG was not accompanied with the negative sequelae of hyponasality, sleep apnea or airway compromise. Key Words: cleft palate, fat grafting, velopharyngeal insufficiency.
Darryl Lau; Adam J Oppenheimer; Steven Buchman; Mary Berger; Steven J Kasten
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-2-14
Journal Detail:
Title:  The Cleft palate-craniofacial journal : official publication of the American Cleft Palate-Craniofacial Association     Volume:  -     ISSN:  1545-1569     ISO Abbreviation:  -     Publication Date:  2012 Feb 
Date Detail:
Created Date:  2012-2-14     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9102566     Medline TA:  Cleft Palate Craniofac J     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
a University of Michigan.
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