Comparison between Fat and Cartilage in The Posterior Pharyngeal Wall Augmentation in Velopharyngeal Insufficiency

Background: Velopharyngeal insufficiency (VPI) arises from insufficient closure among the soft palate and the posterior pharyngeal wall, resulting in speech disorders. Aim: This research aimed to compare the efficiency of cartilage either fat in the enhancement of the posterior pharyngeal wall with different bulks in improving velopharyngeal function in velopharyngeal insufficiency from grade 3 to grade 4 closure. Patients and methods: This prospective quasi experimental research with analytic component was conducted on 24 patients at Otorhinolaryngology Outpatient Clinic and Phoniatric Unit, Mansoura university hospital. Results: Both fat and cartilage augmentation significantly improved velopharyngeal closure, APA scores, and velar mobility. However, only the fat augmentation group showed a significant reduction in activity-related velopharyngeal closure ratio. Insignificant variances have been observed in postoperative complications among the two groups. Conclusion: Cartilage and fat enhancement of the posterior pharyngeal wall were equally efficient in enhancing velopharyngeal function in cases with grade 3 to grade 4 VPI closure. Fat augmentation may offer an additional benefit in reducing activity-related velopharyngeal closure ratio.