The effect of pharyngeal flap in treatment of post adenoidectomy velopharyngeal insufficiency due to submucous cleft palate

Background: Validity of pharyngeal flap in the treatment of velopharyngeal insufficiency (VPI) due to submucous cleft palate. Patient and methods: This research has been performed on 18 children (12 males and 6 females, age range from 5-15 years old), who attended the otorhinolaryngology outpatient clinic, Benha University hospitals during the period from January 2023 to January 2024, after obtaining informed consent from their parents. The study has been permitted by the institutional research ethics committee Patients have been chosen from children who developed hypernasality after adenotonsillectomy due to the presence of submucous cleft. All patients underwent complete phoniatric assessment and treated with posterior pharyngeal flap. Results: Males constituted 66.7% and the females constituted 33.3% and the mean age of adenoidectomy was 3.17 years. All patients complained of nasal tone of speech due to submucous cleft following adenoidectomy. There was significant improvement in the degree of closure of lateral pharyngeal wall and posterior pharyngeal walls of the velopharyngeal valve postoperatively, 2 weeks and 3 months following speech therapy. There was significant improvement in the results of all CSL measurements except for Fftr and DUV postoperatively, 2 weeks and 3 months following speech therapy. There was significant improvement in the results of all nasometry measurements postoperatively, 2 weeks and 3 months following speech therapy. Conclusion: pharyngeal flap has a great effect in the management of hypernasal speech after adenotosillectomy due to submucous cleft and this effect is better when the surgery is followed by speech therapy for at least three month.