Posterior Pharyngeal Wall Augmentation with Fat Graft in Patients having Mild Velopharyngeal Insufficiency

Background: The velopharynx functional and structural integrity is essential for the production of normal speech resonance. The velopharynx is a dynamic and intricate structure that serves as a barrier between the oral and nasal cavities through the production of sound. Hyper-nasality, nasal escape, and compensatory errors are all consequences of anatomical abnormalities of the velopharyngeal (VP) valve (VP in-sufficiency = VPI), which collectively diminish speech intelligibility. Aim of the Work: To assess the outcome and the posterior pharyngeal wall augmentation complications the with fat graft in patients having mild VP insufficiency. Patients and Methods: A single-arm clinical trial was conducted on 20 patients with mild VPI. They were treated with the posterior pharyngeal wall augmentation with autologous fat injection at a tertiary hospital. The study started from December 2022 till March 2024. Results: There was a significant development in the open nasality degree, consonants imprecision, audible nasal air emission, overall intelligibility, facial grimace, closure of the gap, distorted vowels, A/E and Cold Mirror tests after the operation in seventeen patients, and three patients did not improve. All patients did not have any complications from the operation. Conclusion: Our study reported that augmenting the posterior pharyngeal wall with fat graft is effective in the management of hypernasality in mild VP gap patients. This method has a minimal complication rate due to autologous tissue application.