Comparison of 2 Pharyngeal Flap Surgical Techniques in the Treatment of Velopharyngeal Insufficiency

INTRODUCTION: Velopharyngeal insufficiency (VPI) is a significant complication of palate repair, with the potential to markedly impair speech quality and intelligibility. The modified superior-based pharyngeal flap technique represents an innovative approach to address velopharyngeal insufficiency (VPI), a condition characterized by incomplete closure of the velopharyngeal port during speech production. This study's focus on evaluating the efficacy of this modified technique underscores the ongoing efforts in the field of cleft palate and craniofacial surgery to refine and optimize treatment strategies for VPI. METHODS: Thirty patients with VPI were included, with 15 patients undergoing the modified technique (study group) and 15 undergoing traditional pharyngeal flap surgery with Hogan modification (control group). Preoperative and postoperative nasalance scores and fiberoptic nasopharyngoscopy records were compared between the 2 groups. RESULTS: The results showed significant postoperative improvements in nasalance scores for various syllables and sentences in both groups. However, the study group demonstrated more significant improvements in certain sounds and had a lower postoperative complication rate than the control group. The modified technique involves folding the flap to cover open areas, which is thought to increase soft tissue stability, reduce air leakage, and minimize the risk of residual openings. These advantages are particularly evident in patients with preserved lateral wall mobility. CONCLUSION: The findings suggest that the modified pharyngeal flap technique may be a promising alternative for the treatment of VPI, offering both functional and healing benefits. However, careful patient selection and individualized surgical planning based on comprehensive preoperative evaluation are essential for optimal outcomes. Further long-term studies with larger sample sizes are required to validate the efficacy of this technique.