Journal of Cleft Lip Palate and Craniofacial Anomalies

REVIEW ARTICLE
Year
: 2014  |  Volume : 1  |  Issue : 1  |  Page : 4--10

Diagnosis and management of velopharyngeal insufficiency following cleft palate repair


Michael S Gart1, Arun K Gosain2 
1 Department of Surgery, Division of Plastic Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
2 Department of Surgery, Division of Plastic Surgery, Northwestern University Feinberg School of Medicine; Department of Surgery, Division of Plastic Surgery, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA

Correspondence Address:
Arun K Gosain
Department of Surgery, Division of Plastic & Reconstructive Surgery, Ann and Robert H. Lurie Children«SQ»s Hospital of Chicago, 225 E Chicago Avenue, Chicago, IL 60611
USA

Background: Cleft lip and palate repair seeks to restore normal form, improve feeding and achieve normal speech, which requires velopharyngeal competence. The absence of this ability, termed velopharyngeal insufficiency (VPI), is seen in a wide range of patients following primary cleft palate repair. This review article focuses on patient assessment and the surgical management of VPI. Recent trends and future directions in management are also presented. After reading, one should be able to describe the various treatment approaches for a patient with suspected VPI. Materials and Methods: A PubMed search was conducted using the following search terms: VPI, velopharygneal incompetence, VPI, velopharynx, velopharyngeal port, velopharyngeal mechanism, veloplasty, intravelar veloplasty and hypernasal speech. Relevant manuscripts were identified by abstract review and additional articles selected based on bibliography review. Articles were restricted to those in the English language. A total of 88 articles were selected for further review. Conclusions: VPI is a common complication following primary palatoplasty. The decision to operate, as well as the selection of operative procedure, depends on a multimodal patient assessment, including speech evaluation and imaging studies of the pharyngeal mechanism. A thorough understanding of velopharyngeal anatomy and physiology is crucial to understanding the deficits in patients with VPI as well as the myriad methods of surgical correction. While many techniques are available, there are no conclusive data to guide procedure choice and newer techniques of imaging and treating patients with VPI continue to evolve.


How to cite this article:
Gart MS, Gosain AK. Diagnosis and management of velopharyngeal insufficiency following cleft palate repair.J Cleft Lip Palate Craniofac Anomal 2014;1:4-10


How to cite this URL:
Gart MS, Gosain AK. Diagnosis and management of velopharyngeal insufficiency following cleft palate repair. J Cleft Lip Palate Craniofac Anomal [serial online] 2014 [cited 2021 Feb 26 ];1:4-10
Available from: https://www.jclpca.org/article.asp?issn=2348-2125;year=2014;volume=1;issue=1;spage=4;epage=10;aulast=Gart;type=0