Pharyngeal flap and intravelar veloplasty: effect on breathing and speech

Abstract

Velopharyngeal insufficiency (VPI) surgical management must assure upper airway patency besides speech symptoms elimination. Among the surgeries for VPI correction are pharyngeal flap surgery and intravelar veloplasty. Objective: To investigate the effect of pharyngeal flap and intravelar veloplasty surgery on breathing and speech, comparing hypernasality, hiponasality, nasopharyngeal dimensions and the occurrence of postoperative respiratory complaints between both surgeries. Methods: A minimum of 50 cleft palate patients undergone surgical management of VPI for, at least, 12 months: 25 patients with pharyngeal flap surgery and 25 with intravelar veloplasty. Hypernasality and hiponasality will perceptually analized by three examiners speech pathologists using CD-recorded speech samples. Hypernasality will be classified using a 4-point scale (1=absence of hypernasality to 4=severe hypernasality) and, hiponasality will be classified as 1=absent or 2=present. Nasopharyngeal area dimensions during breathing and speech will be obtained by means of aerodynamic assessment (pressure-flow technique). Respiratory complaints (mouth breathing, snoring and breathing obstruction during sleep) will be investigated by specific interviewing. The significance of differences between the two surgical techniques outcomes will be analyzed for each variable with a significance level of 5%. (AU)