Augmentation of the posterior pharyngeal wall with autologous tragal cartilage for management of velopharyngeal valve insufficiency in adults |
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| Authors: | Ahmed Gamal Khafagy Hany Kassamy Ahmed A Mohamed |
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| Institution: | 1. Department of Otorhinolaryngology, Faculty of Medicine, Ain Shams University, Cairo, Egypt;2. Unit of Phoniatrics, Department of Otorhinolaryngology, Faculty of Medicine, Ain Shams University, Cairo, Egypt;1. Department of Otolaryngology-Head and Neck Surgery, Guangdong Provincial People''s Hospital and Guangdong Academy of Medical Sciences, Guangzhou, Guangdong 510080, China;2. The Second School of Clinical Medicine, Southern Medical University;3. Shantou University Medical College, Shantou, Guangdong, China;4. Department of Oral and Maxillofacial Surgery, Guangdong Provincial People''s Hospital and Guangdong Academy of Medical Sciences, Guangzhou, Guangdong 510080, China;1. Division of Otorhinolaryngology, Department of Surgery, Dentistry, Gynecology, and Pediatrics, University of Verona, University Hospital of Verona, Borgo Trento, Piazzale Aristide Stefani, 1, 37126 Verona, Italy;2. Otorhinolaryngology Head and Neck Surgery Department, University Hospital of Modena, Largo del Pozzo, 71, 41125 Modena, Italy;3. Division of Maxillo-facial Surgery, Department of Surgery, Dentistry, Gynecology, and Pediatrics, University of Verona, University Hospital of Verona, Borgo Roma, Piazzale L.A. Scuro, 10, 37134 Verona, Italy;1. Department of Otolaryngology-Head & Neck Surgery, Taipei Veterans General Hospital, Taipei, Taiwan;2. School of Medicine, National Yang-Ming University, Taipei, Taiwan;3. Department of Otolaryngology-Head & Neck Surgery, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City, Taiwan;4. School of Medicine, Tzu Chi University, Hualien, Taiwan;1. Department of Gastroenterology and Hepatology, Tokyo Medical University, Tokyo, Japan;2. Department of Otorhinolaryngology, Head and Neck Surgery, Tokyo Medical University, Tokyo, Japan;3. Endoscopy Center, Tokyo Medical University Hospital, Tokyo, Japan;1. Divisions of Gastroenterology, Ise Red Cross Hospital, 471-2, 1, Funae, Ise, Mie 516-8512, Japan;2. Divisions of Otolaryngology-Head and Neck Surgery, Ise Red Cross Hospital, Mie, Japan;3. Divisions of Radiation Oncology, Ise Red Cross Hospital, Mie, Japan |
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| Abstract: | ObjectiveThe study aims to evaluate posterior pharyngeal wall augmentation using autologous tragal cartilage graft in adults with velopharyngeal valve insufficiency (VPI).MethodsThe study included 23 patients with VPI (grade I, II, III), with ages ranging from 19 to 45 years. Six patients had previously undergone simple palatoplasty for cleft palate, 8 patients had previously undergone adenotonsillectomy and 9 patients had previously undergone uvulopalatopharyngoplasty (UPPP). The procedure was done by implanting a piece of autologous tragal cartilage in the posterior pharyngeal wall. Patients were followed up for 24 months postoperatively. The evaluation of percent of speech intelligibility and grade of the closure of the velopharyngeal valve using video-nasopharyngoscopy was evaluated preoperatively and postoperatively.ResultsHighly statistically significant improvement in the grade of the closure of the velopharyngeal valve (P = 0.009) and percent of intelligibility (P = 0.001) was found after surgery. There were no postoperative airway obstruction or sleep apnea.ConclusionAugmentation of the posterior pharyngeal wall using tragal cartilage is an effective, safe and physiological surgical procedure in the management of VPI in adults who suffered hypernasality following palatal and oropharyngeal surgeries. |
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