Correlation between velopharyngeal closure and nasopharyngeal dimensions after pharyngeal flap surgery assessed by pressure-flow technique

摘要

PURPOSE: To investigate whether postoperative velopharyngeal orifice area during nasal breathing at rest (VPAb) can predict velopharyngeal closure during speech (VPAs). METHODS: The subjects were 62 patients with cleft palate, associated or not with cleft lip, of both genders, with ages between six and 32 years, who underwent pharyngeal flap surgery (PFS) at least 12 months before the evaluation performed for this study. VPAb and VPAs were assessed using the pressure-flow technique. VPAb values below 0.500cm2 were considered subnormal. VPAs was categorized as adequate (0-0.049cm2), borderline (0.050-0.199cm2) or inadequate (0.200cm2). A logistic regression model analyzed the association between VPAb and VPAs. RESULTS: After PFS, 92% of the patients with subnormal VPAb values (0.500cm2) presented adequate velopharyngeal closure. The percentage of patients with normal VPAb values (0.500cm2) who also presented adequate closure was smaller, but still significant (55%). The association between VPAb and VPAs values was not statistically significant. CONCLUSION: Most patients with large flaps presented adequate velopharyngeal closure during speech. However, the findings show that the velopharyngeal orifice area during breathing is not a good predictor of the effectiveness of the pharyngeal flap for speech.