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Augmentation of the posterior pharyngeal wall with autologous tragal cartilage for management of velopharyngeal valve insufficiency in adults.

Authors
  • Khafagy, Ahmed Gamal1
  • Kassamy, Hany2
  • Mohamed, Ahmed A3
  • 1 Department of Otorhinolaryngology, Faculty of Medicine, Ain Shams University, Cairo, Egypt. Electronic address: [email protected] , (Egypt)
  • 2 Department of Otorhinolaryngology, Faculty of Medicine, Ain Shams University, Cairo, Egypt. , (Egypt)
  • 3 Unit of Phoniatrics, Department of Otorhinolaryngology, Faculty of Medicine, Ain Shams University, Cairo, Egypt. , (Egypt)
Type
Published Article
Journal
Auris, nasus, larynx
Publication Date
Jun 01, 2021
Volume
48
Issue
3
Pages
428–433
Identifiers
DOI: 10.1016/j.anl.2020.09.016
PMID: 33067051
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

The study aims to evaluate posterior pharyngeal wall augmentation using autologous tragal cartilage graft in adults with velopharyngeal valve insufficiency (VPI). The 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. Highly 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. Augmentation 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. Copyright © 2020 Elsevier Ltd. All rights reserved.

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