Cleft palate repair and velopharyngeal dysfunction

Richard A. Hopper, Raymond Tse, James Smartt, Jordan Swanson, Sara Kinter

Research output: Contribution to journalArticle

21 Citations (Scopus)

Abstract

Learning Objectives:: After studying this article, the participant should be able to: 1. Describe the technical details common to all cleft palate repairs that optimize outcomes and minimize complications. 2. Explain the subjective and objective evaluation of speech in children with cleft palate. 3. Practice with an increased awareness of the management of complications associated with cleft palate repair. 4. Design a treatment plan for velopharyngeal dysfunction. Summary:: Goals of a successful cleft palate repair include separation of the oral and nasal components without fistula, achieving sufficient velar length, and creating functional transverse orientation of the levator muscle sling. A number of techniques have been described to achieve these goals, but they all have the following technical details in common: elevation of oral mucosal flaps based on the greater palatine arteries, tension free nasal lining mobilization, and functional intervelar muscle dissection. After palate repair, speech evaluation needs to be performed by an objective interdisciplinary team following a standardized protocol. Identification of velopharyngeal insufficiency secondary to an incompetent nasopharyngeal port will necessitate secondary speech surgery. These secondary techniques include pharyngeal flaps, soft palate lengthening, or pharyngeal sphincters, which should be tailored to optimize speech, while minimizing the risk of obstructive sleep apnea.

Original languageEnglish (US)
JournalPlastic and Reconstructive Surgery
Volume133
Issue number6
DOIs
StatePublished - 2014

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Cleft Palate
Nose
Velopharyngeal Insufficiency
Soft Palate
Muscles
Palate
Obstructive Sleep Apnea
Fistula
Dissection
Arteries
Learning
Therapeutics

ASJC Scopus subject areas

  • Surgery

Cite this

Cleft palate repair and velopharyngeal dysfunction. / Hopper, Richard A.; Tse, Raymond; Smartt, James; Swanson, Jordan; Kinter, Sara.

In: Plastic and Reconstructive Surgery, Vol. 133, No. 6, 2014.

Research output: Contribution to journalArticle

Hopper, Richard A. ; Tse, Raymond ; Smartt, James ; Swanson, Jordan ; Kinter, Sara. / Cleft palate repair and velopharyngeal dysfunction. In: Plastic and Reconstructive Surgery. 2014 ; Vol. 133, No. 6.
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