Velopharyngeal insufficiency (VPI) means that the velopharyngeal closure is inadequate or disturbed. VPI may be organic or functional, congenital or acquired and is caused by structural alterations or paresis. The symptoms are primarily to be found in speech (hypernasality), more rarely in swallowing and hearing. The management types are as follows: speech therapy, surgery, speech bulb, and oth...

BACKGROUND Lujan-Fryns syndrome (LFS) is an extremely rare, X-linked disorder, for which the full clinical spectrum is still unknown. Usually, it presents with neuropsychiatric problems such as learning disabilities and behavioral issues in a typical combination with marfanoid features. Often, there is a positive family history for the disorder. However, sporadic cases have also been reported i...

(1) Faculdade de Odontologia de Bauru; Hospital de Reabilitação de Anomalias Craniofaciais da Universidade de São Paulo – USP, Bauru, SP, Brasil. (2) Faculdade de Filosofia e Ciências da Universidade Estadual Paulista – UNESP, Marília, SP, Brasil. (3) Faculdade de Odontologia de Bauru, USP, Bauru, Brasil. This study was conducted at the Hospital for Rehabilitation of Craniofacial Anomalies, Uni...

BACKGROUND Oronasal fistulas (ONF) following cleft palate repair are commonly encountered and remain a challenging problem. With reported recurrence rates between 33% and 37%, this urges us to critically evaluate the current treatment and propose a surgical management protocol. METHODS A retrospective study of patients treated for ONF by a single surgeon between 1995 and 2005 was performed. D...

STATEMENT OF PROBLEM Speech bulbs and palatal lift prostheses are used to improve oral-nasal balance in speakers with hypernasality resulting from velopharyngeal dysfunction. Fabricating such speech prostheses is often a protracted process, and the nasopharyngeal impression can be uncomfortable for the client. PURPOSE The purpose of this study was to develop and test a modular palatal lift pr...

INTRODUCTION Maxillectomy is the surgical removal of part or the entire maxillary bone. It is indestined for tumors of the hard palate, nose, maxillary sinus or other tumors that have grown to involve the maxilla. Speech intelligibility and swallowing difficulties are the major concerns after maxillectomy surgery. These are the after effects of inappropriate coupling between the oral and nasal ...

89 Velopharyngeal insufficiency (VPI) is a condition in which the velopharyngeal structures fail to close the nasal cavity while the patient is speaking. VPI usually presents in association with cleft palate, submucous cleft palate, palatal fistulae, adenoidectomy, and neuromuscular disorders; after cleft palate surgery; or after the removal of tumors. Adult onset VPI is uncommon, and relativel...

BACKGROUND Posterior pharyngeal augmentation is an accepted method of treating velopharyngeal insufficiency (VPI). Techniques using autologous fat harvest, preparation, and grafting are well described. Based on the complications from retropharyngeal injection, we performed augmentation of the nasal surface of the palate to reduce hypernasality with decreased risks. METHODS After Institutional...

OBJECTIVE To report our experience in the care of patients treated for velopharyngeal insufficiency (VPI) with sphincter pharyngoplasty (SP) with or without the addition of palatal lengthening by Furlow palatoplasty (FP). DESIGN Retrospective analysis. SETTING Tertiary care cleft palate and craniofacial clinic. PATIENTS Forty-six children with VPI, most of whom had palatal clefts, treated...

BACKGROUND The 2-flap palatoplasty technique is actually the approach most commonly used in the United States for cleft palate repair. This is a one-time surgery that enables closure under minimal tension, lowering rates of subsequent fistula development. However, its primary disadvantage is potential detriment to maxillary growth (due to extent of dissection on both sides of the cleft and raw ...