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Update on surgery for velopharyngeal dysfunction

Crockett, David J.; Goudy, Steven L.

Current Opinion in Otolaryngology & Head and Neck Surgery: August 2014 - Volume 22 - Issue 4 - p 267–275
doi: 10.1097/MOO.0000000000000063
FACIAL PLASTIC SURGERY: Edited by Travis T. Tollefson

Purpose of review To review journal articles discussing surgery for velopharyngeal dysfunction over the past year. All articles ascertained by a PubMed search relevant to this topic were reviewed.

Recent findings Articles evaluated from the past year discussed the variations, effectiveness, and feasibility of multiple surgical techniques for velopharyngeal dysfunction, including the Furlow palatoplasty, sphincter pharyngoplasty, pharyngeal flap procedure, and other less known novel surgical options. Outcomes, comparisons, and complications were a focus of the majority of the studies. Combinations of the above procedures are also assessed. Nonsurgical options, such as prosthetic devices and pharyngeal augmentation, are mentioned.

Summary Multiple surgical options exist to assist patients with velopharyngeal dysfunction. The majority of the surgical options can be highly successful. A multispecialty team is critical in providing patients with the most appropriate treatment for their specific situation. Standardized speech and velopharyngeal dysfunction outcome measures are necessary to allow accurate preoperative and postoperative comparisons, intrasurgeon comparisons, and multi-institutional comparisons. Unfortunately, there is a lack of standardization in speech outcome measures among the studies published over the last year. The risk of postoperative obstructive sleep apnea must be assessed and discussed prior to surgery for any patient scheduled to undergo surgery for velopharyngeal dysfunction. Future studies promise to improve our understanding of velopharyngeal dysfunction and provide further guidance as to the best surgical options to assist these patients.

Department of Otolaryngology – Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA

Correspondence to Steven L. Goudy, MD, Associate Professor, Department of Otolaryngology – Head and Neck Surgery, Vanderbilt University Medical Center, 1211 Medical Center Drive, Nashville, TN 37232, USA. Tel: +1 615 936 8176; e-mail:

© 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins