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Autologous Fat Grafting for the Treatment of Mild to Moderate Velopharyngeal Insufficiency

Adams, Saleigh MD*; Xoagus, Elizabeth A. MD; Lazarus, Dirk MD; Lentin, Roslyn BSc; Hudson, Donald A. MD

doi: 10.1097/SCS.0000000000005337
Clinical Studies
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Background: To assess speech results following the treatment of mild to moderate velopharyngeal insufficiency (VPI) post cleft palate surgery with autologous fat grafting to the velopharynx.

Methods: A retrospective study was conducted on 9 consecutive patients who underwent velopharyngeal fat grafting for the treatment of VPI at the Red Cross War Memorial Children's hospital from 2010 to 2014. All the patients previously had primary palatoplasty performed and subsequently developed VPI. Patients were assessed pre- and postoperatively by an experienced speech and language therapist looking at perceptual speech and by 2 senior cleft surgeons interpreting lateral view videofluoroscopies.

Results: Eleven fat grafting procedures were performed on 9 patients and an average of 5.64 mL (range 1–7 mL) of autologous fat was transferred to the velopharynx. The average age at the time of operation was 6.5 years (range 3–14 years) with a follow-up period of 18 months (range 7–34 months). Most of the patients (7 out of 9) showed improved speech after fat grafting. One of the 7 patients had multiple procedures. The 2 who did not show speech improvement only had a single procedure. There were no complications related to the fat grafting procedure.

Conclusion: This small study suggests that fat grafting either as a single procedure or as multiple procedures is an effective, safe, minimally invasive surgical alternative, and/or adjunct for the treatment of mild to moderate VPI in patients following cleft palate surgery and to the knowledge, is the first reported study from Africa.

*Division of Plastic and Reconstructive Surgery, Red Cross War Memorial Children's Hospital

Division of Plastic and Reconstructive Surgery, Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa.

Address correspondence and reprint requests to Dr Saleigh Adams, MD, Division of Plastic and Reconstructive Surgery, 6th Floor, ICH Building, Red Cross War Memorial Children's Hospital, Klipfontein Road, Rondebosch, 7700 Cape Town, South Africa; E-mails: saleigh.adams@uct.ac.za; saleigh@capetownplasticsurgeon.co

Received 23 November, 2017

Accepted 31 December, 2018

The authors report no conflicts of interest.

Supplemental digital contents are available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Web site (www.jcraniofacialsurgery.com).

© 2019 by Mutaz B. Habal, MD.