Surgical Considerations and Choices in the Management of Velopharyngeal Dysfunction Determining the type of secondary surgical management to treat velopharyngeal dysfunction requires the incorporation of surgical indications and principles to the perceptual, acoustic/airflow, and imaging results of a comprehensive evaluation by a speech-language pathologist. In addition, how the specific type of surgical technique (primary and/or secondary) may affect velopharyngeal function ... Article
Article  |   October 01, 2015
Surgical Considerations and Choices in the Management of Velopharyngeal Dysfunction
Author Affiliations & Notes
  • John Jensen
    Department of Plastic Surgery, Medical College of Wisconsin
  • Michael VanLue
    Masters Family Speech and Hearing Center, Children's Hospital of Wisconsin, Milwaukee, WI
  • Disclosure: Financial: John Jensen and Michael VanLue have no relevant financial interests to disclose.
    Disclosure: Financial: John Jensen and Michael VanLue have no relevant financial interests to disclose.×
  • Nonfinancial: John Jensen and Michael VanLue have no relevant nonfinancial interests to disclose.
    Nonfinancial: John Jensen and Michael VanLue have no relevant nonfinancial interests to disclose.×
Article Information
Speech, Voice & Prosodic Disorders / Special Populations / Genetic & Congenital Disorders / Articles
Article   |   October 01, 2015
Surgical Considerations and Choices in the Management of Velopharyngeal Dysfunction
SIG 5 Perspectives on Speech Science and Orofacial Disorders, October 2015, Vol. 25, 54-65. doi:10.1044/ssod25.2.54
History: Received June 23, 2015 , Revised August 13, 2015 , Accepted August 20, 2015
SIG 5 Perspectives on Speech Science and Orofacial Disorders, October 2015, Vol. 25, 54-65. doi:10.1044/ssod25.2.54
History: Received June 23, 2015; Revised August 13, 2015; Accepted August 20, 2015

Determining the type of secondary surgical management to treat velopharyngeal dysfunction requires the incorporation of surgical indications and principles to the perceptual, acoustic/airflow, and imaging results of a comprehensive evaluation by a speech-language pathologist. In addition, how the specific type of surgical technique (primary and/or secondary) may affect velopharyngeal function also should be considered. The purpose of this paper is to consider three standard techniques commonly employed in speech surgery—Pharyngeal Flap; Sphincter Pharyngoplasty; and Furlow Double Opposing Z-Plasty—and provide examples of the specific imaging parameters that support the choice of surgical technique. In addition, information is provided regarding the characteristics of different primary surgical techniques for cleft palate which can influence velopharyngeal closure, given that the most common cause of velopharyngeal dysfunction seen in the clinic is a patient with a history of repaired cleft palate.

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