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January 1988

Revision Surgery and Therapy of Velopharyngeal Incompetence

Author Affiliations

Fort Sam Houston, Tex

Arch Otolaryngol Head Neck Surg. 1988;114(1):17. doi:10.1001/archotol.1988.01860130021001

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At the fall meeting of the American Academy of Facial Plastic and Reconstructive Surgery in Chicago, Steven Gray, Iowa City, and Robin Cotton, Charles Myer, and Robert Miller, Cincinnati, presented their experience with 11 patients who required therapy for velopharyngeal incompetence. A total of 18 revision procedures were performed on this group. The problems of ports that were either too small or too large were specifically addressed. The patients with small ports were assessed preoperatively with a nasal examination, sleep study, and speech evaluation. Opening of these small ports was then undertaken with: (1) dilation, (2) miniflap transposition, (3) taking down the pharyngeal flap, (4) trimming the flap, or (5) lysis of adhesions. Large ports were assessed with a speech evaluation and nasopharyngoscopy, and then treated with: (1) Teflon injection, (2) scarification techniques, (3) tissue excision or transposition, or (4) a repeated pharyngeal flap. The authors noted that the most

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