Does pharyngoplasty work? Outcomes of 100 consecutive operations over 10 years

Abstract

AbstractBackgroundVelopharyngeal insufficiency is a commonly encountered problem in Cleft Surgery, with pharyngoplasty being the mainstay of surgical management. In this study we aim to investigate the indications and outcomes of a single institution's experience and compare to international literature.MethodsA retrospective review was performed looking at over 100 consecutive primary pharyngoplasty operations for velopharyngeal dysfunction over a 10‐year period at a single institution. Aetiology, peri‐operative course and speech outcomes for the cohort between January 2010 through January 2020 were assessed. A comprehensive literature review was performed for comparison and analysis of the studies' data.ResultsNinety‐seven consecutive patients were included in the study on which 103 operations were performed. Average age at time of surgery was 7.25 years old. Approximately 37% of the patients had a diagnosed syndrome, sequence or chromosomal abnormality. Ninety‐seven of the 103 operations were primary pharyngoplasties, 4 were revision pharyngoplasties and 2 return to theatre procedures. Regarding speech outcomes, 51% of the patients that had formal speech assessments were found to have a significant improvement, 42% moderate improvement and 7% had no improvement. 93% of the patients that underwent pharyngoplasty in this study had significant or moderate improvement in speech outcomes. These speech outcomes and post‐operative complications such as obstructive sleep apnoea are analysed.ConclusionThis study demonstrates that pharyngoplasty is a safe procedure for velopharyngeal insufficiency with a good overall success rate. The major outcomes assessed including complications & safety, revision rate and speech outcomes are comparative to previous international studies.