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Journal articles on the topic 'Velopharyngeal incompetence'

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Published: 4 June 2021
Last updated: 14 February 2022

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1

&NA;. "Velopharyngeal Incompetence:." Plastic and Reconstructive Surgery 112, no. 7 (December 2003): 1982. http://dx.doi.org/10.1097/00006534-200312000-00070.

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2

Pannbacker, Mary. "Velopharyngeal Incompetence." American Journal of Speech-Language Pathology 13, no. 3 (August 2004): 195–201. http://dx.doi.org/10.1044/1058-0360(2004/020).

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Speech-language pathologists are often involved in the diagnosis and treatment of velopharyngeal incompetence (VPI). Some speech-language pathologists have extensive educational and clinical experience with VPI; others have limited training and experience. Thus, the quality of speech-language services for people with VPI is heterogenous, and it ranges from poor to excellent. There are, as yet, no specific guidelines for speech-language pathologists providing services to people with VPI. Optimal services require specific guidelines for training and experience. The purpose of this article was to (a) review speech-language pathology standards and qualifications, (b) provide reasons for identifying qualified speech-language pathologists, and (c) identify strategies for reduction of risks involved in the delivery of speech-language services for people with VPI.
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3

Swibel Rosenthal, Laura H., Kathleen Walsh, and Dana M. Thompson. "Velopharyngeal incompetence." Current Opinion in Otolaryngology & Head and Neck Surgery 26, no. 6 (December 2018): 356–66. http://dx.doi.org/10.1097/moo.0000000000000494.

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4

Johns, Donnell F., Rod J. Rohrich, and Mariam Awada. "Velopharyngeal Incompetence:." Plastic and Reconstructive Surgery 112, no. 7 (December 2003): 1890–98. http://dx.doi.org/10.1097/01.prs.0000091245.32905.d5.

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5

Shprintzen, Robert J. "Evaluating Velopharyngeal Incompetence." Journal of Childhool Communication Disorders 10, no. 1 (May 1986): 51–66. http://dx.doi.org/10.1177/152574018601000105.

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6

Westby, Carol. "Assessing Velopharyngeal Incompetence." Word of Mouth 23, no. 3 (November 21, 2011): 14–15. http://dx.doi.org/10.1177/1048395011428422d.

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7

Malick, Deonne, Jerry Moon, and John Canady. "Stress Velopharyngeal Incompetence: Prevalence, Treatment, and Management Practices." Cleft Palate-Craniofacial Journal 44, no. 4 (July 2007): 424–33. http://dx.doi.org/10.1597/06-176.1.

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Objective: Stress velopharyngeal incompetence is the unwanted coupling of the oral and nasal cavities while brass and woodwind musicians play their instruments. This study investigated both (1) the prevalence of stress velopharyngeal incompetence in college musicians, delineating symptoms and situations possibly associated with the condition; and (2) physicians’ experiences with musicians exhibiting stress velopharyngeal incompetence, including typical treatment and management techniques. Methods: Questionnaires were distributed to 297 brass or woodwind student musicians at three public universities and to 998 plastic surgeons and otolaryngologists. The musician questionnaire focused on demographic data and identification of symptoms that might indicate the presence of stress velopharyngeal incompetence. The physician questionnaire addressed demographics of the physician and his or her practice, familiarity and experience with stress velopharyngeal incompetence, and treatment and management suggestions for individuals experiencing the condition. Results: Thirty-four percent of the responding musicians reported symptoms of stress velopharyngeal incompetence, most often after 30 minutes of playing. Forty-five percent of the responding physicians reported being familiar with the term stress velopharyngeal incompetence, although only 27% reported ever having seen a patient with the condition. The seven most frequently reported intervention strategies were referral to a speech language pathologist (47.50%), sphincter pharyngoplasty (30.00%), pharyngeal flap (26.88%), referral to a cleft palate team (24.38%), watch and wait (18.75%), posterior wall fat injection (12.50%), and palatal lift (10.00%). Conclusions: Stress velopharyngeal incompetence is a potentially career-ending (or career-preventing) problem that currently may be undertreated and that is in need of more systematic study both in terms of its physiologic underpinnings and its management.
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Kumar, Sandeep, and Veena Hegde. "Prosthodontics in velopharyngeal incompetence." Journal of Indian Prosthodontic Society 7, no. 1 (2007): 12. http://dx.doi.org/10.4103/0972-4052.32510.

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9

Kuehn, David P. "Causes of Velopharyngeal Incompetence." Journal of Childhool Communication Disorders 10, no. 1 (May 1986): 17–29. http://dx.doi.org/10.1177/152574018601000103.

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10

Rajan, S., M. Kurien, A. K. Gupta, S. S. Mathews, R. R. Albert, and D. Tychicus. "Velopharyngeal incompetence in patients with cleft palate, flexible video pharyngoscopy and perceptual speech assessment: a correlational pilot study." Journal of Laryngology & Otology 128, no. 11 (October 22, 2014): 986–90. http://dx.doi.org/10.1017/s0022215114002266.

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AbstractObjectives:To assess the role of video endoscopy in evaluating velopharyngeal incompetence and investigate a possible relationship between velopharyngeal incompetence type and speech defect in cleft palate patients.Methods:A prospective study of 28 pre- or post-operative cleft palate patients with speech defects who attended Plastic Surgery–Cleft Palate and ENT out-patient clinics was performed. The velar defect type was determined using a flexible endoscope and findings were video recorded. Speech pathology was assessed using the cleft palate audit protocol for speech.Results:A significant, clinically relevant relationship was noted between the perceived characteristics of hypernasality and velopharyngeal insufficiency type. Hypernasal speech was a definite clinical indicator of velopharyngeal incompetence, and the type 1 velopharyngeal defect was most common. Type 1 velopharyngeal coronal-type dysfunction was strongly associated with hypernasality (p < 0.05). When speech substitution was noted, type 2 velopharyngeal (or sagittal) incompetence could be predicted (p < 0.05).Conclusion:In the management of cleft palate patients, it is important that surgical correction of the defect and achieving velopharyngeal competency for speech are performed simultaneously. Pre-operative velopharyngeal endoscopy with speech assessment will define the anatomical and functional bases for velopharyngeal correction and assist in planning and tailoring the pharyngeal flap.
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11

Tachimura, Takashi, Hisanaga Hara, Hideyasu Koh, and Takeshi Wada. "Effect of Temporary Closure of Oronasal Fistulae on Levator Veli Palatini Muscle Activity." Cleft Palate-Craniofacial Journal 34, no. 6 (November 1997): 505–11. http://dx.doi.org/10.1597/1545-1569_1997_034_0505_eotcoo_2.3.co_2.

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Objective: The objective of this study was to clarify electromyographically the effects of closing an oronasal fistula on levator muscle activity and oral air pressure in patients with velopharyngeal incompetence and in those with adequate velopharyngeal function. Subjects: Five patients with adequate velopharyngeal function and six patients with velopharyngeal incompetence were studied. All subjects had an oronasal fistula at the anterior third portion of the hard palate in spite of primary palatal closure using palatal push-back operation. Outcome Measures: The smoothed electromyographic activity of the levator veli palatini muscle was measured with the fistula closed with a cotton swab dipped in saline and with the fistula left open. Results: Under the closed fistula condition, oral air pressure was greater than that observed under the open fistula condition irrespective of velopharyngeal function. Levator veli palatini muscle activity was significantly lower in magnitude under the condition of closure than under the open condition in the patients with adequate velopharyngeal function, whereas in those with velopharyngeal incompetence, it was not significantly changed. Conclusions: The results suggest that velopharyngeal function is affected by temporary closure of an oronasal fistula, and that the magnitude of the effect is greater for subjects with adequate velopharyngeal function than for subjects with velopharyngeal incompetence.
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12

Crockett, Dennis M., Robert M. Bumsted, and Duane R. Van Demark. "Experience with Surgical Management of Velopharyngeal Incompetence." Otolaryngology–Head and Neck Surgery 99, no. 1 (July 1988): 1–9. http://dx.doi.org/10.1177/019459988809900101.

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Accurate mapping of the defect of velopharyngeal closure in patients with velopharyngeal incompetence is paramount to the planning of an operative procedure that will have a successful outcome. Nasoendoscopy and videonasoendoscopy are valuable tools for examination of the abnormal pattern of velopharyngeal movement in patients with velopharyngeal incompetence. On the basis of the knowledge of the observed defect in velopharyngeal closure for the particular patient, a pharyngeal flap operation is planned. The flap width, level of placement of the flap base, and control of the lateral port size vary to suit each individual velopharyngeal closure defect. Postoperative speech results in 86 patients are reported.
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13

Agarwal, Pratik. "Prosthetic Rehabilitation of Velopharyngeal Incompetence." International Journal of Prosthodontics and Restorative Dentistry 7, no. 2 (2017): 71–76. http://dx.doi.org/10.5005/jp-journals-10019-1180.

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ABSTRACT Velopharyngeal (VP) dysfunction takes place when palatopharyngeal valve is unable to perform its own closing due to a lack of tissue or lack of proper movement. Insufficiency induces nasal regurgitation of liquids, hypernasal speech, nasal escape, disarticulations, and impaired speech intelligibility. Treatment options include surgical correction, prosthetic rehabilitation, and speech therapy, though optimal results often require a multidisciplinary approach. This case report describes a novel approach for rehabilitation of a patient with soft palate defect (VP incompetence). How to cite this article Agarwal P, Dhawan P, Madhukar P, Tandan P. Prosthetic Rehabilitation of Velopharyngeal Incompetence. Int J Prosthodont Restor Dent 2017;7(2):71-76.
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14

Jobe, Richard. "Retropharyngeal implants for velopharyngeal incompetence." Operative Techniques in Plastic and Reconstructive Surgery 2, no. 4 (November 1995): 251–54. http://dx.doi.org/10.1016/s1071-0949(06)80041-7.

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15

Baker, L. Dwight, R. P. Clay, Uldis Bite, and I. T. Jackson. "SPHINCTER PHARYNGOPLASTY, FOR VELOPHARYNGEAL INCOMPETENCE." Southern Medical Journal 85, Supplement (September 1992): 3S—86. http://dx.doi.org/10.1097/00007611-199209001-00240.

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16

Argamaso, Ravelo V. "Physical Management of Velopharyngeal Incompetence." Journal of Childhool Communication Disorders 10, no. 1 (May 1986): 67–74. http://dx.doi.org/10.1177/152574018601000106.

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17

Andres, Robert, David Bixler, James C. Shanks, and Wilbur L. Smith. "Dominant inheritance of velopharyngeal incompetence." Clinical Genetics 19, no. 6 (April 23, 2008): 443–47. http://dx.doi.org/10.1111/j.1399-0004.1981.tb02062.x.

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18

Hill, C., C. Hayden, M. Riaz, and A. G. Leonard. "Buccinator Sandwich Pushback: A New Technique for Treatment of Secondary Velopharyngeal Incompetence." Cleft Palate-Craniofacial Journal 41, no. 3 (May 2004): 230–37. http://dx.doi.org/10.1597/02-146.1.

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Objective A small percentage of patients have inadequate velopharyngeal closure, or secondary velopharyngeal incompetence, following primary palatoplasty. Use of the buccinator musculomucosal flap has been described for primary palate repair with lengthening, but its use in secondary palate lengthening for the correction of insufficient velopharyngeal closure has not been described. This study presents the results of a series of patients who had correction of secondary velopharyngeal incompetence using bilateral buccinator musculomucosal flaps used as a sandwich. Patients In this prospective study between 1995 and 1998, a group of 16 patients with insufficient velopharyngeal closure as determined by speech assessment and videoradiography were selected. Nasopharyngoscopy was carried out in addition in a number of cases. Case selection was a result of these investigations and clinical examination in which the major factor in velopharyngeal insufficiency was determined to be short palatal length. Design The patients underwent palate lengthening using bilateral buccinator musculomucosal flaps as a sandwich. All patients were assessed 6 months postoperatively. The operative technique, postoperative course, and recorded postoperative complications including partial/total flap necrosis and residual velopharyngeal insufficiency were evaluated. Preoperative and postoperative speech samples were rated by an independent speech therapist. Results Ninety-three percent (15 of 16) had a significant improvement in velopharyngeal insufficiency, and 14 patients had no hypernasality postoperatively. Both cases of persistent mild hypernasality had had a recognized postoperative complication. Conclusion The sandwich pushback technique for the correction of persistent velopharyngeal incompetence was successful in achieving good speech results.
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19

Park, Susam, Makoto Omori, Kogo Kato, Naotugu Nitta, Ichiko Kitano, and Tomomi Masuda. "Cephalometric Analysis in Submucous Cleft Palate: Comparison of Cephalometric Data Obtained from Submucous Cleft Palate Patients with Velopharyngeal Competence and Incompetence." Cleft Palate-Craniofacial Journal 39, no. 1 (January 2002): 105–9. http://dx.doi.org/10.1597/1545-1569_2002_039_0105_caiscp_2.0.co_2.

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Objective The purpose of this study was to investigate the relationship between craniofacial and nasopharyngeal morphology and velopharyngeal function in submucous cleft palate. Design and Patients Fifty-two lateral cephalometric radiographs of 46 sub-mucous cleft palate (SMCP) patients with velopharyngeal competence (24 patients) and incompetence (22 patients) at 4 and 7 years of age were studied. The patients had not received any surgical or orthodontic treatment prior to cephalography being performed. Results Significant differences were found between cephalometric variables (N-Ba, N-S-Ba angle) in children with velopharyngeal competence and incompetence. However, the results of our study showed that cephalometric data alone are not useful for predicting velopharyngeal function and can not serve as an absolute prognostic indicator. Conclusion There are many factors that can influence velopharyngeal function in SMCP patients. Cephalometric data did not demonstrate a strong relationship to velopharyngeal function.
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20

Boorman, John G., Sanjay Varma, and Caroline Mackie Ogilvie. "Velopharyngeal incompetence and chromosome 22q11 deletion." Lancet 357, no. 9258 (March 2001): 774. http://dx.doi.org/10.1016/s0140-6736(00)04183-0.

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21

Kamel Abdel-Haleem, Emad. "Protocol of assessment of velopharyngeal incompetence." International Congress Series 1240 (October 2003): 663–67. http://dx.doi.org/10.1016/s0531-5131(03)00818-5.

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22

Trost-Cardamone, Judith E. "Effects of Velopharyngeal Incompetence on Speech." Journal of Childhool Communication Disorders 10, no. 1 (May 1986): 31–49. http://dx.doi.org/10.1177/152574018601000104.

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23

Ito, Asako, Harumi ARAO, Reiko BEPPU, Mikito NAIKI, Tsutomu NAKASHIMA, and Noriyuki YANAGITA. "Adenotomy in Cases with Velopharyngeal Incompetence." Practica Oto-Rhino-Laryngologica 90, no. 6 (1997): 657–63. http://dx.doi.org/10.5631/jibirin.90.657.

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24

Rieder, Anthony A., Stephen F. Conley, and Laura Rowe. "Pediatric myasthenia gravis and velopharyngeal incompetence." International Journal of Pediatric Otorhinolaryngology 68, no. 6 (June 2004): 747–52. http://dx.doi.org/10.1016/j.ijporl.2004.01.006.

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25

Rikihisa, Naoaki, Akikazu Udagawa, Shinya Yoshimoto, Masaharu Ichinose, Tomoe Kimura, and Sara Shimizu. "Treatment of Velopharyngeal Inadequacy in a Patient with Submucous Cleft Palate and Myasthenia Gravis." Cleft Palate-Craniofacial Journal 46, no. 5 (September 2009): 558–62. http://dx.doi.org/10.1597/08-049.1.

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Objective: To describe the clinical course and management of a patient with submucous cleft palate who developed myasthenia gravis (MG) as an adult and suffered recurrent hypernasality. Few reports have described MG patients undergoing pharyngeal flap surgery for velopharyngeal incompetence, and these have described only slight speech improvement in such patients. Design: Case report. Patient: The patient underwent primary pushback palatoplasty and superiorly based pharyngeal flap surgery for submucous cleft and short palate at age 7. Hypernasality showed major improvement after initial surgery. At age 19, the patient developed MG that triggered the recurrence of velopharyngeal incompetence. Intervention: After MG was treated, revision pushback palatoplasty was performed for velopharyngeal incompetence when the patient was 24 years old. Preoperatively and postoperatively, the patient was evaluated by the same speech-language-hearing therapists, each with at least 5 years of clinical experience in cleft palate speech. Results: After the second pushback palatoplasty, hypernasality and audible nasal air emission during speech decreased to mild. Conclusion: Primary pushback palatoplasty and pharyngeal flap surgery were performed for the submucous cleft palate. Revision pushback palatoplasty improved velopharyngeal inadequacy induced by MG. Decreased perceived nasality positively influenced the patient's quality of life. Combined pushback palatoplasty and pharyngeal flap surgery is thus an option in surgical treatment for velopharyngeal inadequacy to close the cleft and the velopharyngeal orifice in cases of cleft palate and MG.
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Deshmukh, Mazin M., and Gaurav Deshpande. "Musculomucosal Flap: A Technique for Correction of Velopharyngeal Insufficiency by Palate Lengthening." Journal of Contemporary Dentistry 7, no. 3 (2017): 174–77. http://dx.doi.org/10.5005/jp-journals-10031-1209.

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ABSTRACT A small but significant percentage of patients have inadequate velopharyngeal closure, or secondary velopharyngeal incompetence, following primary palatoplasty. The use of the buccinator musculomucosal (MM) flap has been described for both primary palate repair with lengthening and secondary palate lengthening for the correction of insufficient velopharyngeal closure. The MM flap was first described in 1969 for the primary repair of a wide cleft palate by Mukherji, and it was Bozola et al in 1989 who first formally described it and gave first description of its anatomy. The first report on its use to lengthen the palate in secondary velopharyngeal insufficiency (VPI) was published by Hill et al in 1999. This case report presents a patient who had correction of secondary velopharyngeal incompetence using bilateral buccinator MM flaps used as a sandwich and also gives a brief review of the literature regarding its application in cases of secondary VPI. How to cite this article Deshmukh MM, Deshpande G. Musculomucosal Flap: A Technique for Correction of Velopharyngeal Insufficiency by Palate Lengthening. J Contemp Dent 2017;7(3):174-177.
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Kinnebrew, Michael C., Mary D. Pannbacker, and Donald L. Rampp. "The Residual Submucous Cleft Palate." Language, Speech, and Hearing Services in Schools 17, no. 1 (January 1986): 16–27. http://dx.doi.org/10.1044/0161-1461.1701.16.

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An anatomic and functional condition associated with repaired cleft palate, the "residual submucous cleft," is described in five patients. Identified at varying ages, the patients had speech problems associated with velopharyngeal incompetence and chronic otitis media. These problems were at least partially related to initial palatal surgery which did not reconstruct the muscular "rings" of the palate and velopharyngeal portal. Instead, edge-to-edge closures were made, creating a continuous mucosal surface but leaving the "cleft muscle" arrangement common to other submucous clefts, which may lead to velopharyngeal incompetence. The anatomy and pathophysiology, as well as diagnosis and management, of residual submueous cleft palate is discussed by way of targeting these correctable patients.
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Barr, LL, CK Hayden, LC Hill, and LE Swischuk. "Radiographic evaluation of velopharyngeal incompetence in childhood." American Journal of Roentgenology 153, no. 4 (October 1989): 811–14. http://dx.doi.org/10.2214/ajr.153.4.811.

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29

Naito, Kensei, Tomoko Horibe, and Seiji Horibe. "Pharyngeal Flap Construction Surgery for Velopharyngeal Incompetence." Practica Oto-Rhino-Laryngologica 100, no. 4 (2007): 241–50. http://dx.doi.org/10.5631/jibirin.100.241.

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30

Bennett, Kassidy, and Jeannette D. Hoit. "Stress Velopharyngeal Incompetence in Collegiate Trombone Players." Cleft Palate-Craniofacial Journal 50, no. 4 (July 2013): 388–93. http://dx.doi.org/10.1597/11-181.

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31

Shifman, Arie, Yehuda Finkelstein, Ariela Nachmani, and Dov Ophir. "Speech-aid prostheses for neurogenic velopharyngeal incompetence." Journal of Prosthetic Dentistry 83, no. 1 (January 2000): 99–106. http://dx.doi.org/10.1016/s0022-3913(00)70094-1.

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32

Pigott, R. W. "Velopharyngeal incompetence treated by the Orticochea pharyngoplasty." British Journal of Plastic Surgery 50, no. 6 (September 1997): 471. http://dx.doi.org/10.1016/s0007-1226(97)90338-6.

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33

JARCHOW, R. C. "Revision Surgery and Therapy of Velopharyngeal Incompetence." Archives of Otolaryngology - Head and Neck Surgery 114, no. 1 (January 1, 1988): 17. http://dx.doi.org/10.1001/archotol.1988.01860130021001.

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34

Bibars, Abdel Rahim M., Firas S. D. Alfwaress, Abed Al-Hadi Hamasha, Zeid A. Al-Hourani, and Khader Almhdawi. "Prosthodontic Rehabilitation of Arabic Speaking Individuals with Velopharyngeal Incompetence: A Preliminary Study." Open Dentistry Journal 11, no. 1 (August 30, 2017): 436–46. http://dx.doi.org/10.2174/1874210601711010436.

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Background:Hypernasality is a frequently encountered problem in the speech of individuals with velopharyngeal incompetence. The use of palatal lift appliance (PLA) is the main treatment option for correction of velopharyngeal incompetence. The literature on the outcomes of using prosthetics treatment for Arabic speaking patients is scarce.Objective:The aim of this study was to investigate the effect of using PLA on hypernasality of Arabic speaking patients with velopharyngeal incompetence.Methods:Six participants with age ranging from 9 to 61 years (4 males and 2 females) were recruited between October 2013 and August 2014. Written informed consents were taken from all the adult participants/the guardians of under-aged participants. All patients exhibited hypernasality with different etiologies for velopharyngeal incompetence (head injury, cerebrovascular accident, and neurological disorders). They were treated with PLAs which were constructed to elevate the dysfunctional soft palate. Nasalance scores and perceptual speech acceptability ratings were measured/evaluated in both situations; with and without appliances. Paired t-test was used to analyze the perceptual ratings and nasalance scores in order to detect any significant change in hypernasality pre and post insertion of PLA.Results:There was a statistically significant decrease (p>0.05) in nasalance scores (Pa, Pi, Ma, Mi, a, i) after PLA insertion. The subtest /u/ showed insignificant change (p= 0.056). Perceptual ratings showed significant reduction in hypernasality which was consistent with nasalance measurements.Conclusion:PLAs can reduce hypernasality in Arabic speaking patients who suffer from velopharyngeal impairment.
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Mehendale, Felicity V., Malcolm J. Birch, Louise Birkett, Debbie Sell, and Brian C. Sommerlad. "Surgical Management of Velopharyngeal Incompetence in Velocardiofacial Syndrome." Cleft Palate-Craniofacial Journal 41, no. 2 (March 2004): 124–35. http://dx.doi.org/10.1597/01-110.

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Objective To analyze the results of surgery for velopharyngeal incompetence (VPI) in velocardiofacial syndrome. Design Prospective data collection, with randomized, blind assessment of speech and velopharyngeal function on lateral videofluoroscopy and nasendoscopy. Setting Two-site, tertiary referral cleft unit. Patients Forty-two consecutive patients with the 22q11 deletion underwent surgery for symptomatic VPI by a single surgeon. Interventions Intraoral examinations, lateral videofluoroscopy (± nasendoscopy) and intraoperative evaluation of the position of the velar muscles through the operating microscope. Based on these findings, either a radical dissection and retropositioning of the velar muscles (submucous cleft palate [SMCP repair]) or a Hynes pharyngoplasty (posterior pharyngeal wall augmentation pharyngoplasty) was performed. As anticipated, a proportion of patients undergoing SMCP repair subsequently required a Hynes. The aim of this staged approach was to maximize velar function, thereby enabling a less obstructive pharyngoplasty to be performed. Thus, there were three surgical groups for analysis: SMCP alone, Hynes alone, and SMCP+Hynes. Main Outcome Measures Blind perceptual rating of resonance and nasal airflow; blind assessment of velopharyngeal function on lateral videofluoroscopy and nasendoscopy; and identification of predictive factors. Results Significant improvement in hypernasality in all three groups. The SMCP+Hynes group also showed significant improvement in nasal emission. There were significant improvements in the extended and resting velar lengths following SMCP repair and a trend toward increased velocity of closure. Conclusions Depending on velopharyngeal anatomy and function, there is a role for SMCP repair, Hynes pharyngoplasty, and a staged combination of SMCP+Hynes, all of which are procedures with a low morbidity.
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Elsherbiny, Ahmed, Ahmed Gelany, Ahmed S. Mazeed, Eman Mostafa, Mohammed A. Ahmed, Karam A. Allam, and Ahlam A. N. Nabeih. "Buccinator Re-Repair (Bs + Re: IVVP): A Combined Procedure to Maximize the Palate Form and Function in Difficult VPI Cases." Cleft Palate-Craniofacial Journal 57, no. 5 (January 24, 2020): 543–51. http://dx.doi.org/10.1177/1055665619900621.

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Objectives: To assess the outcome of a modified buccinator flaps’ palatal lengthening combined with radical intravelar veloplasty (Bs + Re: IVVP) for the management of postpalatoplasty velopharyngeal incompetence and report the functional and structural changes occurring in the palate. Design: Prospective cohort study of consecutive cleft patients presenting with velopharyngeal incompetence and managed by buccinator re-repair procedure. Blind assessment of randomized recordings of speech and evaluation of velar form and function with nasoendoscopy and lateral videofluoroscopy were done. Patients’ demographic data were also collected. Patients: Among 30 consecutive cases who had Bs + Re: IVVP, 24 had adequate pre- and postoperative records of speech outcome data. Setting: Multidisciplinary cleft team in a tertiary referral center. Results: There were significant improvements in hypernasality, nasal emission, facial grimace and weak consonants, and overall intelligibility of speech. Endoscopy and lateral videofluoroscopy showed significant improvement in total and functional velar length, closure ratio, velopharyngeal gap at closure, palatal thickness, palatal convexity, and mobility. Regarding the procedure complications, no flap ischemia, fistula, or obstructive sleep apnea reported, but there were one cheek hematoma and two minor oral mucosal dehiscence which healed spontaneously. Conclusions: Buccinator re-repair (Bs + Re: IVVP) has been shown to be an effective and safe procedure in treating difficult postpalatoplasty velopharyngeal incompetence. It was also shown that it is still a physiological nonobstructive procedure with low morbidity.
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Conley, Stephen F., Robert B. Beecher, and Susan Marks. "Stress Velopharyngeal Incompetence in an Adolescent Trumpet Player." Annals of Otology, Rhinology & Laryngology 104, no. 9 (September 1995): 715–17. http://dx.doi.org/10.1177/000348949510400909.

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The youngest reported patient with stress velopharyngeal incompetence is presented. The patient's symptoms responded to rest with a possible contribution from palatal exercise. Surgical correction would appear to best be reserved for the professional musician with this unusual condition.
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38

TSUKAMOTO, Takahisa, Kazuhisa TANGE, Keisuke IIDA, Takasi TAKEMOTO, Mitio KANEKO, and Masahiko FUKAYA. "A case of noonan's syndrome with velopharyngeal incompetence." Japanese Journal of Oral & Maxillofacial Surgery 42, no. 9 (1996): 929–31. http://dx.doi.org/10.5794/jjoms.42.929.

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39

Lan, Keijun, Yukihiro Michiwaki, Susumu Sunaga, and Ken-ichi Michi. "Congenital velopharyngeal incompetence in Kabuki make-up syndrome." International Journal of Oral and Maxillofacial Surgery 24, no. 4 (August 1995): 298–300. http://dx.doi.org/10.1016/s0901-5027(95)80033-6.

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40

Sweeney, T., and M. J. Earley. "Velopharyngeal incompetence of sudden onset: A case report." British Journal of Plastic Surgery 44, no. 7 (1991): 548. http://dx.doi.org/10.1016/0007-1226(91)90021-b.

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41

Fernandes, D. B., A. O. Grobbelaar, D. A. Hudson, and R. Lentin. "Velopharyngeal incompetence after adenotonsillectomy in non-cleft patients." British Journal of Oral and Maxillofacial Surgery 34, no. 5 (October 1996): 364–67. http://dx.doi.org/10.1016/s0266-4356(96)90088-1.

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42

James, N. K., and T. M. Milward. "Velopharyngeal incompetence treated by the Orticochea pharyngoplasty — reply." British Journal of Plastic Surgery 50, no. 6 (September 1997): 471. http://dx.doi.org/10.1016/s0007-1226(97)90339-8.

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43

Guerrerosantos, Jos??, Mario Chicas, and Hilda Rivera. "PALATOPHARYNGEAL LIPOINJECTION: AN ADVANTAGEOUS METHOD IN VELOPHARYNGEAL INCOMPETENCE." Plastic and Reconstructive Surgery 113, no. 2 (February 2004): 776–77. http://dx.doi.org/10.1097/01.prs.0000104515.51639.6b.

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44

Tweel, Benjamin C., and Charles Elmaraghy. "Velopharyngeal Incompetence as a Complication of Grisel Syndrome." Otolaryngology–Head and Neck Surgery 149, no. 4 (July 24, 2013): 645–46. http://dx.doi.org/10.1177/0194599813496972.

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45

Mazzola, Riccardo F., Giovanna Cantarella, and Isabella C. Mazzola. "Regenerative Approach to Velopharyngeal Incompetence with Fat Grafting." Clinics in Plastic Surgery 42, no. 3 (July 2015): 365–74. http://dx.doi.org/10.1016/j.cps.2015.03.002.

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46

Nakamura, Norifumi, Yuko Ogata, Kyoko Kunimitsu, Akira Suzuki, Masaaki Sasaguri, and Masamichi Ohishi. "Velopharyngeal Morphology of Patients with Persistent Velopharyngeal Incompetence following Repushback Surgery for Cleft Palate." Cleft Palate-Craniofacial Journal 40, no. 6 (November 2003): 612–17. http://dx.doi.org/10.1597/1545-1569_2003_040_0612_vmopwp_2.0.co_2.

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Abstract:
Objective To characterize the velopharyngeal morphology of patients with persistent velopharyngeal incompetence (VPI) following repushback surgery for cleft palate. Participants Seven patients with moderate to severe VPI following repushback surgery for secondary correction of cleft palate, and 14 patients who had already obtained complete velopharyngeal closure function (VPF) were enrolled. Control data were obtained from the longitudinal files of 20 normal children in Kyushu University Dental Hospital. Main Outcome Measures Skeletal landmarks and measurements were derived from tracing of lateral roentgenographic cephalograms. The measurements included velar length, pharyngeal depth, and pharyngeal height and the ratio of velar length to pharyngeal depth. Additionally, the configuration of the upper pharynx (pharyngeal triangle) involving the cranial base, cervical vertebrae, and the posterior maxilla and also the position of posterior pharyngeal wall (PPW) in the pharyngeal triangle were analyzed. Results The VPI group had a significantly shorter velar length and greater pharyngeal depth, resulting in a smaller length/depth ratio than the controls. The points of PPW and cervical vertebrae of the VPI group were located more posteriorly and inferiorly than those in the group with complete VPF after the primary operation and the controls. The positions of cranial base and maxilla were not significantly different. Additionally, the position of PPW in the pharyngeal triangle was located significantly posteriorly and superiorly in the VPI group, compared with the controls. Conclusions The craniopharyngeal morphology of patients with persistent VPI was characterized by a short palate, wide-based and counterclockwise-rotated pharyngeal triangle, and posteriorly and superiorly positioned PPW. These might be contributory factors for the prediction of VPF before repushback surgery for cleft palate.
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Nakamura, Norifumi, Yuko Ogata, Kyoko Kunimitsu, Akira Suzuki, Masaaki Sasaguri, and Masamichi Ohishi. "Velopharyngeal Morphology of Patients With Persistent Velopharyngeal Incompetence Following Repushback Surgery for Cleft Palate." Cleft Palate-Craniofacial Journal 40, no. 6 (November 2003): 612–17. http://dx.doi.org/10.1597/1545-1569(2003)040<0612:vmopwp>2.0.co;2.

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IMAI, Satoko, Noriko SUZUKI, Saori KAMIZASANUKI, Kimie MORI, Ken-ichi MICHI, and Toshio KAKIICHI. "A case of CATCH22 syndrome with congenital velopharyngeal incompetence." Japanese Journal of Oral & Maxillofacial Surgery 43, no. 3 (1997): 203–5. http://dx.doi.org/10.5794/jjoms.43.203.

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49

Nachmani, Ariela, Dror Aizenbud, Gilead Berger, Rachel L. Berger, Hagai Hazan-Molina, and Yehuda Finkelstein. "The Prevalence of Platybasia in Patients with Velopharyngeal Incompetence." Cleft Palate-Craniofacial Journal 50, no. 5 (September 2013): 528–34. http://dx.doi.org/10.1597/11-265.

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50

Shanks, James C. "Velopharyngeal incompetence manifested initially in playing a musical instrument." Journal of Voice 4, no. 2 (January 1990): 169–71. http://dx.doi.org/10.1016/s0892-1997(05)80143-2.

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