Flashcards on Velopharyngeal Dysfunction: Diagnosis and Treatment
Velopharyngeal Dysfunction: Diagnosis and Treatment Guide
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Velopharyngeal surgery techniques
54 cards
Card 1
Question: What is the main goal when insetting flaps in sphincter pharyngoplasty?
Answer: To inset the flaps high on the posterior pharyngeal wall at the site of attempted velopharyngeal closure as determined by preoperative imaging.
Card 2
Question: Which anatomical factor(s) may be essential for achieving postoperative velopharyngeal competence besides a dynamic sphincter?
Answer: Reduced velopharyngeal port size and augmentation of the posterior pharyngeal wall.
Card 3
Question: What operative mistake was most commonly associated with surgical failure after sphincter pharyngoplasty?
Answer: Placing the pharyngoplasty too low on the posterior pharyngeal wall.
Card 4
Question: What did Orticochea emphasize as necessary to achieve velopharyngeal competence with sphincter pharyngoplasty?
Answer: Creating a true "dynamic sphincter" by dissecting bilateral palatopharyngeal myomucosal flaps and insetting them into an inferiorly based posterior ph
Card 5
Question: How did Jackson and Silverton modify Orticochea’s original sphincter pharyngoplasty?
Answer: They eliminated the posterior pharyngeal flap and inset the palatopharyngeal flaps into a transverse incision located higher on the posterior pharynge
Card 6
Question: Describe the widely used modification of Hynes pharyngoplasty technique for creating palatopharyngeal flaps.
Answer: Make vertical incisions anterior to both posterior tonsillar pillars to expose palatopharyngeus muscles, dissect longitudinal muscle fibers from the p
Card 7
Question: What are the key surgical planning considerations stressed by Riski et al. for optimizing sphincter pharyngoplasty outcomes?
Answer: Preoperative patient selection and proper surgical planning, including using preoperative imaging to determine the site for high flap inset.
Card 8
Question: What speech outcomes have been reported after sphincter pharyngoplasty in retrospective series?
Answer: Shewmake et al. reported 85.4% achieved normal resonance in 48 patients; Riski et al. reported 78% showed resolution of hypernasality and normal press
Card 9
Question: What proportion of patients required revision after sphincter pharyngoplasty in Witt et al.’s series, and what was a noted cause of failure?
Answer: 16% required pharyngoplasty revision; a noted cause of failure was incomplete closure of the velopharyngeal port and the use of bulky, often contracti
Card 10
Question: What is the primary purpose of lateral relaxing incisions during velopharyngeal surgery closures?
Answer: To achieve a tension-free closure when primary closure would be under tension.