Taular The greatest advantage of the technique proposed is precisely that it returns the normal velar morphology and thus the capacity to the velopharyngeal structures to obtain competence, leaving this sector in conditions of being reeducated phonoaudiologically and thus achieving a correct voice free of nasalizations, preserving the caliber and functionality of the upper airway. Hypernasality, assessed by perceptual ratings and by means of nasalance scores provided by nasometry, and velopharyngeal function, assessed perceptually and by means of velopharyngeal orifice area provided by pressure-flow technique, before 1 to 4 days and after 6 to 48 months surgery. Cleft Palate Craniofac J ; Universidad de Chile Oral and maxillofacial pathology K00—K06, K11—K14—, — In the immediate postoperative period, the discomfort caused by the exposure and manipulation of the pharyngeal tissues determined by the pharyngoplasty techniques are obviated when a secondary functional veloplasty is performed for the same reason detailed in the previous point. In the decision to perform this surgical procedure or not, we have defined Inclusion Criteria, considering those patients who, in spite of velar shortening, have a morphologically adequate velar muscular tissue and as Exclusion Criteria, those patients with previous marked asymmetric muscular reparations or in whom severe tissue loss is verified or in whom there is some neurological incapacity or alteration. Periapical, mandibular and maxillary hard tissues — Bones of jaws Agnathia Alveolar osteitis Buccal vvelofaringea Cherubism Idiopathic osteosclerosis Mandibular fracture Microgenia Micrognathia Intraosseous cysts Odontogenic: It is started by closing the inferior side of the posterior pillars, the uvula, the soft palate area itself until reaching the hard palate area. Velopharyngeal inadequacy The use or orthesis or other prosthesic additions that help to improve the velopharyngeal competence and surgical techniques, as the reoperation of the velum or the pharyngoplasty techniques, have been tested.

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Figuras 1 y 2. Tensor Palatini. Levator Palatini 3. Figura 3. Es importante tener en mente este esquema cuando estamos evaluando los pacientes. Figura 4. Dentro de los elementos que se valoran en la nasofaringoscopia. Figuras 5 y 6. Figuras 7 y 8. Figura 9. De las consideraciones anteriores se desprende el siguiente algoritmo, que en mi concepto es el que tiene el mejor balance entre resultados y complicaciones. Figura El sitio donde se coloca el material de relleno debe escogerse con la ayuda del nasoscopio Trost-Cardamone JE.

Clasification of velopharyngeal inadequacies. Cleft Palate J 26; 68, Chapter 3. Mosby, St; Louis. Oronasal fistulas, intraoral air presure, and nasal airflow during speech. Cleft Palate J. Influence of palatal fistulae on speech and resonance. Folia Phoniatr , The use of magnetic resonance angiography prior to pharyngeal flap surgery in patients with velocardiofacial syndrome. Plast Reconstr Surg 97, , Plast Reconstr Surg , Marsh JL.

The evaluation and management of velopharyngeal dysfunction. Clin Plast Surg , A comparison of three techniques of palatorrhaphy: Early speech results. Ann Plast Surg , Shaw WC et al: A six-center international study of treatment outcome in patients with clefts of the lip and palate: Part 5. General discussion and conclusions. Cleft Plalate Craniofac J , Peat BG et al. Tailoring velopharyngral surgery: the influence of ethiology and type of operation. Kravath RE et al. Obstructive sleep apnea and death associated with surgica correction of velopharyngeal incompetence.

J Pediatr , Pediatr Otorhinolaryngol , Effect of cleft palate repair and pharyngeal flap surgery on upper airway obstruction during sleep.

Sirios M et al: Sleep apnea following a pharyngeal flap: a feared complication. Plast Reonstr Surg , Ysunza A, Garcia-Velasco M. Cleft Palate Craniof J , Perioperative complications of superior pharyngeal flap surgery in children. Br J Plasr Surg. Aerodynamic and cephalometric analyses of velopharyngeal structure and function following re- pushback surgery for secondary correction in cleft palate. Cleft Palate Craniofac J.

Correction of secondary velopharyngeal insufficiency in cleft palate patients with the Furlow palatoplasty. Plast Reconstr Surg. Treatment of velopharyngeal incompetence by the Furlow Z-plasty. Ann Plast Surg. Radiographic and aerodynamic measures of velopharyngeal anatomy and function following Furlow Z-plasty. Results with Furlow palatoplasty in management of velopharyngeal insufficiency. Plast Reconst Surg 72, Cleft Palate Craniofacial J. Kapetansky DI. Transversal pharyngeal flaps: a dynamic repair of the velopharyngeal isdufficiency.

Cleft Palate J , Shprintzen RJ. The effect of pharyngeal flap surgery on the movements of the lateral pharyngeal walls.


O que é Insuficiência Velofaríngea e Como é Tratada?



Disfunção velofaríngea


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