Cephalic de-mucosalized superiorly –based pharyngeal flap: A modified mucosa – preserving technique for velopharyngeal insufficiency

Faculty Medicine Year: 2018
Type of Publication: ZU Hosted Pages:
Authors:
Journal: Annals of Otology Rhinology &Laryngoloy International Journal Of pediatric Otorhinolaryngology Volume:
Keywords : Cephalic de-mucosalized superiorly –based pharyngeal flap:    
Abstract:
Introduction: Superiorly-based pharyngeal flap (PF) is the most frequently employed surgical technique to correct velopharyngeal insufficiency (VPI). Bared posterior pharyngeal wall might prolong the period of convalescence with throat pain and discomfort. Delayed donor site healing problems and subsequent fibrosis with downward migration of the transposed flap might be one a cause of failure and might necessitate revision. Aim of the work: To present a modified technique of PF aiming at dealing with the problems of donor site defects via immediate self-mucosal covering of the cephalic portion of the bed. Methods: This case series study was conducted on patients with persistent VPI. All patients underwent the new modified technique of cephalic de-mucosalized pharyngeal flap (CDPF). The basic premise was to harvest a laterally-based mucosal flap from the upper part of the posterior pharyngeal wall. A superiorly-based pharyngeal flap (with a bared cephalic segment and a mucosalized caudal segment) was elevated off the posterior pharyngeal wall and inserted in the soft palate. Then the laterally-based mucosal flap was spread over the superior part of donor site of the posterior pharyngeal wall. Results: 13 VPI patients were included in this study. Their age ranged from 5 to 12 years with a mean of 5.6 ± 1.2. The follow-up period ranged from 8 to 14 months. All flaps and beds were completely healed within 2–3 weeks and no patients showed flap dehiscence, infection or palatal fistula. Postoperative speech assessment showed significant improvement of velopharyngeal function, resonance balance, and reduction in nasal emission. Conclusions: The modified technique provides an immediate self-mucosa cover to the superior part of the posterior pharyngeal wall, thus it could promote primary healing at the donor site with a short period of convalescence. CDPF separates the two opposing raw surfaces of the flap and the posterior pharyngeal wall. The mucosal flap might guard against downward migration of the flap.
   
     
 
       

Author Related Publications

  • Ashraf Alsayed Ahmed Elmalt, "Surgicel use in control of primary postadenoidectomy bleeding", VENDOME GROUP, 2017 More
  • Ashraf Alsayed Ahmed Elmalt, "Speech Outcomes after Tonsillectomy (For Tonsillitis) in Patients with Submucous Cleft Palate", CLINICAL IN SURGERY, 2016 More
  • Ashraf Alsayed Ahmed Elmalt, "Surgicel use in control of primary postadenoidectomy bleeding", ENT-Ear,Nose & Throat Journal, 2017 More
  • Ashraf Alsayed Ahmed Elmalt, "Extrenal Nasal Valve Repair in Children: Alar Batten Graft Reinforced by External Temporary Suspensory Suture", Annals of Otology Rhinology &Laryngoloy, 2018 More
  • Ashraf Alsayed Ahmed Elmalt, "Partial laryngotracheal resection and anastomosis, institutional 10 years' experience", The Egyptain Journal of Otolaryngology, 2018 More

Department Related Publications

  • Ahmed Gaber Ibrahiem Mohamed Elhag, "Silicone Intubation assisted with nasalendoscopic visualization in cases of congenital nasolacrimal duct obstruction.Zagazig University Medical Journal, Vol.bo4, Oct. 2006:3214-3221", لايوجد, 1900 More
  • Ismaeil Sedik Hassan Elnashar, "7- POLYVINYL FOAM VERSUS GEL FOAM FOR THE PREOPERATIVE EMBOLIZATION IN TRANSNASAL ENDOSCOPIC SURGERY OF JUVENILE NASOPHARYNGEAL ANGIOFIBROMA: A PROSPECTIVE STUDY. Zagazig Med J,", لايوجد, 1900 More
  • Samir Soror Soror Atia, "cytological study and p53 gene altration of nasal mucosa in wood workers", لايوجد, 1900 More
  • Samir Soror Soror Atia, "increased plasma level of immunoreactive endothelin-1 in patients with sudden sensory neural hearing loss", لايوجد, 1900 More
  • Samir Soror Soror Atia, "reduction rhinoplasty and nasal patency acoustic rhinometric evaluation", لايوجد, 1900 More
Tweet