Dr. Yu-Wun Liu
3rd-year resident
Dr. Tzu En Lin
5th-year resident
Topic
Journal Club
Association of Sphincter Pharyngoplasty and Long-Term Maxillary Hypoplasia in Patients with Cleft Palate
Evaluating Surgical Outcomes: A Comparative Analysis of 2 Techniques for Sphincter Pharyngoplasty
Association of Sphincter Pharyngoplasty and Long-Term Maxillary Hypoplasia in Patients with Cleft Palate
This retrospective cohort study evaluated the long-term effects of sphincter pharyngoplasty on craniofacial growth in 200 patients with cleft palate. Compared with matched controls, patients undergoing pharyngoplasty had significantly higher rates of maxillary hypoplasia, increased need for Le Fort I advancement, and smaller SNA angles at skeletal maturity. Multivariable analysis demonstrated that sphincter pharyngoplasty independently increased the risk of maxillary hypoplasia by 3.8-fold. These findings highlight the importance of long-term growth surveillance and consideration of potential orthognathic consequences following velopharyngeal insufficiency surgery.
Evaluating Surgical Outcomes: A Comparative Analysis of 2 Techniques for Sphincter Pharyngoplasty
This retrospective study compared end-to-end (ETE) and overlapping inset techniques for sphincter pharyngoplasty in 90 patients with cleft-related velopharyngeal insufficiency. The overlapping technique achieved significantly better speech outcomes, with higher rates of balanced resonance and fewer compensatory articulation errors. However, it was associated with a greater incidence and severity of obstructive sleep apnea. Revision rates were similar between groups. These findings suggest that overlapping inset offers superior speech improvement but requires careful consideration of postoperative airway compromise, emphasizing the importance of balancing speech outcomes with respiratory risk.