Presenter Status
Fellow
Abstract Type
Research
Primary Mentor
Jill Arganbright, MD
Start Date
16-5-2025 11:30 AM
End Date
16-5-2025 1:30 PM
Presentation Type
Poster Presentation
Description
Background: The use of bilateral myomucosal buccal flap palatoplasty (BMBFP) for velopharyngeal insufficiency (VPI) has increased in popularity. Despite the increasing popularity, there is a paucity in research examining their outcomes, especially in reference to the pediatric population.
Objectives/Goal: The objective of this paper was to investigate the utility of BMBFP for the correction of VPI in children.
Methods/Design: Retrospective chart review was performed using CPT codes to locate patients with BMBFP performed at our pediatric institution between July 2020 to July 2024. Data collected included demographics, associated syndromes, complications, pre-operative and post-operative resonance outcomes, and the need for revision surgeries.
Results: A total of 11 patients had BMBFP performed at our institution by a single surgeon, 7 male and 4 female. Mean age at time of surgery was 9.1 years (range 5.4-14.0). Most patients were White (73%) or Hispanic (18%). Past medical history included 8 with developmental delay, 4 with 22q11.2 deletion, 4 with congenital heart disease, and 1 with cleft palate. Two patients had previous pharyngeal flap surgery and 3 had previous Furlow palatoplasty. Preoperative speech nasopharyngoscopy evaluation showed all patients had small-medium velopharyngeal gap with a mobile soft palate. Postoperatively, all patients were admitted to the floor. The average length of hospital stay was 2.7 days (range 2.0-4.0). For complications, 2 patients required revision surgery to correct a wound dehiscence, and 2 patients with 22q11.2 deletion syndrome had postoperative hypocalcemia. There were no other postoperative bleeds, no PICU admissions, and no hospital readmissions. For speech outcomes, 8/11 (73%) /patients showed an improvement in resonance following surgery, 2 patients remained the same, and 1 patient was lost to follow-up and outcome was unknown. One patient went on to have a secondary speech surgery with a pharyngeal flap.
Conclusions: The use of BMBFP for correction of VPI showed overall successful outcomes in our small cohort of pediatric patients, specifically for patients with small-medium gaps and mobile palate on speech nasopharyngoscopy. Future larger prospective studies are needed to better quantify the risks and expected outcomes for children undergoing BMBFP for VPI.
Included in
Higher Education and Teaching Commons, Medical Education Commons, Pediatrics Commons, Science and Mathematics Education Commons
Bilateral Buccal Myomucosal Flap Palatoplasty for the Management of Velopharyngeal Dysfunction in Children
Background: The use of bilateral myomucosal buccal flap palatoplasty (BMBFP) for velopharyngeal insufficiency (VPI) has increased in popularity. Despite the increasing popularity, there is a paucity in research examining their outcomes, especially in reference to the pediatric population.
Objectives/Goal: The objective of this paper was to investigate the utility of BMBFP for the correction of VPI in children.
Methods/Design: Retrospective chart review was performed using CPT codes to locate patients with BMBFP performed at our pediatric institution between July 2020 to July 2024. Data collected included demographics, associated syndromes, complications, pre-operative and post-operative resonance outcomes, and the need for revision surgeries.
Results: A total of 11 patients had BMBFP performed at our institution by a single surgeon, 7 male and 4 female. Mean age at time of surgery was 9.1 years (range 5.4-14.0). Most patients were White (73%) or Hispanic (18%). Past medical history included 8 with developmental delay, 4 with 22q11.2 deletion, 4 with congenital heart disease, and 1 with cleft palate. Two patients had previous pharyngeal flap surgery and 3 had previous Furlow palatoplasty. Preoperative speech nasopharyngoscopy evaluation showed all patients had small-medium velopharyngeal gap with a mobile soft palate. Postoperatively, all patients were admitted to the floor. The average length of hospital stay was 2.7 days (range 2.0-4.0). For complications, 2 patients required revision surgery to correct a wound dehiscence, and 2 patients with 22q11.2 deletion syndrome had postoperative hypocalcemia. There were no other postoperative bleeds, no PICU admissions, and no hospital readmissions. For speech outcomes, 8/11 (73%) /patients showed an improvement in resonance following surgery, 2 patients remained the same, and 1 patient was lost to follow-up and outcome was unknown. One patient went on to have a secondary speech surgery with a pharyngeal flap.
Conclusions: The use of BMBFP for correction of VPI showed overall successful outcomes in our small cohort of pediatric patients, specifically for patients with small-medium gaps and mobile palate on speech nasopharyngoscopy. Future larger prospective studies are needed to better quantify the risks and expected outcomes for children undergoing BMBFP for VPI.
